Urban Indian Center of Salt Lake Community Health Representative Needs Assessment

Background: The purpose of this needs assessment project was to evaluate the need and cultural acceptance of community health representatives (CHR) at the Urban Indian Center of Salt Lake. It also serves to gather information concerning cultural acceptance of a CHR program and the need for cultural revisions to the Utah Department of Health's current CHR training curriculum. Community health representatives have been shown to be effective in mitigating health inequalities by bridging the gap between patients and providers to foster a more culturally integrated approach to care.Methods: A needs assessment was completed at the Urban Indian Center of Salt Lake where a community health representative program was identified as the most significant and desired need of the center. A survey was developed and distributed to staff members (N=17) at the Urban Indian Center in an effort to evaluate both perceived need and hypothetical utilization of CHRs. Three focus groups were held between November 2019-January 2020 at which time three American Indian leaders offered their feedback and recommendations for cultural revisions to the Utah Department of Health's current CHR training curriculum.Results: The survey response rate was 65.4% with 17 of 26 staff members responding. The majority of staff member (88.2%, 15/17) felt CHRs were a need of the Urban Indian Center. The four most significant need for health improvements according to UIC staff were nutrition, exercise, diabetes management, and mental health services. More than half (58.8%, 10/17) of staff members felt the most significant barrier to CHR program success was a lack of cultural competency among these health workers. Focus groups had a 100% attendance rate by all three American Indian leaders who piloted Utah Department of Health's current training curriculum. The survey data and focus group data was then presented to interested staff and stakeholders at the Urban Indian Center in March 2020.Conclusion: Community health representatives have the potential to mitigate health inequalities and improve health outcomes for American Indian individuals. In an effort to evaluate the community, a needs assessment was completed at the Urban Indian Center of Salt Lake. It was concluded that the creation of a community health representation program for the Urban Indian Center was the most significant need of the center. In February 2020, the Urban Indian Center hired two full-time community health representatives. In April 2020 the Utah Department of Health released their revised, state-certified, and culturally competent community health representative training program.