Commentary: From the fringe to the mainstream: building the community health workforce

Courtesy San Antonio Express News

The key to unlocking improved health outcomes in the United States has been in our hands for hundreds of years: community health workers.

Also known as community outreach workers, patient navigators, health educators, community health representatives and promotores de salud, community health workers deliver a variety of health and social services to people where they live, learn, work and play. They are trusted members of their community, sharing a common ethnicity, language, culture and life experiences.

They connect individuals to resources, and improve quality and cultural competency of care. They build individual and community capacity to increase  health knowledge, health behaviors and, ultimately, better health outcomes.

More than 60 years of evidence in primary care, maternal health,  chronic disease interventions, immunizations, oral health and HIV care proves community health workers play a crucial role in improving the health of our country.

In Texas, there are more than 5,000 certified community health workers, along with many others working without certification. All are on the front lines of health care to serve our most vulnerable populations.

Unfortunately, community health workers remain on the fringes of public health. With less than 3% of U.S. health care expenditures going to public health and disease prevention, these positions are often grant-funded, contributing to a lack of sustainable recruitment, training, professional development and career pathways.

The good news is the U.S. government has significantly invested in building the community health workforce, an interest renewed in part by COVID-19.

In 2022, the Health Resources and Service Administration granted over $225 million to train community health workers. Three San Antonio organizations received $9 million of these funds. We represent one of these programs, a community-academic collaborative led by the University of Texas Health Science Center at San Antonio (UT Health San Antonio). As part of our efforts, we bring together training centers and employers in an apprentice program to elevate the community health workforce in South Texas.

Like apprenticeships for trades and professions such as plumbing and electrical, a community health worker apprenticeship is a structured training program that combines on-the-job learning with classroom instruction.

Through registered apprenticeships, employers can learn how to optimally integrate community health workers into their organization and mold future leaders to meet the needs of the populations they serve.

As a cross-sector workforce, community health workers work beyond inpatient and outpatient health care. They also work in schools, government agencies, faith-based organizations, neighborhood centers,  on the street, and   in libraries, pharmacies, affordable housing purveyors and other trusted organizations.

These organizations already face a demand among patrons for linkages to health and social services. A community health worker can alleviate these tasks and allow other team members to focus on other responsibilities.

From the standpoint of an employer, there is no better time to train future health professionals through a registered apprenticeship program. The city of San Antonio’s Ready to Work program and Alamo Workforce Solutions have funds to support the salaries of new and current workers in apprenticeship programs. Our community health worker training program also provides technical expertise in designing  job descriptions, executing on-the-job training and mentorship.

One of the most influential actions a South Texas employer can take this year is hiring a community health worker to prioritize health and well-being. By pulling community health workers from the fringes and into a formalized apprenticeship pathway, we can strengthen the entire public health ecosystem.

Shayanne Martin is a senior project manager with the Charles E. Cheever Jr. Center for Medical Humanities and Ethics at UT Health San Antonio.  Dr. Jason Rosenfeld is an associate professor of medicine at UT Health San Antonio and co-director of Health Confianza.

Health Confianza receives NACCHO Award

San Antonio, TEXAS — The National Association of County and City Health Officials (NACCHO) selected Health Confianza and the City of San Antonio Metropolitan Health District (Metro Health) with its Promising Practice Award for their work to improve health literacy in underserved areas in San Antonio.

The award was presented on Thursday, July 25, at a ceremony during the annual NACCHO360 Conference held in Detroit, Michigan. “Each year, we are thrilled to recognize the incredible work of local health departments through our Model and Promising Practice Awards,” said Lori Tremmel Freeman, NACCHO CEO. “This year’s awardees have demonstrated exceptional service in developing programs to address substance use, health inequities, infant and child health, health literacy, immunization, foodborne illnesses, hepatitis, and other pressing health challenges in their regions. This recognition is sure to inspire continued excellence and progress in public health practices across the country.”

Health Confianza began as a partnership between The University of Texas Health Science Center at San Antonio (UT Health San Antonio), Metro Health and The University of Texas at San Antonio with funding from the U.S. Department of Health & Human Services Office of Minority Health. In 2024, Health Confianza transitioned to UT Health San Antonio and is housed at The Charles E. Cheever, Jr. Center for Medical Humanities & Ethics.

