1. Brazos Valley Community Health Centers a division of BVCAA, Inc.
Julie Ribardo, PhD
Director of Health Education & Prevention
February 2008
Service to 7 counties: Health Centers in - Brazos, Robertson, Grimes, Leon, Washington, Madison
Other health services to Burleson (plan to build a CHC in Somerville)

2. About BVCAA, Inc. BVCAA, Inc. is a private not for profit agency
Serving the 7 counties of the Brazos Valley since 1972
Providing health and social services to the underserved
Mission Statement
To assist in the empowerment of individuals, families and communities to reach their full potential economically, educationally, health-wise, culturally and socially
BVCAA, Inc. has community Service Programs too – Early Head Start, Head Start, CCMS, Food Services, Energy and Housing, Elder Aid

3. Brazos Valley Community Action Agency, Inc.
Health Services
Brazos Valley Community Health Centers (5 locations)
Bryan-College Station CHC
Grimes County CHC (Navasota)
Robertson County CHC (Hearne)
Madison County CHC (Madisonville)
Leon County CHC (Centerville)
College Station Community Health Center
Women, Infant, and Children (WIC) nutrition program
Family Planning Clinic in Washington County
Community Services
Elder Aid
Head Start and Early Head Start
Food Services – Senior Nutrition
Energy and Housing Services
Child Care Management Services
Under the umbrella of BVCAA, Inc.
BVCAA has health and community services
Review list …

4. What is an FQHC? Federally Qualified Health Center
Over 3000 FQHCs nationwide
Over 49 FQHCs in Texas
All focus on medically underserved populations
Rural and urban
Migrant
Homeless
Affordable health care
Sliding fee scale
Benefiting those at 200% or below of the Federal Poverty Income Limits
Comprehensive package of services
FQHC’s receive an enhanced rate of reimbursment from medicaid and medicare along with the federal grant.
In 2002, President Bush announced the Health Center Initiative, which plans to increase the number of health centers and increase primary health care access to more Americans. The initiative is a five-year plan to increase health center funding by $2.2 billion through fiscal year It also proposes to build 1,200 new health center sites to accommodate an additional 6.1 million patients. This additional funding will be awarded on a competitive basis through Federal health center grants, which are limited to operating expenses only. States that contribute state resources, particularly capital construction funds, are better situated to compete for the grants.
Funding for health centers comes from a variety of public and private sources. According to the National Association of Community Health Centers, health centers receive half of their funds from state and local sources, such as Medicaid (35.8 percent), state and local funds (12 percent) and to a small extent, the children's health insurance program (three percent). The remainder comes from federal grants, which make up approximately 26 percent of total funds, followed by private insurance (14.8 percent), Medicare (7.2 percent) and patients themselves (2.8 percent).
Federally Qualified Health Centers (FQHCs) are nonprofit, consumer-directed corporations that provide high quality of care and cost-effective treatment to the underserved and the uninsured. FQHCs include Community Health Centers (CHCs), Migrant Health Centers, Health Care for the Homeless programs, Public Housing Primary Care programs, and Urban Indian and Tribal Health Centers. The approximately 93 million medically underserved people in the United States include those populations that are geographically, economically, and culturally challenged.
There are approximately 722 FQHCs, and 4,059 health center delivery sites in the United States. These centers are supported by federal health center grants, Medicaid, Medicare, private insurance payments, and state/local contributions.
The President's Health Center Initiative is a five-year $2.2 billion plan aimed at building 1,200 new health center delivery sites to accommodate 6 million new patients. This initiative identifies FQHCs as a cost-effective way to deliver health care to underserved and uninsured populations. Centers help control medical costs associated with chronic disease and decrease use of emergency room services for non-emergency purposes.
The use of FQHCs helps improve infant mortality rates, prenatal care, reduce low birthweight, and control chronic disease and disability.

