Michigan group (GRIN) partners locally to test Community Health Education and Referral Liaison (CHERL) Program

The Great Lakes Research Into Practice Network (GRIN) is a practice-based research network that has successfully developed partnerships with several community health organizations and clinical practices in the Michigan area. The Community Health Education and Referral Liaison (CHERL) Program provides clinicians with an opportunity to refer patients with unhealthy behaviors in the area of tobacco use, sedentary lifestyle, unhealthy diet, and alcohol misuse to health educators (CHERLs). The CHERLs provide motivational information and educational strategies to promote behavior change by linking the patient to appropriate community services. In addition to this assistance, the CHERLs provided feedback to the clinicians regarding their patients’ progress.

GRIN feels that the most important aspect to running its CHERL program, besides funding, is strong relationships. These relationships have to be established successfully with both community organizations and busy, overburdened practices. Maintaining these relationships over time is key. CHERLs try to do this by providing a worthwhile and reliable service. One mechanism for maintaining this service is by making sure the patients are referred appropriately. CHERLs accomplish this by confirming patient eligibility and making sure the patient not only has access to the services but is satisfied with them as well.

GRIN describes the most successful aspects of their partnership as the ability to provide health behavior interventions to patients who may not otherwise receive them. Clinicians and practice staff often become discouraged or overwhelmed trying to identify appropriate community services themselves. By having one entity with which to refer, the CHERL program has eased the practices' burden for health behavior referrals and is able to increase the utilization of available community resources.

Besides starting up such a collaborative process, one must also recognize the efforts that are needed to maintain it. GRIN cautions that engaging practices in a sustained way can be challenging. One way GRIN has tried to ameliorate this is by having regular communication with the practices and their clinicians through regular feedback on the number of referrals and the progress of patients. In addition to practice engagement, finding community services for certain behaviors can be difficult as the availability of programs varies widely by community and can be limited.

GRIN’s CHERL program is wonderful example of how collaborations between community resources and practices can make a difference. When asked to describe the success of their program, Trissa Torres stated “CHERL is like a bridge to support and sustain key relationships between physicians, patients, and community services for the purpose of supporting healthy behaviors.”

This project is currently funded by a grant from Robert Wood Johnson Foundation. The group is working on establishing mechanisms to continue the program after research funding ends.

For more information about this program, please feel free to contact Dr. Jodi Holtrop or Dr. Trissa Torres.