“We are honored to be recognized for Health Confianza’s innovative approaches to public health and health equity,” said Jason Rosenfeld, DrPH, MPH, associate professor at UT Health San Antonio and co-director of Health Confianza. “To sustainably address health inequities, we must address health literacy at the community, workforce and organizational levels – it shouldn’t be the sole responsibility of already marginalized communities to change. It’s incumbent upon all of us to design more responsive systems to deliver culturally and linguistically appropriate services and information.”

Jason Rosenfeld, DrPH, MPH

About 90% of Americans struggle with health literacy challenges, resulting in worse health outcomes, less use of preventive health services, more emergency room visits, fewer cancer screenings and fewer immunizations, and leading to billions of dollars in avoidable health care expenses.

“This U.S. Department of Health and Human Services’ Office of Minority Health grant allowed Metro Health, UT Health San Antonio and partners to launch a health literacy initiative in our community’s under-resourced neighborhoods,” said Metro Health Director and past president of NACCHO Dr. Claude A. Jacob. “These milestones showcase the new ways Metro Health and overall partners have grown and positioned themselves to impact our community’s well-being.  I would like to congratulate Drs. Jason Rosenfeld and Melanie Stone (of Health Confianza) for the collaboration, and I am very proud of this national recognition.”

Melanie Stone, DrPH, MEd

“People with low health literacy may not be able to follow instructions on a prescription label, navigate the jargon on health insurance paperwork or know how to make diet changes to prevent diabetes — one of our community’s biggest health challenges,” said Melanie Stone, DrPH, MEd, an assistant professor of Family and Community medicine at UT Health San Antonio and co-director of Health Confianza. “We know health literacy can improve people’s confidence in their ability to make good health decisions for themselves and their families. We hope this award raises awareness of the importance of health literacy and encourages greater community involvement in our efforts.”

Since its inception three years ago, Health Confianza has been featured by global, national, regional and local entities – including the National Academies of Science, Engineering Medicine and now, NACCHO. As a Promising Practice winner, Health Confianza’s strategic model will be featured in NACCHO’s Model Practices Database for other local health departments to review and replicate.

Additional Information:

Established in 2021 as a response to the COVID-19 pandemic, Health Confianza is a collaborative program that utilizes health literacy principles and strategies to enhance health equity for those individuals living in ZIP codes with the most significant health disparities. The goal is to equip people with skills and access to scientific/accurate health information to make informed health decisions for themselves and their families.

Health Confianza offers an innovative Health Literacy Pledge Program for organizations, a peer-based Community Health Club Program for community members, workforce training, mobile clinics, and accurate and accessible bilingual health communications. All programs are provided at no cost to participants.

In 2022, the City of San Antonio Metro Health’s COVID-19 Community Response and Equity Coalition (CREC) was recognized by NACCHO with an Innovative Practice Gold Award acknowledging the efforts of community partners that included Health Confianza.

Two-minute Reads on Health Literacy and Planetary Health

San Antonio, Texas — Melanie Stone, director of Community Service Learning at The University of Texas Health Science Center San Antonio and co-director of Health Confianza, recently spoke with The School of Public Health at UT Health San Antonio about health literacy and planetary health.

Read the quick 2-minute Q&As below.

Melanie Stone

Q: What is health literacy?

A:  Simply put, it’s being able to find, understand and use health information to make decisions that position you for greatest success for health.

Q: Why is health literacy important to health care?

A:  As I point out to my students, what is the point of being a health care professional if your patients walk away from your encounter not knowing what to do?

Q: Why is health literacy important to public health and the health system?

A:  Community members should not be bearing this burden of health literacy.  We need to fix the underlying issues that make our health system so difficult to use.

Q: What program do you oversee and what are its goals?

A:  Health Confianza is a novel approach to health literacy, using multi-level strategies that couple technical expertise with trusted partners in the community.

Q: How does organizational health literacy help clients and patients?

A:  Organizations have a responsibility to create policies and practices that ensure their health services are able to be used as effectively as possible.

Q: What do you want public health students to know about the power of health literacy?

A:  People want to do what’s best for their and their family’s health.  Let’s do what we can to make it a level playing field and give everyone that chance.

Stone organizes an annual Community Service Learning conference. Last year, the theme was “One Planet. One Health” conference, exploring the ties between public health and the environment. 

Q: What is the difference between planetary health and global health?

A:  Planetary health is a transdisciplinary field focused on human disruptions to the planet, inclusive of global health, OneHealth, environmental science, and more.

Q: What did you find most surprising as you delved into this topic during the conference?

