Colorado Heart Healthy Solutions

Program Framework

Home
CHHS Framework

A focus on the underserved

CHHS focuses on reaching underserved populations. Underserved populations are defined as people who face disadvantages because of social, economic and/or geographic factors. People who are included in our definition of underserved are ethnic minorities, the poor, those with less education, un- or under-insured and those who live far from resources in rural and frontier communities. CHWs reach out to individuals in venues such as big box stores, community centers, clinics, and work sites where they are likely to engage with underserved populations.

Measurement

CHWs measure & collect cholesterol, glucose, blood pressure, body mass index, medical history, dietary habits, and exercise behavior.

Health Assessment

A comprehensive health assessment is generated by our OSCAR system which includes a 10-year risk score & tailored health recommendations.

Resource Referral

Support also includes referral to medical clinics and healthy living resources networks that are tuned to the client's local community.

Navigation

CHWs are trained to provide ongoing support with Motivational Interviewing skills that are applied through regular follow-up contact.

Program Staff

CHHS program staff is made up of a team of physicians, researchers, and public health professionals from CPC Community Health. The diverse backgrounds, educations, and skill sets of our staff enrich all aspects of our programs and most importantly that of our program outcomes. The staff is responsible for providing CHHS with:

Community health worker logistical and educational support

Healthy living, health care access and provider educational resources

Promotion, advocacy & fundraising activities

Evaluation expertise

Project management of CHW work and overal integrity of the CHHS program

Community Navigation

CHHS supports health care providers within our partner communities in two ways:

Monthly newsletters which include short case studies informed by evidence-based guidelines are sent to participating providers

Onsite continuing education is delivered to local providers by our cardiologist at no cost

For at-risk individuals looking for ways to improve their health, the CHWs provide:

Health education conveyed with motivational interviewing skills to facilitate the creation of an action plan to achieve desired goals.

Referrals to local medical clinics and healthy living resources such as walking clubs, diabetes management classes, nutrition programs and exercise facilities and classes.

Ongoing support through regular follow-up calls to at-risk individuals.

Repeat Health Assessment

To demonstrate health improvements, CHWs retest at-risk individuals between 3- and 12-months. Considerable evidence exists indicating that CHWs are capable of providing a positive impact on the health of populations, especially those with high incidence of hyper tension and cardiovascular disease. Our results are published in the American Journal of Public Health