Training key to successful program of lay educators

To be effective, lay home educators must be carefully selected and well-trained, saysMaryjane Henning, BSN, MPA, director of Sterling, VA-based MotherNet America. That’s why this organization, which uses community members to help families access important health services and information, created a detailed curriculum to evaluate and train community health workers.

This curriculum can be used by patient education managers to create an outreach program for their hospital’s OB department or women’s health center targeting women who tend to slip through the cracks. "The power of the program is in the skills and ability of the home visitor or the community health worker," says Henning.

Those selected for the MotherNet program work with pregnant women who need help accessing the health care system and information on how to have a healthy baby and raise a healthy child.

MotherNet programs across the United States seek mature, empathetic individuals who have faced some of the challenges their clients are facing. To find these women, ads are placed in church bulletins and community newspapers, and some referrals are by word-of-mouth. However, before any training takes place, each applicant is interviewed to see if she is an appropriate candidate. The questions help the program managers determine each applicant’s experience, knowledge, motivation, and ability to be non-judgmental. (Interview questions along with other instructions about the selection process are included in the Implementation Guide written for the MotherNet program. For details on this book and the other manuals written for the program, see source box, p. 17.)

If the interview goes well, the applicant enters the training program. The training usually takes two weeks, but it can be consolidated into five days if follow-up classes are scheduled at later dates. During the training, the home health workers learn about pregnancy and prenatal care and how to use the Resource Mothers Handbook they use as a guide on home visits.

Part of the training includes making home visits with an experienced home health worker. At first, the new candidate observes the worker; later, she does the education portion on the visit as the experienced worker observes. "We also do spot checks for quality assurance. Staff know that on any given day, the supervisor of the program could show up on the home visit," says Henning.

In addition to the program manuals available from MotherNet headquarters, the organization will provide hands-on training. The cost varies according to the number of training days, the type of training, and number of people being trained. For example, MotherNet sent three trainers to conduct a three-day session for the 35 home visitors who work out of the Cleveland Neighborhood Centers. "They have been using the materials and doing some home visits. They just want to fine-tune their program," says Henning. The cost for the training was $9,000.

The cost of running the program has many variables as well. Some agencies that use the MotherNet program use volunteers for home health workers. However, the program relies on using home visitors from the target community, and most cannot afford to volunteer. They need to be paid for their time or spend it working in a position that does pay. The average wage for a home health worker is $8 an hour, says Henning.

Other costs include the program manager’s salary and the time nurses and social workers spend intervening in each case.

"The most expensive part of the program is maintaining the home visitor’s salary," says Henning.