(provided by the applicant): Reducing health disparities has increasingly meant working more closely with the community and tailoring services and content to community members, including 120,000 Community health workers (CHWs) nationwide. CHWs receive a variable mix of training and maintenance of skills, and few evidence-based resources. Our working hypothesis is that health disparities are reduced when the CHW has the best, relevant, evidence-based information. We need Information flow in the opposite direction, where the CHW community informs the EBM community what evidence they need and how they need it. We have developed a prototype Web-based system of "Task Guides" that approaches Information provision from the perspective of problem-based tasks that users need to accomplish. We propose to create an Evidence-Based Resource (EBR), comprising a set of Task Guides, for CHWs'work with community members. At the same time, we recognize the need to provide CHWs a voice in judging the resources, the tasks, and the EBR Itself. For this function, building on an existing provider-oriented online knowledge exchange (OKE) Infrastructure, we propose to build a knowledge-exchange customized to CHWs. We will then compare the relative efficacy in a 2-arm randomized study of EBR alone vs. EBR+OKE. At completion, we will have supplied the CHW community with a set of resources they will have vetted for themselves. More powerfully, we will have defined the contributors to their success, including the relative value of the resources and of the community of CHWs. The CHW community will have provided requirements that can be used in constructing future evidence-based resources. These requirements are invaluable in the recurring discussion about the value of evidence to all participants in the health care system.
Community Health Workers help patients of all types, especially those at most risk for poor health care. Providing such workers with the best possible evidence should help their clients. We will provide tablet computers with those resources and with the ability to share what they have learned about those resources.