A:  I was surprised that the US health care sector is a leading contributor to carbon emissions globally.  We can do better.

Q: In your opinion, what is the biggest public health challenge related to planetary health?

A:  Public health must lead the way in making decisions that will affect our planet for coming generations, while ensuring equity in our mitigation efforts.

Q: What can those in the health professions do to improve our planetary health?

A:  Be mindful of the needless waste occurring every day in hospitals and clinics and be advocates for change.

Q: What message can we give to our future generations of leaders?

A:  We believe that collectively our actions will reverse the tide and open new pathways to a sustainable future. Time is ticking, but it’s not too late.

 

 

 

 

Club Spotlight: Grupo Nueva Vida

San Antonio, Texas — When Guadalupe Campos and Miguel Padilla arrive at Family Service’s The Neighborhood Place in San Antonio’s Westside, they have homemade food in a crockpot, fruit and snacks. With warm smiles, Campos and Padilla turn a classroom space into a cozy retreat with delicious aromas, a welcoming spread for people to come in and grab a place to sit and talk.

The husband-and-wife team, who work for the City of San Antonio Metropolitan Health District’s Healthy Neighborhoods program, co-facilitate a Community Health Club that can best be described as a mix of an adult learning annex and neighborhood party.

Community Health Clubs are a free peer-to-peer learning format focused on improving health and wellbeing. Health Confianza, a health literacy initiative housed at The University of Texas Health Science Center at San Antonio, provides community members with Community Health Club facilitator training, curriculum and ongoing support for clubs throughout Bexar County.

The most successful and effective clubs are tailored to whatever the community needs and are constantly reinventing themselves. Campos and Padilla’s club is a great example of how a club is a living, evolving organism all its own.

Campos started the club about two years ago during the COVID pandemic and Padilla followed as a co-facilitator. Since then, the club has continued to be active, attracting a group of eight to 10 women every week who are predominantly Spanish speaking. Many are retirees or stay-at-home mothers.

Guadalupe Padilla

In addition to common life experiences, these women share a desire to learn new things and keep moving forward, Campos said, adding this environment of learning and transformation is why they named their club Grupo Nueva Vida, which means New Life Group.

Campos and Padilla have facilitated meetings on nutrition, COVID-19 and computer basics, but they’ve also handed over leadership to other members to facilitate sessions on different subjects. The club format stresses the power of sharing collective knowledge and community wisdom.

“We are a group with a lot of talent. I didn’t know Julieta could teach about real estate, Ernestina knew sewing, or that another knows Eastern medicine. That’s the purpose is to bring out our talents,” Padilla said. “That’s the purpose of the group. It’s not static. It’s not only one thing. Through one another, we can keep learning different things and having different discussions.”

Some of the members have been with the club more than a year, while others a few months, but they all say it is a place they want to keep returning to. When talking about the club, members report feeling relaxed, comfortable and a sense of belonging.

While topics covered during the club may not always be directly health focused, such as the sewing meetings, Padilla said, they are fulfilling a need to learn and socialize.

“If they are relaxing in our club, that is good for their health,” he said.

We sat down recently with club members and asked about their experiences. Below is an excerpt of some of that conversation (translated into English).

Community Roundtable with Grupo Nueva Vida

Maria Rodriguez

“I was invited by Lupita and Miguel Angel. We’ve known each other many years, but we ran into each other again recently. I have been coming here about a month and a half. It’s interesting. I’ve been learning a lot and enjoying the festive atmosphere with the other ladies. I look at all their faces, happy like mine. That helps me and I think that helps them too – to be part of this program that has so many benefits.”

Josie Torres

“I’ve liked everything that I’ve learned here. My (volunteer) work wanted me to work three days in a row, but I told them not on Tuesdays because that’s the day I go to my class. I like it because I feel very relaxed here. Thank you to Angel and Guadalupe. They have a lot of patience.”

Sol Castillo

“I’d like to give thanks to Miguel Angel and Guadalupe for giving us the opportunity to learn things that we might only know a little bit about. Here, we really learn the topics, like finances, health, sewing and decorating. The company is great and we really eat well. We cannot really say a bad thing because we are comfortable here and we look forward to Tuesdays. Like Josie said, it’s relaxing here.”

Julieta Hernandez

“A friend told me that there are some meetings (at the club) here and I just started coming. I am a person who if I have something to give or something to learn, I love to do it. It has been such a privilege for me. I’ve become very comfortable here and have taken advantage of the meetings. I’ve learned about email, sewing and other things. I really like sharing and supporting each other. I’ve seen a closeness develop. I’m listening and learning from other people. We are good here. One relaxes and feels comfortable more than anything.”

