A Pilot Community Health Worker Program in Subsidized Housing: The Health + Housing Project

Amy L. Freeman, Tianying Li, Sue A. Kaplan, Ingrid Gould Ellen, Ashley Young, Diane Rubin, Marc N. Gourevitch, Kelly M. Doran
Cityscape, Cityscape: A Journal of Policy Development and Research, 20:2 (2018), pp. 19-38.

Objectives: We examine the implementation of a community health worker (CHW) program in subsidized housing, describe needs identified and priorities set by residents, and summarize participant-reported outcomes. Methods: Partnering with a local community-based organization, four bilingual CHWs recruited adult residents in one public housing building and one Section 8 building to participate in a 15-month intervention. Residents set health-related and life-improvement goals and developed an action plan for achieving them. CHWs used a motivational interviewing framework to help residents achieve their goals and connect them to case management, healthcare services, and other community resources. Prior to the intervention, surveyors approached every unit in both buildings for a baseline survey; 390 of an estimated 819 residents responded (47.6 percent). Of the 226 who completed an intake assessment with a CHW, 149 completed the program assessment questionnaire (65.9 percent). Results: Residents reported high levels of chronic disease, mental health issues, and low satisfaction with social relationships. 226 residents (61.3 percent female, 29.7 percent age 65 years or older, and 68.6 percent Hispanic or Latino) completed an intake assessment with a CHW and received an average of 11 in-person visits. Most program assessment respondents reported partially or completely achieving their most important goal (82.0 percent). They also reported high levels of satisfaction with the CHW program (96.6 percent) and improved overall well-being (78.6 percent). Conclusions: CHWs based in subsidized housing buildings encountered high levels of medical and social needs among residents. Improvements in self-reported well-being and high levels of satisfaction with the program suggest that such place-based initiatives may be effective in addressing health and its determinants.

Wagner Faculty