Community Health Worker - Asthma

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Time Type:

Full time

Department:

MassPort Asthma

All Locations:

10 Gove Street – Taylor Building, 17 Main Street – WCHC

Position Summary:

A Community Health Worker is a member of the Medical Home who collaborates with other staff in NeighborHealth's Asthma/ COPD Program to positively improve the health of Boston area and Winthrop residents living with asthma and COPD. The CHW will deliver asthma/COPD education, nicotine cessation counseling and environmental/home interventions to improve asthma/COPD symptom control and long term asthma/COPD management in person and over the phone. In the home, the CHW will provide environmental asthma kits, develop a plan and reinforce medication adherence. The CHW performs a variety of clerical and reception activities that support the delivery of services to patients/staff of the Asthma/COPD Program; develops efficient workflows by assisting in scheduling medical appointments, facilitating community resource access, organizing and supporting efforts for community outreach, and other services as necessary. The CHW will work with and report to the Asthma Program Nurse Practitioner/Clinical Program Manager. NeighborHealth is seeking an individual to serve as a Community Health Worker in our Pediatric Asthma Program. This role is ideal for a professional with deep expertise in community engagement, health education, care coordination and addressing social and environmental factors that impact children’s health. The CHW will serve as a trusted liaison between families, health care providers schools and community resources, helping children with asthma achieve better health outcomes and improved quality of life. We are seeking a compassionate, culturally responsive individual who is passionate about health equity and committed to empowering families through education, advocacy, and support.

What You'll Do

As a Community Health Worker in the Asthma/COPD Program, you will work directly with children and families to improve asthma management and health outcomes through home-based education, support and care coordination. You will also work directly with adults in our Nicotine Cessation Program to provide nicotine cessation counseling and support.

The CHW primarily conducts home visits to assess environmental factors that may contribute to asthma symptoms, provide education on asthma self-mangement, medication use, and trigger reduction, and help families implement strategies to create healthier home environments. In this role, you will build trusting relationships with families, identify barriers to care, connect patients with community resources, and collaborate with healthcare professionals, schools, and community partners to support comprehensive, family-centered asthma care. You will document patient visits, monitor progress towards goals, and contribute to efforts to advance health equity and improve well-being of children with asthma.

In addition to pediatric asthma responsibilities, the CHW will provide nicotine cessation counseling and support to adult patients of the health center. The CHW will assess nicotine use and readiness to quit, provide evidence-based behavioral counseling, support individualized quit plans, connect patients with appropriate cessation resources and clinical services, and provide follow-up to promote sustained behavior change.

The successful candidate will be able to perform the following responsibilities:

Asthma Home Visiting Program

Conduct asthma home visits with pediatric patients and their families to provide education, support, and environmental assessments.

Assess home environments for asthma triggers and educate families on strategies to reduce exposure and improve asthma control

• •Deliver culturally responsive asthma education, including medication adherence, proper inhaler and spacer use, symptoms monitoring, and asthma action plan implementation both in the clinic and during home visits.
• •Establish and maintain trusting relationships with children, caregivers and community partners to support patient engagement and positive health outcomes.

• •Identify social, environmental, and economic barriers affecting a family’s ability to manage a child’s asthma and access health services.
• •Connect families to community resources and assist with referrals to address health-related social needs.
• •Collaborate with healthcare providers, schools, housing agencies, and community organizations to support coordinated care and advocacy for patients.
• •Maintain accurate and timely documentation of patient encounters, assessments, referrals and follow-up activities in the electric health record.
• •Participate in team meetings, trainings, quality improvement activities and community outreach to support program objectives.

Adult Nicotine Cessation Counseling and Support

• •Provide nicotine cessation counseling and behavioral support to adult patients of the health center, including patients who use cigarettes, cigars, smokeless tobacco, e-cigarettes, and other nicotine products.
• •Assess tobacco and nicotine use, dependence, cessation history, current readiness to quit, and individual barriers to cessation.
• •Use motivational interviewing and evidence-based behavior-change techniques to engage patients in conversations about nicotine use and cessation.
• •Provide patient-centered counseling based on each individual's readiness to quit, preferences, cultural background, and personal goals.
• •Assist patients in developing individualized quit plans, including identifying triggers, managing cravings, preparing for withdrawal symptoms, and developing strategies to prevent relapse.
• •Provide ongoing encouragement, education, and follow-up to patients who are attempting to quit or reduce their nicotine use.
• •Educate patients about the health effects of tobacco and nicotine use and the benefits of cessation.
• •Provide education regarding evidence-based nicotine cessation treatment options and refer patients to appropriate medical providers for evaluation and management when medication or other clinical treatment may be indicated.
• •Connect patients with appropriate cessation resources, including tobacco quitlines, community programs, behavioral health services, primary care providers, and other health center resources.
• •Coordinate with primary care providers, behavioral health professionals, pharmacists, and other members of the healthcare team to support integrated nicotine cessation care.
• •Document nicotine use assessments, counseling interventions, cessation goals, referrals, patient progress, and follow-up activities accurately and timely in the electronic health record.
• •Monitor patient engagement and progress toward cessation goals and modify supportive interventions based on patient needs and readiness.
• •Maintain patient confidentiality and provide nonjudgmental, culturally responsive, and trauma-informed support to adult patients who use nicotine products.
• •Participate in health center initiatives, outreach, education, quality improvement, and population health activi