5. Brazos Valley Community Health Centers
Mission Statement
We strive to eliminate health disparities by offering quality primary and preventive health care to the medically underserved of the Brazos Valley
Bryan-College Station Community Health Center became fully operational as an FQHC in December 2002
Expansion of satellite CHC’s
Robertson County CHC in February 2004
Grimes County CHC in July 2004
Madison County CHC in August 2005
Leon County CHC in December 2006
College Station CHC in October 2007
The B-CS CHC is the setting for this project.
Read slide…

6. B-CS Community Health Center
Services include
Medical care (adults and pediatrics)
Dental care
Pharmacy
Pfizer Sharing the Care program
Client Services
Registration and eligibility determination
Medical Case management
Medication Assistance Program (MAP)
Health education
HIV Prevention
WIC nutrition program
The B-CS CHC is the setting for this project. Satellite clinics have access to services here
Read slide…

7. B-CS Community Health Center
Co-located agencies provide comprehensive package of services
TAMU Counseling and Assessment Clinic
Prenatal Clinic
Project Unity – Medical Case Management
TDHS – Medicaid Screening and Enrollment
Brazos Transit System
The clinic is co-located with several agencies to provide a comprehensive package of services.
The idea is to have a ‘One stop shop’

8. Brazos Valley Community Health Centers
Adult Medicine
4 Family Practice Physicians
1 Family Nurse Practitioner
1 Women’s Health Nurse Practitioner
2 Physician Assistants
1 Dir. of Adult Health, RN
1 RN
1 Dir. of Quality Management, RN
2 LVNs
14 nursing staff (CNAs/CMAs/MAs)
Dental Services
2 Dentists
4 Dental Assistants
2 Dental Students (periodically)
Pediatric Medicine
Medical Director/Pediatrician
1 full-time Pediatrician
1 part-time Pediatrician
1 Pediatric Nurse Practitioner
1 Director of Pediatrics, LVN
2 LVNs
4 nursing staff (CNAs/CMAs/MAs)
A lot of folks don’t realize we have a full paid medical staff. We have physicians, dentists and nurses. Specifically……We are currently interviewing for an internist, family practice physician, and a midlevel.
Our dental clinic used to be run on a network of over 40 volunteers, as of Feb 3, 2005, we have a full fledged dental clinic
Have one provider that provides prenatal and perinatal services.

9. Brazos Valley Community Health Centers
Over 16,918 unduplicated clients in 2007
Over 40,000 encounters in 2006 (dental & medical)
Gender
66% Female
34% Male
Race/Ethnicity
57% Hispanic
19% African American
20% White
1% Asian/Pacific Islander
1% Other
Language
40% identify English as primary language
In 2003 (calendar year) we had 9690 unduplicated clients, in 2004 we grew to 12,476
In 2003 (calendar year) we had 31,518 encounters, in 2004 we had 41,557
In terms of demographics….
Read slide

10. Brazos Valley Community Health Centers
Poverty Level
66% 100% and below
29% and below
3% Over 200%
2% Unknown
Health Insurance Status
61% of clients are uninsured
31% of clients have Medicaid
2% of clients have Medicare
2% have CHIP (public insurance)
3% have private insurance
Health insurance status
Diabetes diagnosis…
We collected data last year using a health status assessment and 11% of the adults aged 18 years or older reported a diabetes diagnosis
With that in mind it is estimated we have over 550 adults with a diabetes diagnosis

11. Health Education Department Overview

12. Health Education Department
Mission
We strive to provide quality health education services to clients of the Brazos Valley Community Health Centers and individuals in the Brazos Valley in an effort to increase the practice of healthy behaviors
Services
Patient Education
Community Education
HIV Prevention
Breast and Cervical Cancer case management
Staff Development

13. Health Education Department
Staff
Director of Health Education
Full-time Staff
Health Educator, Desiree Flores
Health Educator, Carolina Diaz-Puentes
HIV Prevention Specialist, Derek Gentry
HIV Prevention Specialist, John Phelps
BCCS, open
Health education interns/students
Volunteers
Varies each semester

