A New York CBO Trains a New Generation of Community Health Workers
For Lantern Community Services, equipping people from within the community to promote vaccines is key to reaching people impacted by homelessness.
Community organizations have been key in promoting COVID-19, flu, RSV, and other routine vaccines in recent years, but a New York City nonprofit that works with people impacted by homelessness says it’s important for CBOs to equip the people they serve to be trusted messengers.
Like many historically underserved communities, people experiencing homelessness are at greater risk for COVID-19.
In the U.S., the number of people experiencing homelessness has climbed steadily since 2017. In 2023, there were more than 650,000 people experiencing homelessness nationwide, a record-high since reporting began in 2007, and a 12 percent spike over 2022.
New York is among the top three states with the highest numbers of unhoused people.
Public Good News reached out to New York City-based Lantern Community Services, a CBO supporting the city’s unhoused population. Carol Lemus, vice president of program development; Tracey Robinson, case manager; and Kimberly Thomas, vaccine ambassador, talked about their trusted messenger programs and the importance of continuing to help the residents of their emergency housing sites get access to vaccinations.
Here’s what they said.
PGN: Can you share more about your mission and about your trusted messenger model? How have your programs shifted over time?
Carol Lemus: Lantern champions the independence and well-being of New Yorkers who are impacted by or threatened with homelessness. We provide housing and health and wellness programs to people impacted by homelessness.
In 2021, we were funded by the CDC Foundation to use a peer-driven model in response to the COVID-19 pandemic. So we started the On Point program. We recruited vaccine ambassadors and we did a pretty extensive training with our first group. [The] baseline number for COVID-19 vaccination rates in our buildings or supportive housing buildings was at about 12 percent. The ambassadors started doing their work, and within four months, it was over 60 percent.
They really demonstrated the ability to connect and relate to the concerns and barriers that people would express around not getting vaccinated.
It was such a successful program, [that] we applied for and got funding for another one-year peer program called Knowledge Equals Power, to have people be aware of their HIV status through self-testing at home. We discovered that one of the important pieces for our residents is to have somebody on site, who’s like their touchstone.
So, after that program ended—and [a Request for Proposal] came from the Mother Cabrini Health Foundation—it seemed like a perfect opportunity for us to apply.
I had a vision, which was ultimately to train peers on not just one specific topic, but really to become community health workers. We did our first year, last year, and had a lot of lessons learned.
Three weeks ago, we started training 16 people [to become certified community health workers].
PGN: Kimberly, can you share how you became a vaccine ambassador and community health worker?
Kimberly Thomas: My counselor Tracy came to me and she told me about On Point, the vaccine ambassadors program. Then, I talked to Carol and she explained it more. So, I said, ‘OK, I’m gonna give it a try.’ I wasn’t too enthusiastic at first, but I just said, ‘Let me try something new.’
Once I got started, it changed for me. Before, I was in my apartment, not really paying attention to anything. Now, I’m downstairs, meeting my community, talking to them, getting to know them.
Now, I’m knocking on doors, saying, ‘Can I give you some information concerning the flu and COVID-19 vaccines?’ And, ‘Here’s some information on why it’s so important: Just because it’s not an emergency no more, doesn’t mean it doesn’t exist. With your health conditions, as we know, COVID-19 and RSV are killing people young and old, so a little protection might help you a long way. If you're not comfortable, here’s all the information that you need. So, you can look at it. [If] you have any questions, you know I'm downstairs.’
So I’ve been doing the On Point program for over a year. Then, Tracy came to me again, and told me about the Neighbor 2 Neighbor program to become a certified community health worker. It just makes me want to continue. I want to become a caseworker now.
I’m learning every day—one on one—that a person like me [can] have the capacity to actually change somebody’s life, or help them to change it. I matter and they matter.
PGN: A recent Ad Council study on trusted messengers found that, the closer a messenger is to a person, the more they trust them in later stages of the knowledge journey. How does your lived experience inform your work as a community health worker-in-training?
K.T.: It’s all about just being you. We’re not always treated right at the places that we have to go to get the services we need.
People look at you and judge you, especially once you tell them certain things. You can see the look on their face and you start feeling inadequate, you start feeling embarrassed, or ashamed.
Why should I feel that way? I’m trying to get out. I have worth, I have value.
[We] have people in my building who have been turned away, no matter how hard they tried to get help. When you go through all that and you get turned down, you feel defeated.
So when they come to me, they know that’s not gonna happen.
The housing system is very broken. But you have to do the best you can with what you got.
I made it. But I had to learn on my own to navigate it, to get the things that I needed and wanted. I don’t want people to have to do that, which is why I am grateful that I’m able to do something. [I'm] learning skills, learning how to use the resources that are there to help other people, so their transition is a better experience than mine.
PGN: Tracey, as a caseworker, what do you look for in potential ambassadors? What skills do residents-turned health workers need to be successful?
Tracey Robinson: First and foremost, we want to make sure that they’re connected to services for their own personal, mental, and physical health.
I make sure that when they’re getting into these roles, they have a full understanding of what their expectations are. And how they’re going to deal with different people from diverse backgrounds, diverse attitudes, behaviors.
It’s something that you have to watch for: How is this person going to adapt in that environment? Are they going to be able to thrive?
Because they’ve been through traumas, [and] you don’t want to add to those traumas. You want to make sure you see them through. You want to make sure you meet them on the other side and give them that support.
PGN: The CDC recently announced the Bridge Access Program will end at the end of summer. How will Lantern adapt to continue providing vaccines to residents?
C.L.: For any program, you have to understand what’s important to the people you serve.
Even though you can say, ‘It’s really important to get your vaccine,’ that may not be their first priority. Their first priority is, ‘How do I pay for my food? How do I pay my bills?’
So, the use of incentives has been really important, particularly since lifting the public health emergency.
And then, the role of their peers has been really important. Having somebody who lives next door or upstairs, somebody who you know is a survivor and has those skills that helped them get to where they are now. That role, I think, is always going to be important in our health work, not just in the vaccination [work], but in health in general. The message is very different coming from somebody who has shared your struggles.
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This article first appeared on Public Good News and is republished here under a Creative Commons license.