Hope …demands an anchoring in practice.
–Paulo Freire, Pedagogy of Hope
The CHWsP/s’ scope of practice is the inspiration that animates the work of the El Sol CHW/P TC. CHW/P-centered interventions can take place with the community, most especially hard-to-reach populations, and for the community at both the individual and the group level.
In this section of the El Sol Training Center theory of change, we summarize how El Sol CHW/P TC engages in and learns from that practice. El Sol Training Center addresses current and relevant public health issues by building the capacity of CHWs/Ps to intervene at different levels and in different settings such as in homes, communities, and health centers.
▶ SPECTRUM OF PREVENTION
There are various practice settings in which CHWs/Ps are able to utilize as Areas of Action. The El Sol CHW/P TC selects areas for action that allow for conscientización and social change outcomes using public health frameworks such as the Spectrum of Prevention. The Spectrum of Prevention (Prevention Institute, 2022) articulates the levels where health equity interventions can be addressed.
▶ media advocacy and public policy
▶ promoting organization change
▶ fostering collaboration
▶ educating providers
▶ community education
▶ building individual skill and knowledge
The Spectrum of Prevention levels include building individual skills and knowledge, community education, educating providers, fostering collaboration, promoting organization change and media advocacy and public policy. At the Fostering Collaboration level, CHWs/Ps learn about the various local committees, collaboratives, partnerships, and organizations that influence health in surrounding communities. CHWs/ Ps participate in network activities that lead to CHWs/Ps partnering with organizations on efforts to address social determinants of health collectively. These types of experiences provide CHWs/Ps an opportunity to build collective power to address social determinants of health.
At the organizational change level, CHWs/ Ps can help institutions that they serve to strengthen the organization’s commitment to positive community transformation.
These changes might influence resource allocation and decision-making as well as strengthen health navigator support systems. As community advocates functioning outside of institutions, CHWs/Ps can impact organizational/ administrative policies that affect local communities. These system changes can also transform how organizational leaders and team members define CHWs/Ps roles and their potential for impacting the health and wellbeing of communities.
While working at any level on the Spectrum of Prevention, El Sol CHW/P TC highlights the importance of CHWs/ Ps using an empowerment approach and to embrace an ongoing learning approach. This involves a CHW/P assuming roles as a collaborator and facilitator rather than expert and counselor. As a collaborator, CHWs/Ps learn about the community they serve through their culture, worldview, and life struggles, by working with the community rather than advocating for them. The CHW/P’s skills, interests and plans are not imposed on the community, but rather they become a resource for the community. On-going learning involves practicing self-assessment, reflection and striving to strengthen their capacity in the areas they feel less experienced. El Sol CHW/P TC encourages each CHW/P to individually identify training opportunities to grow in and further nurture, while reinforcing their expertise.