14. Patient Education Community Health Education Center (CHEC)
Health Education resource center at the CHC
Open Monday through Friday from 8:00 am – 5:00 pm
Services available by walk-in or appointment
Services include
Public access computers for online health information
Individual sessions with a health educator
Brochures and health education written materials
Education and information provided on any health topic

15. Patient Education Diabetes and heart disease self-management
Individual educational sessions, coordinated visits, group sessions, and follow-up phone calls
Health education services include: assessment of educational needs, collaborative goal setting with patients, problem solving, action planning and follow-up
Diabetes and heart disease prevention
Individual sessions for children and their caregivers
Tobacco Use Cessation
Individual sessions to assist in quitting tobacco
Group series of 4 classes
Family planning/reproductive health
Group classes twice a week in each language

16. Patient Education
Partnering with Texas Cooperative Extension on two community education programs
Do Well, Be Well with diabetes (5 week program)
Diabetes Cooking School (4 week program)
Partnering with Area Agency on Aging to offer Stanford Chronic Disease Self-Management Program
Living Well Brazos County (6 week program)

17. Community Education Promotores (Lay Health Advisor) Program
Implementing first promotores program in the Brazos Valley
Trained 9 volunteers to date
Training includes: logistics of being a promotora, safety, professionalism, confidentiality, resources in the community, facilitating access to affordable health and social services, evaluation and the health topic of their choice (nutrition and family planning)
Quarterly trainings and monthly meetings also provided to continue to increase skills and provide support to the volunteers
Volunteers conduct health education within their community and facilitate access to affordable health and social services
Volunteers began conducting outreach in their communities June 2005 on nutrition education
Education component of grant includes on-site education as well as educational outreach

18. Community Education Educational Outreach Tobacco use cessation program
Programs on a variety of topics including
Reproductive health, healthy relationships, communication skills, motivation for change, stress management, preventing diabetes and heart disease and much more!
Information dissemination through health fairs
Program advertisement through flyers at clinic, PSAs, press releases, and flyer distribution through network of local social and health service providers
Tobacco use cessation program
Teen pregnancy/STI prevention program
Partnerships with community organizations
Do Well, Be Well with Diabetes
Cooking School
Education component of grant includes on-site education as well as educational outreach

19. HIV Prevention HIV Prevention services
HIV counseling, testing and referral (CTR)
Free anonymous/confidential CTR is provided at the community health center, local health and social service agencies, correctional facilities, and TAMU
Community Education and Outreach
Includes street outreach, condom distribution, and education/presentations on HIV prevention

20. Breast & Cervical Cancer Services
The Breast and Cervical Cancer Services program (BCCS) offers clinical breast examinations, mammograms, pelvic examinations, and Pap tests throughout Texas at no or low-cost to eligible women

21. Staff Development Staff development
Train staff once per month on a variety of topics including
Stress management
Cultural competency
Communication skills
Work styles
Diabetes and heart disease basics
Health education staff provide training or coordinate guest speakers
Provide additional training as needed
Departmental trainings
Agency wide trainings and health services wide trainings
Education component of grant includes on-site education as well as educational outreach

22. Intervention Details

23. Health Disparities Collaboratives
FQHCs are invited to participate in National Health Disparities Collaboratives
BPHC began Collaboratives in 1997 with focus on Diabetes
Currently implementing Collaboratives on
Diabetes
Cardiovascular Disease
Depression
Cancer
Asthma
Redesign system to improve chronic illness care for patients with a specific condition
Chronic Care Model
Improvement Model
Learning Model
Refer to for more information