Ernestina Galvan

“I love supporting and belonging to various groups. I try to learn lots of things. For a long time, my job has been sewing. I’ve been at it for many years. I have a lot of experience and I want to share that before I leave. It’s not a good paying job but it’s always there, and it is needed in all parts and all communities. In this group, I’ve gotten to know Lupita a little more. We were already in various groups together. But I’ve very grateful to them both. It’s my first steps toward doing what I want to do. I’m grateful to them and to all the girls. I’ve met new friends here. We all have a lot of talent to put forward and share.”

Juanita Mendoza

“Now that I’m not working a lot, I love coming here because I’m learning so many things. For example, about finances, social security and different things about health. I really like coming and inviting people to come because the meetings are really very interesting.”

 

Club Spotlight: Advocates for Salud!

San Antonio, Texas — As soon as Abraham Baistra, a student at Cast MED High School, heard about the new Community Health Club at his school he was curious.

CAST MED puts an emphasis on project-based learning, medical and biomedical education, college pathways and student organizations. Baistra, a college-bound senior who is interested in a career in medicine, was drawn to discussions the club was having about barriers to health in the community he lives in.

“CAST MED is a small school. We have about 200 students. At the meetings I learned about the changes that can happen in your own community. I thought it was a fantastic idea and I wanted to be part of it,” Baistra said, adding. “We are on the Southside of San Antonio. We learned from our guest speakers that this area is very underserved, and we need help with our health.”

Community Health Clubs are a peer-to-peer learning model focused on improving health literacy in underserved areas, so that people have the information and confidence they need to ask questions and make the best decisions for themselves and their families. Health Confianza, a health literacy initiative serving Bexar County, provides training, curriculums and support for Community Health Clubs across the county.

Jeanette Jacobs, a CAST MED teacher with a doctorate in nursing education, started the club after a professional connection introduced her to Jason Rosenfeld, co-director of Health Confianza and director of Global Health Education at the Charles E. Cheever Jr. Center for Medical Humanities and Ethics. Jacobs admits she didn’t immediately understand how the Community Health Club model could fit into a high school setting.

“I was really struggling with the concept of Community Health Club. I could visualize it in the community, but I was really struggling to see how it would work in schools,” Jacobs said. “A school is a community, and once I realized that, it fell into place for me.”

The group, which includes Jacobs and the school nurse, now has about 30 members. They are called Advocates for Salud (Health).

With direction from Jacobs and Rosenfeld, the students chose a topic of discussion – school lunches. They invited the San Antonio Independent School District’s Child Nutrition Services Department to learn more about how school lunch menus are designed, where the food comes from, and how nutrition is factored into every step of the process. At the same time, they were doing their own self-discovery and sharing what they learned with fellow club members.

“The students now realize that their school has a system for developing what they eat. This isn’t only a school district choice. The food and menu are state influenced and influenced by federal government. They are seeing a systems approach,” she said.

Both Jacobs and Baistra see a for future Advocates for Salud next school year.

Baistra would like to see the club members do more community outreach next year, helping to share the knowledge they gain.

“I think we could help in bringing ideas to others and to work in the community,” he said.

Jacobs is excited about continuing the club and sharing the nutrition and mental health curriculums with students. On top of this, she plans to use the clubs as an example of the importance of health education in schools. In her personal time, Jacobs advocates for the inclusion of health education at all public schools.

“My mission is to let boards of education know that health education should be mandatory. It’s unjust that not all schools are able to offer health education,” she said. “The Community Health Club helps to fill the gap and deliver health education to our students.”

Finding Your Tribe (Gente)

A collection of stories about finding preventive health knowledge, collective wisdom and social connection at Community Health Clubs in San Antonio. 

San Antonio — On a weekday morning a group of women from Harlandale, an economically-disadvantaged community on the Westside of San Antonio, were raising their heartbeats while dancing Zumba to Latin music.  

Harlandale ISD Care Center, a community center that offers programs and services to promote the well-being of students and families in Harlandale, offers Zumba classes once a month. After the music stopped, a few of the class participants quickly arranged tables and chairs and the room transformed back into a community space. It was now time for a Community Health Club and a discussion on mental health. 

Tony Martinez and Maria Ayon
Tony Martinez, former Health Confianza outreach specialist, with Maria Ayon, engagement specialist with Harlandale Sosa Community Center.

