Leveraging Community Health Worker's Deep Community Knowledge to Address Food and Nutrition Security in Appalachia

Area of Science:

• Community Health
• Public Health Nutrition
• Health Disparities

Background:

• Community health workers (CHWs) are vital in Appalachia due to their cultural understanding of social determinants impacting health.
• CHWs' lived experiences provide unique insights into how factors like food and nutrition security affect community well-being.

Purpose of the Study:

• To examine the professional characteristics and knowledge of CHWs in Appalachia.
• To identify culturally sensitive practices employed by CHWs in addressing food insecurity.
• To explore community-based solutions for improving food and nutrition security.

Main Methods:

• Cross-sectional, mixed-methods study utilizing online surveys and in-depth phone interviews with CHWs in the Appalachian Region.
• Quantitative surveys included a Cultural Competence Assessment (CCA) with Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB) subscales.
• Thematic analysis was performed on interview data to identify community-based food and nutrition solutions.

Main Results:

• Fourteen CHWs completed the survey; over 75% could guide families on food assistance programs.
• Interviews revealed challenges families face accessing programs, including generational differences and non-custodial caretaker status impacting entitlement access.
• CHWs' cultural competence is a valuable asset for identifying effective, community-specific solutions.

Conclusions:

• CHWs in Appalachia are essential for understanding and addressing food insecurity due to their deep cultural competence and community integration.
• Their unique position allows for the identification of culturally sensitive, community-driven strategies to enhance food and nutrition security in rural areas.