24. Recipe for Improving Patient Care
Know, apply, and monitor
evidence based guidelines
and standards of care
Know and apply
the Care Model
To manage these people we have to change the way we provide care to the patients and the way our systems at the clinic operate. To do this we must
1). Know the research and guidelines to achieve to better outcomes for patients with diabetes and cvd
this means we need to conduct regular training and education for all staff on chronic disease and orientate new staff to our processes
2). Know the care model so we can regularly conduct PDSAs in each component of the Care model
Conduct PDSAs

25. Clinical Information Systems Self- Management Support
The Care Model
Community
Health System
Resources and Policies
Health Care Organization
Clinical Information Systems
Self- Management Support
Delivery System
Design
Decision
Support
Prepared,
Proactive
Practice Team
Informed,
Activated
Patient
Productive
Interactions
Our premise is that good outcomes at the bottom of the model (clinical, satisfaction, cost and function) result from productive interactions. To have productive interactions, the system needs to have developed four areas at the level of the practice (shown in the middle): self-management support (how we help patients live with their conditions), delivery system design (who’s on the health care team and in what ways we interact with patients), decision support (what is the best care and how do we make it happen every time) and clinical information systems (how do we capture and use critical information for clinical care). These four aspects of care reside in a health care system, and some aspects of the greater organization influence clinical care. The health system itself exists in a larger community. Resources and policies in the community also influence the kind of care that can be delivered. It is not accidental that self-management support is on the edge between the health system and the community. Some programs that support patients exist in the community. It is also not accidental that it is on the same side of the model as the patient. It is the most visible part of care to the patient, followed by the delivery system design. They know what kind of appointments they get, and who they see. They may be unaware of the guidelines that describe best care (but we should work to change that) and they may be totally unaware of how we keep information to provide that care. We’ll talk about each in detail in the following slides.
Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B. A survey of leading chronic disease management programs: Are they consistent with the literature? Managed Care Quarterly. 1999;7(3):56-66.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA 2002 Oct 16; 288(15):
Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A., Improving chronic illness care: translating evidence into action. Health Aff (Millwood) Nov-Dec;20(6):64-78.
Improved Outcomes

26. Model for Improvement Act Plan Study Do What are we trying to
accomplish?
How will we know that a
change is an improvement?
What change can we make that
will result in improvement?
The Model for Improvement (AKA PDSA Cycle) developed by Jerry Langley in 1996 shows how to test changes in a system of care in a fast and efficient way, ensures that changes are an improvement and expands the changes throughout the practice . The improvement model can be used in all of our redesign work. Developed by Langley in 1996 and has several steps
Is a trial-and-learning method to discover what is an effective and efficient way to change a process. We are use to planning, doing and acting… The IHI emphasis on “Study” is the key to learning and establishes knowledge. It compels the team to learn from the data collected, its effects on other parts of the system and on patients and staff, and under different conditions, such as different practice teams or different sites. Most importantly, the study phase is an ideal time to think through how the Care Model helps to generate new ideas and approaches to positive change.
Example health education PDSAs: telephone recruitment; feedback on form;

27. PDSAs Questions to ask yourself
What changes can we make that will improve our environment?
What changes can we make to better serve our patients?
What changes can we make to improve patients’ clinical measures?

28. Improved Outcomes Diabetes Guidelines < 7.0% HbA1c
> 90% of patients with 2 HbA1c in last year
>70% of patients with self management goal
> 75% of patients with ACE/ARB
> 60% of patients on statin
> 40% of patients with blood pressure < 130/80
> 90% of patients with foot exam in last year

29. Improved Outcomes Cardiovascular Disease Outcomes
> 50% of hypertensive patients with blood pressure
<140/90
> 90% of patients with 2 blood pressures in last year
> 80% of patients with fasting lipid profile documented
> 60% of patients with LDL cholesterol < 100 mg/dl
> 70% of patients with documented self management goal
> 90% of patients on aspirin or anti-thrombotic agent use

30. Benefits
Better patient care
Better disease management
More patient participation
Higher level of patient satisfaction
Documented improvement of health status