Tony Martinez and Gracie De Leon, Community Health Workers and senior community outreach specialists with Health Confianza, arrived ready to facilitate an hour-long bilingual discussion on mental health with the small group of women. Most are mothers with children in Harlandale ISD, some only spoke Spanish. 

Martinez stood at the front of the room and began to ask questions. What is mental health? What’s the difference between having a bad day and depression? Martinez, who by his own admission speaks Spanglish, relied on the native speakers to translate certain words.  

Slowly a conversation in two languages began. 

First, the words came slowly and quietly, then the women began to share life experiences. Several mothers recalled not knowing how to deal with their teenager when they were showing signs of depression or self-harm. Another spoke about a distant relationship with a parent and coming to terms with the loss.  

At the end of the hour, the women not only learned about mental health, but they also learned a little more about each other. 

This is what Health Confianza’s Community Health Club model is about — it is a peer-to-peer format that brings people together to learn about health, share knowledge and help one another when they are able, motivating changes in behavior to improve health and wellness.  

Jason Rosenfeld, DrPH, MPH, CHW-I, an assistant professor, director of global health with the Charles E. Cheever Center for Medical Humanities & Ethics and co-director of Health Confianza, first began using the club model during his work in remote villages in Africa. About seven years ago, Rosenfeld started the clubs in Brownsville where there are now six that have been running continuously. In 2021, at the start of the pandemic, Health Confianza received federal funding to roll out health literacy programming, including Community Health Clubs. Today, there are about 25 clubs operating around the city in underserved neighborhoods. Club members face multiple barriers to health care including lack of financial resources, health insurance, transportation and literacy skills.  

Most of the clubs are led by Community Health Workers who work for Health Confianza, the City of San Antonio’s Metropolitan Health District, or local nonprofits. Health Confianza has also trained “natural leaders,” people who have a connection to the community through advocacy and or volunteer work.  

“What we love about seeing the Community Health Club model evolve in San Antonio is that each community will make it its own, give it its own identity,” Rosenfeld said. “It can be a partner club, but most clubs are on top of existing programming to strengthen and sustain that effort, while some are formed from scratch to address community priorities. We are seeing that happen at community centers, schools and apartment complexes.”  

Tight-knit Community  

The mental health discussion at Harlandale was the community’s idea, said Maria Ayon, the Family Engagement Facilitator at Harlandale/Sosa Community Center.  

“We have had groups as large as 15 come to Health Confianza’s club meetings. If they need help, this connects them to help. It is a spider web of connection,” Ayon said, adding that the friendship and support extends beyond the club.  

The center has a separate Whatsapp group that they use to support each other with resources. Health Confianza’s Community Health Workers often provide links to digital resources that are shared through this group. 

“Last week, they were asking how they can get some water. One person said they could drive them to the food pantry, and then a third person said they could carpool with each other,” Ayon said, adding that they help each other with everything from job hunting to immigration questions.  

“This community is like a big family. They take pride in Harlandale, in their group and their work. They are a very close-knit community,” she added.   

Rosenfeld said he knew that club format is effective at sharing community wisdom and changing behaviors for better health after seeing successes in Africa, the Caribbean and South Texas. But in the last few years he noticed the importance of the social connections developing within the clubs. 

“The ideas of bonding and bridging and linking social capital,” Rosenfeld said. “I think it is about gaining a new social network or reinforcing existing ties. It really is about who we know and how we know them and what we gain from those relationships, recognizing that those relationships influence and strengthen our lives.” 

Navigating a new country, and a new health system 

On a chilly weekday morning in December, Health Confianza’s Community Outreach Specialist Gracie De Leon met with Christina Elsaaidi at the Ferrari Adult Education Center, which is part of the North East Independent School District, to check in on Elsaaidi’s Community Health Club.  

De Leon acts as a club mentor to Elsaaidi whose club is under a year old.  

As a program evaluator and epidemiologist for the City of San Antonio Metropolitan Health District, Elsaaidi works in the health field, but she considers the Community Health Club she leads a passion project.

Christina Elsaaidi's club.
From left, Community Health Club facilitators Gracie DeLeon and Christina Elsaaidi, and club member, Nafisa Noorarifi.

