RUSH Generations Gains National Attention for Leveraging CHWs to Lead Health Promotion Programs

Within the RUSH department of Social Work and Community Health (SWaCH), the RUSH Generations team offers a suite of evidence-based group programs in chronic condition management, pain management, emotional wellness, and falls prevention. These programs are disseminated through organizations and agencies throughout the U.S. and internationally; however, the RUSH team has taken some innovative approaches that set our programs apart from others.  

Who are CHWs? 

APHA defines a CHW as “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.” 

Across multiple departments at RUSH, CHWs work to improve community health through resource connection, health promotion and education, social support, advocacy, capacity building, and many other tasks that help RUSH services better reach community members. Within SWaCH, CHWs work closely with other social care professionals including social workers, nurses, and navigators to advance health equity and community health on the West Side of Chicago.  

Why have CHWs lead RUSH Generations workshops? 

CHWs who lead workshops report increased job satisfaction, as well as the opportunity to build skills in group facilitation, community outreach and programming, problem solving, and relationship building. Traditionally, CHWs who work in health care settings serve as “bridges,” connecting patients to programs and services to improve their health. But when CHWs take the training to lead evidence-based workshops, they get the satisfaction of providing the intervention themselves. Many of the CHWs at RUSH have spoken about the confidence they’ve built through leading RUSH Generations workshops, as well as the job satisfaction that comes from seeing the impact of their work on individuals’ behaviors over the course of a 6- or 8-week workshop.  

Having CHWs lead RUSH Generations workshops proves beneficial for the communities served, as well! CHWs’ unique understanding of and shared identity with community members allows them to relate to group participants, keeping the workshops engaging and approachable. 

What happens in RUSH Generations workshops?  

RUSH Generations groups are evidence-based, meaning that instructors follow a manual. That way, the program is disseminated in a consistent manner that’s proven to be effective. Often, people think this means the groups are boring and overly structured. While the workshops do have plenty of activities built in for interaction, participation, and practice, there are some health education portions of the group that seem daunting to a lot of CHWs. The RUSH Generations team has made huge strides in making the workshops more engaging, interactive, and entertaining.  

RUSH Generations also provides guidance for workshop leaders to make sure they are genuinely engaging with the content and the group participants, not just reading the material. Padraic Stanley, LCSW, a program manager in SWaCH who oversees the integration of these programs into community sites, always reminds leaders: “Never forget you’re leading a group. You have important content to get to that you must follow, but always look for chances to engage.”  

Finally, RUSH Generations workshop leaders are trained to identify and escalate the social needs of workshop participants. During workshops, participants often mention varied challenges related to social determinants of health and other issues that can be addressed by social care. For example, a participant in a diabetes workshop may mention: “meal planning sounds like a great idea, but I don’t even have enough food to make it through the week.” Or a chronic pain workshop participant could say, “I stopped taking my medications because I can’t afford them,” when discussing strategies to remember to take medications. RUSH Generations trains workshop leaders (including CHWs) to speak with workshop participants one-on-one during a break or after the session, providing a space to address the participants’ concerns and obtain consent to escalate their needs to social care. Through this new protocol, workshop leaders have escalated more than 52 individuals to CHW or social work coordination since July 2022.  

National attention and recognition 

RUSH Generations’ thoughtful and innovative approach to improving communities’ health through evidence-based programming garnered the attention of the National Council on Aging (NCOA) and the U.S. Administration on Community Living (ACL). This prompted a site visit from NCOA in October 2023, during which NCOA representatives got the chance to observe RUSH Generations’ work, attend RUSH Generations workshops, and talk with CHWs from the RUSH CHW Hub. The visit resulted in an article on the NCOA website highlighting how RUSH leverages CHWs to deliver evidence-based programming. 

Agencies around the U.S. are taking our lead, working to integrate more social workers and CHWs into their teams implementing and disseminating evidence-based group programs, because we’ve proven how effective these programs can be when you treat the whole person.  

Through addressing social needs throughout recruitment and throughout the workshop, we eliminate some of the primary barriers to participating in a group. An individual struggling to manage their chronic health condition may benefit immensely from a group—with access to peer support, great information, goal setting, and motivation. However, this same individual faces barriers to attending the group if they are also facing eviction, don’t have enough food, or are worried about keeping their lights on. By helping address these social determinants of health, we enable those who are most at-need to participate in the groups and focus on themselves.  

 What’s next? 

The biggest challenge to CHW involvement in group facilitation is having enough leaders to meet the demand for the workshops in the areas served by RUSH. These workshops are an important part of addressing the health disparities and the life expectancy gap—or the “death gap” —on Chicago’s West Side, which is attributed largely to disparities in the burden of chronic health conditions. CHWs make amazing leaders, but they are also balancing many other responsibilities, and may not be able to commit to leading 6- or 8-week workshops out in the community. The RUSH Generations team hopes that leadership can prioritize these roles for CHWs, as they are valuable for both the institution’s work and the CHWs’ development. 

Currently, the RUSH Generations team is working on increasing referrals from CHWs to our evidence-based programs. CHWs are doing amazing work out in the community, and many CHWs from the Hub are regularly distributing and promoting these groups. RUSH Generations is working on identifying creative ways to capture those interactions and follow up with community members later on— potentially having sign-up sheets ready at community events or screenings, or integrating referral orders into CHW documentation.  

With new changes to Medicare in 2024, there are some hopeful avenues to support CHWs and social workers implementing evidence-based programs and addressing social needs, which RUSH Generations, CHaSCI, and SWaCH as a whole are actively pursuing. Overall, we hope to continue to train and empower more CHWs to lead workshops, so that we can work to close the death gap on the West Side of Chicago. 


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