31. Challenges Provider buy-in Data entry Resistance to change
Reinforcement of implemented changes

32. What is Self-Management?
“The individual's ability to manage the symptoms, treatment, physical and social consequences, and lifestyle changes inherent in living with a chronic condition.”
Barlow goes on to say:
Efficacious self-management encompasses ability to monitor the condition and to effect cogitive, behavioral and emotional responses necessary to maintain a satisfactory quality of life.
It is a dynamic, continuous process of self-regulation.
Barlow et al, Patient Educ Couns 2002;48:177

33. Self-Management Support
Emphasize the patient’s active and central role in managing their illness
Use effective self-management support strategies that include assessment, goal-setting, action planning, problem-solving and follow-up
Organize internal and community resources to provide ongoing self-management support to patients
Key Elements to an effective self-management support program

34. Patient Education vs. SMS
Information and skills are taught
Usually disease-specific
Assumes that knowledge creates behavior change
Goal is compliance
Health care professionals are the teachers
Skills to solve patient identified problems are taught
Skills are generalizable
Assumes that confidence yields better outcomes
Goal is increased self-efficacy
Teachers can be professionals or peers
Both patient education and SMS are necessary.
Some aspects of patient education work well, some do not. Information is necessary and skills must be taught.
Knowledge does not create behavior change, and compliance is not a useful goal.
Adapted from Bodenheimer, JAMA 2002;288:2469
Norris et al. Effectiveness of self-management training in type 2 diabetes, Diabetes Care 2001;24:

35. Self-Management in Office Practice
Personal Action Plan
1. List specific goals in behavioral terms
2. List barriers and strategies to address barriers
3. Specify Follow-up Plan
4. Share plan with practice team and patient’s social
support
ASSESS :
Beliefs, Behavior & Knowledge
ADVISE :
Provide specific
Information about
health risks and
benefits of change
AGREE:
Collaboratively set
goals based on patient’s
interest and confidence
in their ability to change
the behavior
ASSIST :
Identify personal
barriers, strategies, problem-solving
techniques and
social/environmental
ARRANGE :
Specify plan for
follow-up (e.g., visits,
phone calls, mailed
reminders
This diagram draws on the 5 A’s that some of you may be familiar with from smoking cessation brief counseling.
(Start at the top and go around the figure, reviewing each A.)
The central activity is the creation of a Personal Action Plan.
Glasgow RE, et al (2002) Ann Beh Med 24(2):80-87
Glasgow RE, et al (2002) Ann Beh Med 24(2):80-87

36. Self-Management
Partnership with Center for the Study of Health Disparities at TAMU
Diabetes Prevention and Management Project funded by National Institutes of Health (NIH) for 3 years
Staffed by Dir of Health Education and students from HLKN

37. Self-Management
Intervention is informed by evidence-based practices guidelines, and standards, specifically,
National Health Disparities Collaboratives
Including implementation of the Chronic Care Model and Improvement Model
<
National Standards for Diabetes Self-Management Education (2000)
Developed by task force, including representatives AADE, American Diabetes Association, American Dietetic Association, Centers for Disease Control and Prevention
American Association of Diabetes Educators
A Core Curriculum for Diabetes Education, 5th edition (2003)
Chronic Disease Self-Management Education Program
Developed by Lorig, K. et al at Stanford University

