3 EVALUATION METHODS OF A COMMUNITY-HEALTH ADVOCATE PROGRAM

The title Community Health Advocate (CHA) is one of thirty or more tit les used throughout the world for an indigenous outreach worker who is trusted and respected in his or her community and who serves as a bri dge between peers and health professionals. In 1992, the Center for He althy Communities in Dayton, Ohio developed a program to train as Advo cates people indigenous to the communities in which they would be work ing. Since the first CHAs began work in January 1993, the effectivenes s of the program has been evaluated from three perspectives: the Commu nity Health Advocates, the managers/directors of the community sites a t which the CHAs work, and the clients with whom the CHAs work. Advoca tes indicated that the training program adequately prepared them for t heir roles and functions. They also identified systematic frustrations and barriers that made it more difficult for them to perform their jo b. Community site directors and community leaders indicated that the C HAs were considered a positive force in meeting client needs and facil itating independence, and were very effective in outreach and coordina tion of resources. A survey of CHA clients revealed an overwhelmingly positive response to the Advocate's work, validating the belief that C HAs can fill an important niche in the health care community. The thre e evaluation processes described in this paper helped to document the need for and the effectiveness of this program and can serve as a mode l for similar programs.