“When I first was introduced to this Community Health Club concept, I immediately thought of this place (the Ferrari Adult Education Center) because there are a lot of different backgrounds, people who are having a lot of issues with access to health information and access to health care in general,” Elsaaidi said, adding that when she first arrived to the U.S., she attended the center, which offers English as a Second Language courses, high school equivalency classes and career training. 

The process of recruiting for a Community Health Club took some time, Elsaaidi said. She started with presentations during other programming, introducing the club and its purpose. When she got enough interest, she began a Whatsapp group and a weekly meeting. Today her club is a mix of newly arrived migrants from Afghanistan, Saudi Arabia and other parts of Asia and the Middle East. 

Elsaaidi said the Community Health Club training gave her the tools to start the club.  

“I like the curriculum part because it gave me the structure. I’ve said this before, I had the passion but I needed the structure,” Elsaaidi said. 

Many of the club’s members are learning English as a second language. The most common languages spoken by members are Farsi and Pashtu, but there are also members who speak Arabic and Thai. 

At first, she worried that because of language barriers, it would take longer to go over curriculum. Instead, it gave Elsaaidi an opportunity to adjust how she delivers curriculum. 

“We might divide one topic into three sessions, but my point is not about finishing (the curriculum), my point is people will get what we are talking about and get it very well,” she said. 

De Leon added that the club members were not only encouraging each other to expand their English vocabulary, they were learning important health terminology at the same time. 

“Sometimes we don’t learn that vocabulary until we have an emergency,” De Leon said. “Christina met the needs of the members.” 

Elsaaidi knows the difference the clubs can make for its members. She seen a transformation in Nafisa Noorarifi, who was a midwife in her home country of Afghanistan. Noorarifi’s expressed an interest in exercise and went from walking 10 minutes to two hours.  

“I promised myself I would walk, and every day that I do, I feel fresh and happy,” Noorarifi said. 

Next, Noorarifi wanted to take an English as a Second Language course to help her establish her career as a midwife in the United States. Elsaaidi, who she now considers a friend, connected her to Alamo Community Colleges, and representatives were able to enroll her in a free ESL course. 

Elsaaidi is quick to distinguish her role as a club facilitator from social work. 

“I want to utilize the mental health training to support each other, to build connections,” Elsaaidi said. “Today the club may ask each other, ok, ‘Today, what is your struggle? What is it that does not help you to start your life here?’ And then they will all share and maybe someone will use that information. On the back end, I will utilize the resources that I know about. I don’t want to be a case manager; I want to be a connector.” 

What surprised Elsaaidi most is that club members were interested in establishing social capital, which is a set of shared values or resources that allows individuals to work together in a group to effectively achieve a common purpose. 

“When I came here, I thought that those people have their communities already,” she said, adding that she learned that there was a deeper longing for social connection. 

“Actually, all of them expressed loneliness. We could build that trust after they shared that with me, and we started to build our unique social capital. People are coming from different countries, different background, different cultures, but we trust each other.” 

It also inspired her to want to share Health Confianza’s mental health curriculum while also talking about what they need to get their life in the United States started. The club is typically guided by an 8-week Health Confianza curriculum on different topics including mental health, Covid-19 and nutrition. 

“What connects us here is that there’s always somebody who cares about them,” she said. “They know that when they come to me that I care. And that is what connected us and what keeps them committed to the club,” she said. 

When Building Trust is a Lesson in Patience and Persistence 

Building trust doesn’t happen overnight, especially in underserved neighborhoods that experience greater levels of crime, poverty and unemployment. 

Just ask Santos Barrientes, a Community Health Worker and senior community outreach specialist with Health Confianza, who is from the Westside of San Antonio, a majority Hispanic and low-income neighborhood. 

“I think it’s hard on the Westside and Southside of San Antonio. They see people (from nonprofits or universities) come in and meet their goals and then they’re out. There is no lasting impact,” he said. “Having us come in every week and having us bring different programming shows them that we are invested. I tell people that I grew up on this side of town, just down the street. I tell them that I know their struggles, I’ve seen my mom go through it and my grandparents and I can relate to them.” 

For a year, Barrientes has facilitated a Community Health Club at the nonprofit Madonna Center, which offers programming for anywhere from 20 to 60 seniors who live in a 3-mile radius of the center on the Westside of San Antonio. Barrientes co-facilitates the club at Madonna Center with Alexis Whitt, a Community Health Worker with the City of San Antonio Metropolitan Health District’s Healthy Neighborhoods. 

When they first started the club in early 2023, Whitt and Barrientes offered the topic of mental health, but the seniors were more interested in physical activity and nutrition. After a year of building trust, they decided to introduce the topic to see how the club would react. 

