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   Part G. Implementing Promising Community Interventions
      Chapter 23. Modifying Access, Barriers, and Opportunties >
         Section 6. Using Outreach to Increase Access >
             Tools & Checklists - A checklist that summarizes the major points contained in the section. >

Using Outreach to Increase Access

  

Tools & Checklists

 Contributed by Val Renault Edited by Tom Wolff and Jerry Schultz

Tools

Tool: Sample job description for outreach worker
Tips: Spreading the word: 40+ ways to reach people

Checklist


Tools

Tool: Sample outreach worker job description



Adapted from Outreach Works by Michael DeChiara, Ellen Unruh, Tom Wolff, and Anne Rosen of AHEC/Community Partners

Outreach Worker Job Description

(Providing community-based outreach, health insurance enrollment and post-enrollment services)


Position:

Community Outreach Worker (titles may vary) - xx hours per week

Reports to:

[Supervisor' Name]
Program Coordinator, Centerville Health Access Program (CHAP)

Goals:

Increase the number of Centerville residents who have access to health care services by finding those eligible for publicly-sponsored insurance programs and other resources and assisting them to apply successfully. Create referral networks among other programs that can assist with the provision of health care services. Ensure that newly enrolled members of publicly-funded insurance programs understand how their insurance plan works and have a functional relationship with an appropriate primary care provider. Perform community outreach and marketing to increase Centerville Health Access Programs' (CHAP) effectiveness in addressing health care access issues.

Responsibilities:

  1. Assist clients to apply for appropriate health coverage plans, providing necessary follow-up, tracking and data collection.
  2. Initiate post-enrollment support activities with Medicaid/CHIP eligible clients, completing and recording the information required for monthly reports.
  3. Serve as a central resource for community questions and referrals for both consumers and providers, building relationships with outreach workers, community resources, and providers to help identify and solve problems.
  4. Work closely with state agency for Medicaid, CHIP and public health, and with other community outreach workers and agencies to identify potential consumers of the system and to provide them with current, accurate information and assistance, when necessary.
  5. Attend appropriate community or networking meetings to facilitate outreach and gathering of information to increase effectiveness of Centerville Health Access Program.
  6. Work with local medical providers' offices and key employers to train, coordinate and problem-solve so they can make appropriate referrals to Centerville Health Access Program or appropriately support enrollment in or use of services through Medicaid or CHIP.
  7. Prepare or identify educational flyers/handouts to distribute through local health and human services networks and other community-based groups and collaborate on marketing efforts.
  8. Develop and maintain a tracking a follow-up system for Medicaid, CHIP and other applications to ensure that all aspects of the process, from application through post-enrollment, have been completed and that the client is able to receive appropriate services.
  9. Maintain statistics/data on contacts, identify needs, problems and service gaps. Track and tabulate contacts, application submission and post-enrollment follow-up.
  10. Meet regularly with the Centerville Health Access Program supervisor to review activities, identify priorities.

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Tips: Spreading the word: 40+ ways to reach people

There are many creative ways to reach your target population. The following suggestions are adapted from Outreach Works by Michael DeChiara, Ellen Unruh, Tom Wolff, and Anne Rosen of AHEC/Community Partners, which describes a program to increase health insurance enrollment in Massachusetts. The strategies can be revised for different populations and goals.

Use word of mouth. The best source of a referral is someone who was helped and thought the service you offered was good. Encourage your users to "Tell a friend about us." Getting user referrals is a true indication of a program's penetration into a community.

Identify and target "gatekeepers" who affect your population's ability to participate. In rural areas or some cultures, for example, fathers are often seen as "gatekeepers " for the entire family. If they say "No," no one in the family will take part. Direct outreach to fathers, mothers, grandparents or teens-whoever you can identify as gatekeeper /decision-makers.

Take advantage of your board of directors and supporters. These people can "talk up" your project in the community and help create an action plan to increase awareness.

Offer a toll-free telephone number. Especially in rural and/or large service areas, 800-number service increase an individual's ability to call without long-distance phone costs.

Distribute or conduct a survey concerning your issue. Surveys provide a vehicle for communication with individuals or households. You can distribute a survey in schools (with permission from the principal or school district), at community events or one-to-one on the street. Keep questions simple and request contact information for follow-up.

Use the most appropriate channels for your effort and population:

Place inserts in local/regional newspapers. Distribution of inserts/flyers in local papers is cost effective and allows for broad distribution. They reach many people who would not otherwise see your material, in a non-stigmatizing manner. Use the free newspaper if one exists in your community.

