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Two applied anthropology program members are leading a national project to center community health worker voices
Community Health Worker home visit
By Jaycee Kalama, CLA Student Writer
One faculty member and one PhD student in the applied anthropology graduate program are leading a national project that centers and uplifts community health workers.
A community health worker, according to the American Public Health Association, is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.
Keara Rodela is a long-time community health worker and PhD student in applied anthropology in the School of Language, Culture and Society at Oregon State University.
Rodela’s PhD advisor Kenny Maes has been a professor of anthropology since 2012 and director of the Applied Anthropology graduate program since 2016.
Outside of their collaboration at OSU, they are both a part of the Community Health Worker Common Indicators Project leadership team, alongside four other folks.
Kenny Maes and Keara Rodela
According to the CHW Common Indicators Project website, the purpose of the project is “to contribute to the integrity, sustainability and viability of CHW programs through the collaborative development and adoption of a set of common process and outcome constructs and indicators for CHW practice.”
The project works toward maintaining the integrity of the CHW profession, identifying process and outcome indicators promoting sustainable funding, and contributing to grassroots CHW programs.
“The thing I love about working on the CI project is the fact that it truly does use an equity lens,” Rodela said. “Those who are most impacted should have the loudest voice—those who are most impacted should be involved from the start and driving the work we do. There's a phrase along the lines of, 'nothing about us without us.' If we're going to change anything, address any challenges or barriers that negatively impact a community, then the people that are impacted should be the ones that are helping guide the solutions. We know what needs to change, we know the solution to our problems, we know what the problem is, and what's causing the problem. Those most impacted should be at the center, and I think our project does that with CHWs—centering CHWs.”
For those who are not familiar with the CHW Common Indicators Project, Maes said there are at least two things you should know. First, the project’s goal is to ensure that the evaluation of community health worker programs, like what community health workers do and the impacts that they have on people's well being and on the inequities experienced by their communities, is done well with the right tools and indicators.
Second, in doing this work in an intentionallly participatory way, and lifting up CHWs as leaders of this effort, along the way the CI Project has been recognized for having a unique, positive work culture—for being supportive and really caring in the way that it’s led.
According to the CI Project website, the current leadership team consists of:
You can read more about the leadership team and CHW Council members here.
Keara Rodela and Kenny Maes
Maes, who is not a community health worker himself but is a CHW ally, is a part of the founding team for the project, which began in 2015. When Maes became a professor at Oregon State in 2012, he reached out to Wiggins and other folks that were involved with the Oregon Community Health Workers Association.
“I reached out to them because as soon as I got here, or even before I got to Oregon, I learned about the Oregon Community Health Workers Association and I knew that state level associations for CHWs are key to the movement of building the profile of community health workers and having a bigger impact in the United States on health inequities,” Maes said.
After working with CHWs outside of the U.S., primarily in Ethiopia, Maes wanted to have local collaborations in Oregon.
“The folks who started the Common Indicators project noticed there was a lack of standardized ways of measuring CHW practice," Rodela said. There was nothing that was commonly used across all CHW programs at the state and national level. You can't aggregate data when everyone's measuring things differently. Measurement drives practice and as an epidemiologist colleague of mine says, “if you don't measure it, it doesn’t exist.”
The inaugural CHW Common Indicators Project leadership team was made up of Maes, Wiggins, and emerita members of the leadership team Gloria Palmisano and Edith Kieffer.
In 2016, Rodela got involved in the Common Indicators Project, and became a part of the leadership team in January of 2019—Jewell, Adewumi, and Mayfield-Johnson joined shortly after.
“When I first started, it was all volunteer—the CI project had been around since 2015, and they'd been doing this work just because it needed to be done and they wanted to do it,” Rodela said. “The folks on the leadership team were really passionate, committed and did a great job at including everyone's voice, and everyone's expertise into our decision making. Everyone felt valued. I felt valued.”
The Community Health Worker Common Indicators Project continues to grow in both size and impact.
In August 2021, the CHW CI Project became a major partner in a massive and very important national evaluation of CHWs’ impacts in responding to COVID-19, funded by the CDC. The project is helping lead the evaluation of the impacts of the CDC’s grants to nearly 70 CHW programs across the U.S., according to Maes.
So what’s next for the CI Project?
According to Rodela, the project is looking at what new indicators can be added. They developed a new indicator last year to measure the quality of CHW supervision. They are now working on a CHW wellbeing or burnout indicator with their team and various stakeholders, including CHWs across the country. The Project is also planning to expand its goals to train others in best practices in CHW research and evaluation.
“One of the really important principles of the work that we do is that community health workers need to be leading these kinds of initiatives that have to do with their own profession. Allies like me who are not CHWs have to make space for that and share power and decision making,” Maes said. “That's because it's the community health workers themselves who really have ongoing on-the-ground experience, and have to continue in this difficult, but also rewarding role that allies like me think is awesome. The reason that we're committed to working with community health workers is because it's hard for us to imagine more important people in our society, in our health system.”