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CENTER PHOTO:
AT THE RIBBON-CUTTING CEREMONY FOR THE
OPENING OF THE JORDAN & HARRIS
COMMUNITY HEALTH CENTER ARE
S U S A N S A L M O N D , E D D , R N , C T N , DEAN
AND PROFESSOR AT THE SCHOOL OF NURSING;
C I N D Y S I C K O R A , D N P, M S N , R N ;
AND L I S A B L O C K , SENIOR PROGRAM OFFICER
AT THE HEALTHCARE FOUNDATION OF NEW
JERSEY, WHICH PROVIDED A GRANT TO THE
CENTER TO ESTABLISH ITS COMMUNITY HEALTH
WORKER PROGRAM. THE SURROUNDING PHOTOS
ARE FROM THE GRADUATION CEREMONY FOR
THE JORDAN & HARRIS COMMUNITY HEALTH
WORKER TRAINING PROGRAM.
Sickora day in and day
out, they’d ask to have
their blood pressure
checked, and relationships
blossomed.
Eventually Sickora set up
shop in the recreation
room at Hyatt Court to
offer blood pressure
readings and other
services. At first,
residents trickled in
slowly. But as they got to
know her, they returned for follow-up, bringing their friends,
neighbors and relatives. Then, the federal grant enabled Sickora
to hire staff and establish the new center in renovated housing
authority space.
Sickora invited key stakeholders to create a Community
Advisory Board for the center, a step she said was crucial.
Influential residents from all three housing developments were
elected to the board. Over time, she involved more of the nursing
school staff and faculty and continued to bring SN students for
training. One of them, Damaris Grossman, a recent graduate of
the accelerated BSN program, found the experience invaluable
and continues to volunteer there. “We do health assessments,
home visits, head-to-toe examinations,” she says. “A lot of the
work is routine, but sometimes we have a patient who needs specialized
care, so we call in one of the nurse practitioners or Dr.
Shahidi. Many of these residents don’t have physicians and they
don’t look for help. You have to go to them.”
That’s where the community health workers come in,
explains Shahidi. A native of Iran, he did his obligatory military
service in the 1970s and later was part of an initiative launched by
the Iranian government to improve the country’s health care. He
spent several months in the countryside, traveling with nomads.
There, he observed the community health model in action.
“Groups of nomads moved around constantly with their tents and
animals, making it impossible to provide medical services,” he
says. “So a plan was developed in which community members
were trained to provide basic care. We worked with many great
educators and the program really took off. In fact, 17,000 of the
people who were trained and went on to train others are still doing
this work in Iran.” The notion of community health workers is not
new. The World Health Organization estimates there are over 1.3
million of them worldwide. In addition to large-scale implementa-
tion by countries such as China, Brazil and Iran, many countries
have implemented CHW programs on a smaller scale for a variety
of health issues.
Shahidi has met for the past four years with a small group of
UMDNJ colleagues to brainstorm ways to bring a community
health program to Newark. “Our health system doesn’t work
right,” he observes. “We wait until people get sick, and then we
help them. My goal is to prevent them from getting sick in the first
place. You do that through education. People eat unhealthy food,
don’t exercise, smoke, drink and use drugs. If we can change those
behaviors, we improve health.”
In April, the first group of community health workers completed
12 weeks of intensive training in basic health information,
overseen by Shahidi and Sickora. They learned about diabetes,
hypertension, asthma, healthy eating and the importance of exercise.
The project’s goal is to have the health workers visit the
homes of all 3,000 residents. “They will knock on doors, call on
friends and neighbors, take blood pressure, talk about diabetes,
asthma and other health issues,” says Shahidi. All the visits will be
documented and data on health outcomes will be compiled.
What these projects offer is outreach and coordination of care,
SHE ENVISIONS THE COMMUNITY HEALTH WORKERS
eventually providing services in collaboration with physicians, medical students,
physical therapy and respiratory therapy students.
explains Sickora. “If someone needs medical treatment, we’ll be
sure they see a nurse practitioner or physician. We’ll check to see
that they get their medications and take them. We will follow them
every step of the way.” She envisons the community health
workers collaborating with the nurses and nursing students as well
as physicians, medical students, physical therapy and respiratory
therapy students.
Already, success stories abound. Sickora tells about one man
with diabetes who lost his job and his health insurance. “He came
to us with his blood sugar out of control,” she says. “We connected
him to services provided by the American Diabetes Foundation
and within a week he had medication and was stabilized.” Another
man, coughing and wheezing, sought help with his severe asthma.
Shahidi came to the center and successfully treated him. A third
young man came for hypertension treatment and later returned
with his three children for additional services. “You get to know
people and develop relationships, and trust is built,” says Sickora.
In the five years she’s been spending in the housing
complexes, Sickora notices some real changes. “The environment
seems safer here now,” she says. “Yes, part of the reason is more
police presence. They got rid of some drug dealers and crime is
down. But the center has also played a role in the rehabilitation of
this neighborhood. When you put nurses in a housing project, it
changes things.”.
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