National Health Outreach and Engagement Conference 2024

Bryan Mader, DrPH, MPH, CHES; Hunter Goodman, PhD; Jessica Vincent, Ed.D, CPH; Heather Wingo, MS; Tabtha Duvall; Vivian Okanume, BS; Julie Goings (CEA); Terrie James (CEA); Pamela Luker (CEA); Pam Pruett (CEA); Jessica Rodriguez (CEA); JoAnn Vann (CEA)


Problem
While approximately 15% of all Americans live in rural areas, that number is closer to 41% for Arkansans. In fact, 55 of Arkansas’s 75 counties are considered rural by the USDA Rural Continuum Codes mechanism. These rural populations are often under-resourced and face unique challenges with respect to social determinants of health, morbidity and mortality, health equity, and access to healthcare providers and services. These increased health disparities between urban and rural populations are exacerbated by an increasingly complex combination of social, geographic, economic, workforce, ethnic, and racial factors that require innovative and well-planned programs and interventions that focus on human capital assets in order to meet people where they are and reduce these disparities from within the communities themselves.
Response
Asset-based community development (ABCD) and community building are used as applied strategies for strengthening the capacity of individuals in the target rural communities and building increased community engagement and participation. Through recruitment and engagement of volunteers, Extension agents are building upon the strengths, gifts, assets, skills, and talents of community members to create vibrant, inclusive communities. Building on a research-centered approach, ABCD is used globally to engage community leaders, including marginalized persons and populations, through strengthened relationships and a focus on positive discovery.
The project also employs a community health worker (CHW) training and delivery model to promote health within target communities. Specifically, utilizing the Promotores de Salud approach, which recruits community volunteers who are also members of the target population and share many characteristics with the broader community, complements well the ABCD model described above for identifying people as assets and strengths of their communities. Additionally, the proposed project will employ a second CHW model, the Community Organizer and Capacity Builder Model, to assist with the promotion of community action and build community support for new health-related activities. This ground-up approach works to assist communities in identifying and prioritizing needs using assets and resources available within and among that community and its residents.
Action to Date
Community volunteers acting as a cohort of EHAs achieves the goal of giving the community agency and empowering individuals within the community by providing a structured, in-depth, and foundational training curriculum for health education. Acting under the guidance and oversight of the CEAs, EHAs are beginning to deliver Extension health programs to both Extension audiences and new audiences identified in the ABCD process. This broadens and amplifies the reach that a single CEA has, effectively increasing our workforce and program delivery capabilities for reaching rural communities with important health programs.
To date, 22 volunteers have been trained as Extension Health Ambassadors and are beginning the process of community health program delivery across six target counties. Programs include chronic disease prevention, drug misuse and abuse among youth, health literacy, and physical activity for older adults.
Value
This approach bridges the gap between diverse populations and improved health, and builds capacity and human capital toward health promotion and the identification of strategies for reducing chronic disease.