Place inserts into utility bills. Use the distribution capacity of gas, electric, water or phone companies by having flyers inserted in their bills. This gets the word out to many households in a non-stigmatizing way, and can be low-cost or free.

Use commercial mailing services to reach your community. Val-Pak coupon mailings reach thousand of households at a reasonable cost. Company staff often assists with details like layout of your insert.

Advertise on milk cartons. This reaches many homes and is a good, local form of advertising.

Send information home with report cards or place it in school registration materials. Work with local schools to send flyers home with children's report cards or other "must see" school communications.

Create a display window in prominent areas. Put your information in a window on a well-traveled street, at a popular gathering area, or in a bus depot.

Advertise on local billboards. Billboards showing local people and/or phone numbers located in high traffic areas can dramatically increase awareness.

Advertise on radio and cable TV stations in your community. If you know your target community, you will know where they seek entertainment and news. Many communities, or ethnic/cultural groups have preferred stations that provide a credible and concentrate venue for you message.

Use children's artwork in your promotional material. Children's artwork uses unconventional language and has community appeal.

Provide info in welcome packets to new residents. Use the existing community "Welcome Wagon" if possible.

Place information on store/ATM receipts. These advertising efforts can be affordable and targeted.

Use businesses that distribute products in the community. Get flyers/inserts in supermarket shopping bags or in take-out food containers, such as pizza boxes. These messages reach many people throughout the community in a non-stigmatizing manner, at low cost to you.

Advertise in restaurants. Place your program's message on food tray liners or paper placemats at restaurants. This provides a non-tradition context for getting the message to many people in a non-stigmatizing and potentially fun setting.

Distribute flyers in back-to-school shopping bags. Take advantage of seasonal or natural activities like back-to-school shopping. (Depending upon the size of the store, this might require approval from central office.)

Post flyers with tear sheets everywhere possible around town. Flyers are a mainstay of outreach. Providing tear-offs" (tab on the bottom of the sheet that people can tear off and take with them) is most effective. Post fliers everywhere: Laundromats, buts stations, grocery stores, libraries, thrift ships, campground, playgrounds, town halls, and other public places your population gathers or visits.

Seek out audiences likely to be eligible for your program. Find those with a high likelihood of being eligible for your service or product due to their participation in other programs, and contact them through mailings, door knocking, or phone calls. These could include self-pay individuals at the emergency room, households using fuel assistance or receiving subsidized child care, employees at large companies with low paying jobs (such as day-care providers and nurses' aides) or those at large companies that offer less-than-full-time jobs with few or no benefits.

For groups whose identities must remain confidential and are not directly accessible to you, be creative within necessary limits. With children in a school lunch program, for example, provide the staff overseeing the program with prepared information and ask them to distribute as they see fit.

Hold raffles at community events. Raffle off a desirable item as a way to collect names of people interested in getting more information about your service or simply to engage people in discussion. Anyone is eligible to take part in the raffle if they fill out a short questionnaire that asks questions related to your problem and if they want to be contacted with more information.

Use a "loss leader." Offer a service, an item or information that will attract people to contact you. Provide non-stigmatizing service (such as preventive health screening) to bring you into contact with people who would otherwise stay away.

Participate in national promotional campaigns. Create activities to tie in with the Great American Smokeout, National Alcohol and Drug Addiction Recovery Month, National Breast Cancer Awareness Month, or even Grandparents Day to bring awareness to your program. Many of these campaigns provide materials to help develop community forums, articles, media events, exhibits, banners, and the like.

Be creative and interactive at health fairs and community events. These are common places for outreach efforts, but they have mixed results. To increase effectiveness, provide incentives for people to take information, fill out a questionnaire, or complete an application. These may include raffles, small gifts for children or adults, or children's activities. Have unusual attention-getting table displays or have staff wear costumes or eye-catching attire, such as T-shirts saying, "Need free or affordable health care? Talk to me."

Staff tables at job/employment fairs. Unlike health or community fairs, job fairs are oriented toward people looking for work. This different focus tends to draw people who may not attend other types of fairs and may be eligible for your program. Job fairs also offer a setting not directly associated with one's neighbors, so those people you engage feel more free to seek information and/or speak with you.

Sponsor everyday activities in the community. There are activities or functions that are so commonplace that they are often overlooked, yet they reach many people in your target group. If your effort targets children, for example, sponsor "snow day" announcements on the radio or television during winter months when every parent is listening or watching.

Sponsor local sports activities. Community sports involve many people. Sponsoring advertisements through Little League or the local bowling alley will reach many families and youth.

