Form 4 Community Health Worker Interview Protocol

Community Health Worker Interview Guide

Frontier Community Health Care Network Coordination Grant

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0915-XXXX. Public reporting burden for this collection of information is estimated to average 1 hour response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29, Rockville, Maryland, 20857.

Advance Letter

Via Email

Dear Interviewee:

On behalf of the Office of Rural Health Policy, the Altarum Institute, IMPAQ International and the NORC Walsh Center for Rural Health Analysis are conducting an evaluation of the Frontier Community Health Care Network Coordination Grant. The grant is supporting the training and placement of community health workers in several Montana critical access hospitals to facilitate the coordination of care for patients.

The interview will be conducted either in-person or by telephone and will last no longer than one hour. Your participation will provide increased understanding and perspectives on access to quality care, adequate compensation, and regulations that allow for the integration and delivery of high quality care in frontier areas. With your permission, we will record the interview to assist us in taking notes and summarizing the discussion.

Findings from this evaluation will be included in reports for ORHP that may be publicly available. In those reports, data or quotations will not be linked to the identity of a particular respondent or organization.

If you have questions about this study, please contact me at knudson-alana@norc.org. Shena Popat from NORC will be contacting you within the next few days to schedule a telephone interview. For questions about your rights as a study participant, you may call the NORC Institutional Review Board Administrator at 773-256-6000.

Thank you for your participation in this very important study.

Sincerely,

Alana Knudson, PhD

Co-Director, NORC Walsh Center for Rural Health Analysis

Informed Consent

Good morning/afternoon. My name is Alana Knudson and I am a researcher at the NORC Walsh Center for Rural Health Analysis. Altarum Institute, IMPAQ International and the Walsh Center have been contracted by the HRSA Office of Rural Health Policy to ascertain your unique perspective on the Frontier Community Health Care Network Coordination Grant. The grant is supporting the training and placement of community health workers in several Montana critical access hospitals to facilitate the coordination of care for patients.

This interview will last no more than one hour. There are no risks associated with your participation. Your participation is voluntary, and you may skip questions, and stop the interview at any time without any adverse consequences. Your answers will only be reported in aggregate form, and will not identify you or your organization. Your responses will be used in a final report for ORHP. If you have any questions about your rights as a participant in this research project, please call the NORC Institutional Review Board Administrator at 773-256-6000.

Do you consent to participate in this interview? [All parties on line must say “yes” to proceed.]

Do you have any questions for me?

[If “yes” then proceed. If “no” then terminate interview.]

[BEGIN RECORDING]

NORC would like to record this interview in order to ensure our notes are as accurate and comprehensive as possible. This recording will be deleted at the end of the project. Do you consent to have this interview recorded?

[If all parties indicate “yes” then proceed, and continue to record the interview.”]

[If “no” then say: “That's fine. Please be patient as I take notes." Then, stop and delete the recording.]

Community Health Worker Interview Guide

Interview Guide

1. How long have you resided in this community?

2. What is your educational/training background?

Training

3. Was the initial training workshop sufficient to begin your role as a community health worker?

4. What components of the training have been most useful?

5. Are there any components of the training that were not useful?

6. Are there additional topics you would like added to the training?

7. Is there sufficient ongoing support and training?

8. Do you have any recommendations for future trainings?

Patient Recruitment

9. How have you recruited patients into the care coordination program?

10. What has worked well to recruit patients?

11. How have you overcome challenges to patient recruitment?

12. Do you receive any inappropriate referrals? (for services you cannot provide)

Medicare Patients

13. How many patients have you seen in the past year?

14. What proportion of these patients that you saw are Medicare beneficiaries?

15. What proportion of these patients is Medicaid?

16. Do any of your patients have private insurance coverage?

17. What proportion of your patients has at least one chronic disease?

18. What are the top five chronic diseases among the patients that are enrolled in the care coordination program?

Care Coordination

19. Please describe the types of care coordination activities that you have performed.

20. How often do you interact with the Care Transitions Coordinator?

21. How does the coordination of care between your facility, referral facilities and individual care providers work? (e.g., written communication, oral communication, faxes, EHRs, or regularly scheduled meetings)

    1. How do you use EHRs?

    2. How would you like to use EHRs?

22. After a patient is referred to another provider, what is your role?

23. Will a referral provider communicate with you directly regarding the coordination of care for the patient?

    1. If yes, how?

       1. Please provide an example of how this coordination worked well.

    2. If not, why?

       1. What happens to the patient’s care? (e.g., medication reconciliation)

       2. Please provide an example of how this lack of coordination negatively impacted your patient.

24. How do you coordinate care with other health care services/programs, such as home health, hospice, nursing home, and ambulatory care providers? (e.g., making appointments, connecting patient to providers, following up with patients to make sure they have transportation to go to an appointment, etc.)

25. Does your role involve integrating health care services and other health related social services patients may need such as Meals on Wheels?

26. What tasks or services do most patients need your help to coordinate?

27. What are some examples of times you felt your role was effective?

28. What are some lessons learned?

Overall Community Care Questions

29. Are there unmet health care needs for the patients enrolled in the care coordination program (e.g., specialty care, assisted living, home health, meals on wheels, behavioral health)?

    1. If so, how can they be met?

30. Are there unmet non-health care needs you have seen which impact the patient’s ability to be successful in his/her living situation?

Summary Question

31. Are there any other issues we have not discussed pertaining to your role and experiences as a CHW?

Thank you for taking the time to share your experience and ideas with us. We greatly appreciate your input.

OMB Control Number 0915-XXXX Expiration Date: XX/XX/201X