38. SMS Program Components
Adult providers refer patients to health education
Health education staff provide three specific services for patients with diabetes
Individual diabetes self-management education
Group self-management education and goal setting
Coordinated visits
Group nutrition education classes
Individual Sessions
30 minute sessions
Highly individualized
Review goal sheet
Provide education based on selected goal
Several core topics (especially for initial visit)
HbA1c
Monitoring
Target blood sugar ranges
Hypoglycemia and Hyperglycemia
Chronic complications
Create personal action plan
Arrange for follow-up
Group Nutrition Education
Patients are referred by the provider to the Registered Dietitian (RD) as needed
Patients are also referred to health education for group nutrition education
Classes focus on
Nutrition basics
Healthy eating habits
Setting small, manageable nutrition goals
Classes supplement RD efforts
Group Sessions
1 hour sessions
Intended for initial visit with health educator
Provide general overview of all goals
Emphasize importance of goal setting and manageable goals
Circulate and help patients select an individual goal
Arrange for follow-up
Topics covered include
HbA1c
Monitoring
Target blood sugar ranges
Hypoglycemia and Hyperglycemia
Chronic complications
Exercise warning signs
Foot care

39. Self-Management Tools
Self-Management Goal Sheet
Patient selects one of 11 goals
10 are preset goals, one is individual
Personal Action Plan
Specific plan
Barriers to changing behavior
Plans to overcome barriers
Confidence in ability to change behavior
Social support
Health Education Notes Page
Topics covered
Materials distributed
Concerns expressed by the patient
Goal setting notes
Follow-up plan

40. Á

41. Personal Action Plan 1. Goal: something the patient WANTS to do
2. Describe the specific plan
How Where
What Frequency
When
3. Barriers to changing behavior
4. Plans to overcome barriers
5. Confidence rating (1-9)
6. Social support
7. Follow-Up plan
This is the center of the diagram.
Goals are too big to work on all at once, and need to be broken down into steps. Action plans should be made for 1-2 week periods of time.
Need to be behavior-specific (someone could observe them doing it).
Confidence see next slide. Confidence is behavior specific. Can be very confident can take meds, but not confident can avoid salt at the church pot-luck if have CHF.
Follow up may be in person, on phone, . Important to follow-up!!!
(From Kate Lorig, Chronic Disease Self-management program
Lorig K, Holman, H, Sobel D et al Living a Healthy Life with Chronic Conditions 2 ed, Palo Alto, Bull publishing, 2001

42. Follow-up for Self-Management Educ
Health education staff call patients in 1-2 weeks
Check on self-management goal(s)
Answer questions
Provide support
Health education staff schedule follow-up appointments in 3-5 weeks
Total number of visits is individualized
Likely 3 visits

43. Self-Management Achievements
85% met their goal
Decrease in HbA1c

44. Challenges of Self Management Project
Partnership
Decision making
Financial management of grant
Sustainability
Research and benefiting the community
Students
Holiday coverage
Supervision and management

45. Tobacco Cessation Program
Fresh Start Smoking Cessation Program
American Cancer’ Society’s smoking cessation program
Complete online facilitator training
Four one hour sessions
Review of tobacco cessation programs

46. Teen Pregnancy Prevention Program
Safer Choices
School-based program
High risk youth from all racial and ethnic backgrounds
Grades 9 through 12

47. Teen Pregnancy Prevention Program
Safer Choices
The curriculum is skill-based and interactive.
Curriculum focuses on knowledge, social norms, attitudes, and skills to avoid sex or use condoms
Includes practical activities to build skills in communication, delay the initiation of sex, and promote condom use by sexually active participants

48. Teen Pregnancy Prevention Program
Safer Choices
Effective in
increasing condom use and use of other contraceptive methods
decreasing the frequency of sex without condoms
decreasing the number of sexual partners without condoms

49. Teen Pregnancy Prevention Program
School/Community Program for Sexual Risk Reduction Among Teens
School-based intervention
Overall goal of reducing unintended pregnancy
K-12, multiethnic, and rural youth

50. Teen Pregnancy Prevention Program
School/Community Program for Sexual Risk Reduction Among Teens
Instruction is designed to increase knowledge, decision-making skills, communication skills, self-esteem, and to align values with those of the community
Effective in delaying
initiation of sexual intercourse
assisting males in increasing condom use
reducing teen pregnancy rates