To their delight, the seniors were receptive to the topic, even sharing individual experiences of loneliness and mental health issues, as well as how they coped. 

On the first day of the mental health curriculum, Barrientes asked the group if they know what stigma is, and Whitt gave the definition, “the prejudices that society puts on certain conditions or attributes that make them seem different.” 

Santos Barrientes at Madonna Center
Community Health Worker Santos Barrientes co-leading a Community Health Club on the topic of mental health at the Madonna Center.

For example, Barrientes said, “men were always told you can’t have your emotions, you can’t show your emotions, man up and take care of it, and if you do share then it means your weak, not a man.” 

After the meeting, one of the older men in the group pulled Barrientes aside and privately said he needed to talk to someone. 

Barrientes understood the man did not have the financial resources or transportation to go to a counselor or therapist. Through his own professional network, Barrientes connected with a licensed professional counselor (LPC) who agreed to visit the center twice a month.  

“The LPC has only gone once so far, but it’s been a hit with the seniors,” Barrientes said.  

Barrientes said that although they did not set out to make that connection, it felt right to meet their needs.   

“You are helping more than what they expected you to do. What we say in our training is just listen to the community,” Barrientes said, adding the Madonna Center is a “little more personal for me because I grew up there. It feels good to be able to change things and make them a little better.” 

 

 

 

 

 

 

Health Confianza teams up with KLRN’s (PBS) The Healthy Kids Project

In collaboration with KLRN Public Television’s Healthy Kids Project, Jason Rosenfeld, DrPH, MPH, of Health Confianza delivered a lesson on common illnesses and the importance of hand washing in keeping our children and families healthy.

Hand washing is a simple yet powerful tool in preventing common illnesses and saving lives.

“We can reduce the risk of diarrheal illnesses by about 40% by practicing regular hand washing,” Rosenfeld said. “For respiratory illnesses, the data is a little but inconsistent, but the range is from 6% to 40% of respiratory illnesses can be prevented from washing our hands. That is impressive. We don’t often think about the relationship between our hand hygiene and respiratory illnesses.”

This evergreen lesson, with suggested activities for children, is designed for early childhood educators and parents.

KLRN’s The Healthy Kids Project supports healthy lifestyles by influencing eating decisions and physical activities. The project engages all types of learners: visual, auditory and kinesthetic.

View the video, titled “Spring into Healthy Habits,” here.

 

Health Confianza Introduces Long Covid Resource Page

Long Covid -Listening, Learning and Recovery

Four years after the start of the Covid-19 pandemic, an estimated 23 million Americans are living with long Covid, which is defined as the health issues that continue or emerge after the initial COVID infection, and that persist for four or more weeks after the initial infection.

While a more detailed picture of what is means to have long Covid is still emerging, health providers, Community Health Workers and caregivers are learning how to best care and support people with Long Covid. The good news is that the list of what we do know in regards to long Covid is growing every day.

With this in mind, South Central AHEC (Area Health Education Center) and Health Confianza have created the “Long Covid – Listening, Learning and Recovery,” a short video learning series coupled with an evolving set of resources developed with guidance from public health workers and providers.

Designed for health professionals, Community Health Workers and the community, our long Covid resources page offers free videos, documents and resources. Together, we can improve the way we listen, communicate, share best practices, and respond to long Covid.

CSL Conference: Learn How Public Health and Our Planet’s Health is Intertwined

San Antonio, Texas — The 17th Annual Community Service Learning Conference — “One Planet. One Health. We are all connected.”— is pleased to host Teddie M. Potter, clinical professor and director of planetary health at the University of Minnesota School of Nursing, as this year’s keynote speaker.   

The Mayor of San Antonio Ron Nirenberg will give a lunch plenary titled, “San Antonio’s 21st Century Challenge: Balancing Sustainability and Growth.” 

The annual conference is an opportunity to network and share best practices and scholarship in community service learning (CSL), with a unique focus each year. The event is taking place on Saturday, Feb. 3, from 8:00 a.m. to 2:30 p.m. at the University of Texas Health Science Center San Antonio (UT Health San Antonio).  

“There are many, many ways human are disrupting the Earth’s natural systems. Climate change, biodiversity loss, deforestation, and water, soil and air population are impacting agriculture, fishing and hunting, many forms of outdoor recreation and human health,” Potter said. “These human-cause disruptions are reversing decades of public health gains and threatening the survival of future generations. 

