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Brazos Valley Community Health Centers a division of BVCAA, Inc.

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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 <http://www.healthdisparities.net/> 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


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