51. Chronic Disease Self-Management Program (CDSMP)
Stanford Patient Education
Living Well ______ County
6 weekly sessions for 2 ½ hours
Skill based course
Teaches skills needed in the day-to-day management and treatment of chronic disease and to maintain and/or increase life’s activities

52. HIV Testing & Counseling
Protocol based counseling
Evidence based intervention
Focuses on plan-based counseling
Framework provided for risk reduction specialists

53. HIV Testing & Counseling
Protocol based counseling
Essential elements
Introducing and orienting client to the session
Enhancing client's self-perceived risk
Exploring client's most recent risk
Reviewing client's previous risk reduction experiences
Summarizing patterns of risks and triggers (putting risk in context)
Negotiating a realistic and acceptable risk reduction step
Identifying sources of support and providing referrals
Summarizing and closing the session
Supporting test decision counseling (when appropriate)
Providing results simply and supportively
Providing partner elicitation (when appropriate)

54. Program Development Tobacco Cessation as an example
Determine needs of patients (target population)
Research evidence-based programming
Develop program objectives and plan
Train providers on program
Advertise program
Implement program
Evaluate program

55. Assessing Need Focus groups Surveys Government websites Interview
Community leaders
Patients
Program participants

56. Challenges Funding Recruitment & retention Services are not billable
Justifying existence
Change (adaptation and resistance)
Referrals from providers
Patients recognizing value of health education

57. Training Motivational interviewing Introductory counseling course
Introductory counseling course
Cultural competency
thinkculturalhealth.org
Learn second language

58. Partners University/junior college Health department
Local health educators
Hospitals, health department, doctor’s offices

59. Partners Local organizations
March of Dimes, American Heart Association, ACS
Texas AgriLife Extension office
Domestic Violence Shelter
Juvenile Justice Program
Adult Probation programs
Faith based organizations (churches)

60. Partners Local organizations Alternative Education Program
Drug treatment facilities (BVCASA)
School districts
Boys & girls clubs
4-H clubs
Homeless shelter
Local employers

61. Random Thoughts Business of health education Vision & mission
Strategic plan
Goals & objectives
Funding sources
Quality assurance
Managing employees (hiring, evaluating, disciplining)

62. Random Thoughts Staying current in field Serving as a resource
Conferences
Serving as a resource
Leading trainings
Patient education materials
Serving as the marketing department
Change, politics, and administration

63. Random thoughts Materials Rapport building with community Translation
Content
Literacy level
Rapport building with community

64. Summary It’s fun!  It’s hard work
You will be under appreciated at times
You can significantly impact the lives of people

65. Skills Needed as a Health Educator
Public speaking
Teaching and training
Partnering and diplomacy
Public relations, marketing and advertising
Evaluating program goals and objectives
Researching
Grant writing
Reporting
Counseling and communication skills
Organizing and program coordination
Visioning
Working with a team and independently
Ability to analyze data
Ability to assess needs
Like people genuinely

66. Certified Health Education Specialist (CHES) Competencies
Assess Individual and Community Needs for Health Education
Plan Effective Health Education Programs
Implement Health Education Programs
Evaluating Effectiveness of Health Education Programs
Coordinating Provision of Health Education Services
Act as a Resource Person in Health Education

67. Example Job Description for Health Educator
Responsibilities include, but are not limited to:
Assist with the design, organization, implementation and evaluation of health education presentations, classes, programs, and campaigns
Identify, order and organize educational materials for the clinic
Staff health fairs as needed
Assist with staff development and training of volunteers
Assist in completing various obligations and objectives of current grants
Attend bi-monthly meetings and trainings
Assist with other activities/projects as needed
Required:
Bachelor’s degree in community health, health education, or related discipline
Working knowledge of health education principles and techniques, including use of behavior change theories
Desire to work with medically underserved population
Excellent written and verbal communication skills, strong organizational skills, and keen attention to detail
Preferred:
Fully bilingual (English/Spanish)
1-2 years of experience in health education or public health