Projects: Collaborate.Health

Community Health Workers

Expanding Care in the Community using Community Health Workers

Agency Partner
Island Health Care
Program Design for Global Health
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Island Health Care (IHC) is a federally qualified health center and member of the Community Care Collaborative (C3) Accountable Care Organization, . Located in Martha’s Vineyard, Massachusetts, IHC serves the entire island with their team of clinicians, public health professionals, and community health workers (CHWs). IHC’s mission is to “ensure all islanders, regardless of income or insurance status, have access to high-quality health care” with a focus on the disadvantaged community of the Vineyard, including those who are low-income, those without insurance or with inadequate coverage, and other vulnerable residents.


By acting as a link between the clinic and the disadvantaged communities, CHWs play a pivotal role in fulfilling IHC’s mission. They have been recognized by IHC staff as adept listeners who adopt a comprehensive approach to patient care, offering adaptable support personalized to individual needs and preferences.


Though the role of CHWs is significant, IHC’s current CHW program is challenged by the following: absence of an established CHW training procedure, lack of standardized operating procedures for data collection on patient outcomes, and have yet to implement the integration of CHWs into primary care teams. Additionally, IHC is experiencing difficulty recruiting CHWs severely limiting their capacity to impact Martha’s Vineyard’s most vulnerable.


Our proposal intends to present a pathway for IHC to improve and expand their current CHW program, foster collaboration between CHWs and care providers, and employ a system to monitor CHW-served patients outcomes.


By providing a sustainable and functional foundation for the CHW program, we will improve CHW delivered care, ultimately improving health access and outcomes for Martha’s Vineyard’s most disadvantaged population. Duke’s County (where Martha’s Vineyard is located) has high rates of rural mortality, mental health crises, and substance use disorders. CHWs are trained and equipped to address these major issues, in tandem with the primary care of IHC clinicians. It is our hope that with the implementation of our project, IHC may be able to expand and restructure its CHW program and collect data on the patient health outcomes of the program to eventually 1) increase the CHW workforce, 2) Improve CHW delivered care and 3) bolster grant and funding applications. With the completion of these objectives, we hope to ultimately improve patient care and outcomes in Duke’s Country.

Project Timeline

This project took four months to complete from kick-off meeting to presentation of final deliverables. Click the button below for a detailed timeline.

View Project Timeline

Meet the BUSPH IHC Team

Janice Chen, Brian Lara, Arielle Espenilla, Shamirah Davenport, and Beth Williams