The vision and objective of this curriculum is to encourage and inspire Community Health Workers (CHWs) and other paraprofessionals with an emphasis on Refugees, Immigrants and Migrants (RIM) to be effective and better equipped by recognizing the long-term value of self-care.
Self-care is a paramount practice that is needed due to the COVID-19 pandemic, as the heightened awareness of inequities and health disparities have increased the stressors within many marginalized communities. CHWs have stepped up as vital messengers during the pandemic especially in RIM communities, and their work is the underlying catalyst for this curriculum. This course can serve as the foundation to institute a practice of self-care.
About Community Health Workers
American Public Health Association (APHA) defines a CHW as a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables CHWs to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery (APHA, 2014), and improves clinical, behavioral, and social service access, delivery, quality, and care system performance. CHWs have been identified by many titles, such as community health advisors or representatives, lay health advocates, promotoras, outreach educators, peer health promoters, and peer health educators. CHWs are predominately persons of color that are disproportionately affected by inequities, often experiencing many of the same barriers to the social determinants of health and healthcare with marginalized communities.
Since CHWs typically reside in the community they serve, they have the unique ability to understand and meet the physical and emotional needs. They can reach residents where they live, eat, play, work, and worship. CHWs are frontline agents of change, often helping to reduce health disparities in underserved communities.
During the pandemic CHWs became the primary source of reliable information to communities that were adversely impacted by the virus. The pandemic ushered in new challenges as CHWs were not only educators, but also frontline workers. They became students learning to protect themselves and translating what it means to isolate. Overwhelmed by isolation, unemployment, housing challenges, and food insecurity, CHWs have feelings of fear and anxiousness that can lead to unhealthy behaviors and less self-care. However, CHWs were vital to RIM communities for dispelling myths and providing evidence-based facts from a cultural perspective on topics related to COVID-19.
History of Self-Care
Although self-care may appear to be a relatively new, trendy millennial concept, it is an old tradition that has been around since ancient Greece. Prior to the 20th century, self-care was seen within the societal expectations highly linked with affluence and privilege. Over the years, studies began to look at the effects of intense stressors brought on by emotional difficulties and trauma and to recognize the impact on our personal health and wellness. More organizations are paying closer attention and are more cognizant of how self-care can impact our overall health and well-being. In addition, recent studies by the Center for Disease Control and Prevention documented increased mental health conditions for public health workers since the start of the COVID-19 pandemic.
The United States and the medical society have borrowed and incorporated many of the ideas from other countries to promote self-care and well-being. One example of this is in Taiwan. People work exceptionally long hours, so employers make sure the workers take naps during their lunch hours in the office. In fact, offices will turn off the lights at noon to create a calming environment in which to sleep. From Persia, North Africa, England, and the Far East, drinking tea is a needed break in the middle of the day. Japanese bathhouses are a mainstay throughout the country and are considered both physically beneficial for aches and pains as well as a chief method of boosting wellness and reducing stress.
Minnesota CHW Survey
Most of the respondents in a recent Minnesota survey conducted by CHW Solutions were CHWs with more than three years’ work experience. The survey revealed that although selfcare was a consistent practice, 13% rarely practice self-care and 50% practice as needed. The most common reasons respondents did not routinely practice more self-care included “family comes first,” “work comes first,” and “never seem to have the time.” The focus of self-care for participants varied with “emotional” being the primary focus.
While 70% indicated having knowledge and the ability to provide information to clients dealing with stress, resilience, and grief and loss, 35% stated they were somewhat able to identify their own issues of trauma, stress, and grief and loss. Self-care is not only identifying one’s own needs, but also paying attention to them and incorporating self-care as an armor to protect energy needed to survive and thrive
What is Self-Care?
Self-care is not a reward nor a selfish act. SELF-CARE is defined as an individualized practice of activities or health management for the purpose maintaining life, good health, and well-being. It is self-initiated, intentional, and purposeful in handling whatever life brings. It is doing what is necessary to staying physically healthy, including seeking medical care when it is needed. Selfcare is the fuel that propels the mind, body, and spirit.
Self-care is the practice of caring for your physical, emotional, and psychological wellbeing, and it should not be surprising to learn that it does, in fact, also have a positive effect on one’s mental health. The World Health Organization (2005) defines mental health as
"a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community."
Practicing self-care is not always easy, but it is setting the stage to give your best self to every relationship. Most of us are constantly busy caring for family and have stressful jobs that leaves us fatigued, exhausted, feeling drained, and experiencing sleep disturbances; or we are too consumed with technology to make time for ourselves. Audre Lorde, American poet of Caribbean immigrants, says, “I have come to believe that caring for myself is not self-indulgence. Caring for myself is an act of survival.”
In many cultures, family is highly valued. In addition, working or creating a means to provide and care for your loved ones is essential and vital to one’s survival. Therefore, focusing on self may seem to go against caring for your family. Developing a practice of self-care is the start of being better prepared to handle the daily challenges of life for yourself as a member of family and community.