Our team of Community Health Workers use their education as certified health coaches or registered medical assistants and knowledge of community resources to meet Social Influencer of Health (SIOH) needs and Gaps in Care for patients at home. Preventive screens are performed telephonically or in-person with patients, helping to coordinate services including medical transportation, Annual Wellness Visits (AWV), follow-up appointments, and schedule routine preventive screenings. Additionally, Community Health Workers use motivational interviewing skills to empower individuals toward behavioral change in creating healthier lifestyle habits, making choices within the areas of nutrition, physical activity, and stress management, to meet their health and wellness goals in collaboration with their health care providers.
For more information, please contact population health.