The theme for this year’s conference was selected by an interprofessional committee of CSL stakeholders, including students from UT Health San Antonio.  

CSL Conference
The One Planet. One Health. We are all Connected conference is taking place on Feb. 3.

“Our students, like many future and practicing health care professionals, are concerned about the state of the planet, and want a better understanding of how it connects to our overall health,” said Melanie Stone, director of UT Health San Antonio’s CSL program through the Charles E. Cheever, Jr. Center for Medical Humanities & Ethics. “We are excited to have esteemed guest speakers including the mayor and Dr. Potter to lead these timely, solutions-oriented discussions.”       

Potter plans not only to discuss the planet’s challenges but also the opportunities to get the planet and our health back on track.  

“All is not lost. I’ll be speaking about planetary health, a solutions-oriented trans-disciplinary field social movement focused on analyzing and addressing the impacts of human destructions to earth’s natural systems,” Potter said.  

“I’ll share the global vision for a great transition, an emerging solutions particularly for the health sector. More than anything, I plan to share a word of hope because the actions that restore the health of the planet are good for our health too,” she added. 

The Annual CSL Conference at UT Health San Antonio originated in 2008 as an opportunity to learn from the CSL experiences of students, faculty, staff, and community partners in San Antonio and across Texas.  Each year, the conference focuses on a theme relevant to service-learning and hosts experts and guest lecturers, provides skill-building workshops, and showcases CSL projects through students’ poster presentations. 

The conference, which is free and open to the community, is presented by the Cheever Center in conjunction with an interprofessional planning committee.  

For conference agenda and registration details, visit www.texashumanities.org/CSLconference. 

Three Things to Know, Three Resources

San Antonio — ​Don’t forget to keep on top of your and your family’s health this holiday season. Below are three things to know and three resources for a healthier winter and start to the new year.

Three Things to Know

One: RSV, Flu and COVID-19 Move Through Texas
As of early December, cases of RSV and flu were on the rise in Texas, as reported by the Centers for Disease Control and Prevention. While COVID-19 remains low in the San Antonio area, adults ages 65 and up continue to make up the majority of people hospitalized with COVID.

There are simple things you can do to stay as healthy as possible, including keeping your hands clean, sanitizing surfaces, and getting vaccinated — health providers recommend getting the Flu and COVID-19 shots.

One bright spot this winter is that there’s a new RSV vaccine that can protect babies and older adults from serious illness or hospitalization. Because the symptoms of respiratory illnesses (flu, COVID-19, RSV) can be similar, Health Confianza has created a handy guide to help you tell the difference between allergies, cold, flu, RSV and COVID-19 (see resources below).

Lastly, if your seek care over the weekend, UT Health San Antonio Physicians offers Saturday Care at UT Health Medical Arts & Research Center, 8300 Floyd Curl Dr., first floor – Walk-in or call 210-450-9180 to schedule an in-person or virtual appointment

Two: Long Covid Higher Among Minorities
COVID-19 has greatly affected communities of color, with more cases, hospitalizations and deaths reported among Hispanics and Blacks than other populations. The U.S. Census Bureau also found that minority populations are more likely to suffer from long COVID.

With that in mind, The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is working to make sure that minority populations are represented in RECOVER, the largest NIH-supported study focused on understanding the course of long COVID, its symptoms and treatments. The university has enrolled almost 1,000 participants from San Antonio and South Texas.

Learn more about Long Covid:

Three: Health Coverage Enrollment for 2024
Enrolling yourself and your family in health insurance is an important step toward a healthy 2024. To start receiving health coverage by Jan. 1, enroll in the Affordable Care Act (ACA) plan by Dec. 15. Enrollment runs through Jan. 15. Under ACA, health plans can run as low as $10 a month or less. For help understanding insurance plan options, reach out to EnrollSA for free in-person assistance.

Health Insurance Support:

    • UHS Connecting Kids to Coverage: Online or (210) 358-3350
    • Health Collaborative Pathways to Coverage: Online or (210) 761-3420

Three Resources

  1. Symptoms Chart, an easy-to-read chart that helps you decide if it’s allergies, cold, flu, COVID-19 or RSV.
  2. Keep the Germs Away Flyer, a plain language flyer outlining practical steps for staying healthy. A good reminder for school-age children and families.
  3. Wellnesscultura.org, Health Confianza’s bilingual online resource, with a list of clinics, health information and more.