Use existing programs for your population to extend your reach. One group in Massachusetts asked local businesses or institutions providing children's programming, such as ballet and karate schools, to put a sticky label on all their registration forms for health insurance. The labels encouraged parents to call for more information about health coverage. Pre-printed labels are easy to supply and a minimal hassle for those agreeing to use them on their materials.

Attend immunization days. Do outreach when school children receive their immunizations. Those who come to county health centers and other sites could be eligible for your program.

Contact child-care providers. Contact providers with information for the children and families they serve. As with other low-paying, benefit-poor jobs, child -care providers may also need your services for themselves or their children. Ask about their own families once you've established contact.

Provide information to local police. Local police come in contact with many people who may need services of various types, such as victims of domestic violence.

Offer training for doctors and their office staff or schools and their staff. Put together a pleasant experience like a luncheon or coffee for local health care providers or others who work with your population alert them to your program. Don't overlook office managers, secretaries and others in the organization who might spread the word.

Use pharmacists (or other appropriate professionals) as allies. Pharmacists are often on the front line for knowing who has health care needs. Encourage them to post flyers/information on their counters or distribute them to those they serve, and/or set up an information table at a local pharmacy.

Provide trainings and information within the court system (including divorce court and victim assistance programs). In the case of health insurance, these avenues can lead you to people who are anticipating a drop in income or losing insurance that was available through their spouse. Juvenile and other types of court proceedings may lead to connections with your target population. Making information available to court clerks is an important link.

Outreach to the prison population. Outreach to pre-release inmates in correctional institutions requires special permission, but it can be effective.

Hit the streets, talk with people one-on-one. Go to where people live, congregate and shop to engage them one-one one. Establishing this type of contact is hard, but it works. There is no substitute for being out in the community and meeting people. Good places to go include supermarkets, laundromats, libraries, parks, and community events.

Hold off-hour/weekend coffees. Create a low-key gathering by offering informational coffees in towns and neighborhoods. These are best held on weekends or evening, and can be held in town halls, places of worship, or other gathering places. This works well for programs with small budgets and/or large service reaps.

Facilitate your process with portable electronics. If you need original documents (birth certificates, pay stubs, etc.) that people are understandably unwilling to give up, use portable scanners, copiers, or digital cameras to capture information during an outreach visit or presentation. Bring a cell phone with you to track down a contact or make an appointment.

Work with local agencies-let them know you can help. Many community social service agencies are overwhelmed and understaffed. Contact these allies and let them know how your program can help their clients. Emphasize that you are there to help rather than make more work. Post your flyers at their sites for consumers and staff to see. If you have time, do training for their staff and leave behind informational materials.

Above all: be creative in seeking partnerships. Work with services and agencies that connect with your population. Where are the best places to reach them?

  • If you're running an adolescent pregnancy prevention program, look into schools, coffee houses, music stores, video stores.
  • If you're trying to reach uninsured people who need health care, take your outreach to soup kitchens, drop-in shelters and county health centers.
  • There are probably less obvious places to connect with your users also, if you think about the activities of their daily lives and other organizations they come in contact with.
  • For example, the health insurance enrollment program in Massachusetts considered a variety of potential partners that could help get their message about insurance enrollment to the right people:
  • Medical billing services could insert flyers in mailing to families known to without insurance. It is the billing company's interest to see that the bills are paid.
  • "Temp" employment agencies could inform their employees since people working as temps often have no benefits. The information may also help the agency retain employees.
  • Schools can place flyers or stickers on school registration materials because parents are already thinking about insurance. Outreach workers can attend kindergarten registration in the spring/summer.
  • Hospitals can get information to new parents.
  • Video stores can provide health insurance information with every child-oriented video that is rented.


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Checklist

Here, you'll find a checklist summarizing the major points contained in the text.


___ You have analyzed your target population and initiative to determine what type and degree of outreach can help you achieve your objectives.

___ You have determined staffing needs.

___ If you decide to use Community Health Advisors or Workers (some form of trained outreach educator), you look for workers who live in the community who understand the needs, concerns, and questions of the people they serve, and know the barriers they face.

___ You have developed training for staff.

___ You have chosen a physical space carefully if you need one

___ You have developed strategies and action plans for your effort using principles for effective program design (as outlined in Chapter 8: Developing a Strategic Plan).

___ You have used existing resources for your initiative (such as those made available by national organizations).

___ You have identified and contacted potential partners, people and organizations to work with as your allies.

___ You have chosen and implemented appropriate (and creative) strategies to reach your target population. These might include:

___ You have followed up!


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