Trust in the community is earned through the day-to-day work of CHWs, their permanence, and the help they give to the community. It’s a natural connection. In my experience, doing my work with my heart is like putting myself in their shoes. Even if you are not the solution to all their problems, you can help by connecting them with the right resources. Trust is time, dedication, and persistence. It’s empathy, compassion, attentive listening, and responding with kindness. It’s being yourself, being honest, and allowing them to trust you. It is being sensitive to others' situations. It also involves using knowledge about the community, its health problems, and available services. Trust is about providing client-centered health information and counseling. It is about educating clients about how to prevent and manage health conditions and helping them develop healthier habits. It requires CHWs to analyze and reflect on their own emotions, experiences, and biases so that they do not affect their decisions. This allows CHWs to remain nonjudgmental when interacting with clients and colleagues. CHWs also need to always be alert to and respectful of the experiences, beliefs, cultures, and feelings of others. They teach and support clients and communities to develop new skills and confidence, become self- sufficient, and advocate for social change. I learn every day from the people I interact with. Their life experiences teach me the lesson of not judging anyone and understanding our differences without prejudice.

Trust comes in many different forms. The trust walking into a doctor’s office vs. allowing someone into your own home creates different dynamic forces. Participants have to trust doctors and other professionals because of their expertise, and they are assumed to know their job. Working as a CHW, trust is earned differently. CHWs earn trust by getting to know the participants personally, connecting and sharing their stories and ideas, and being dependable, being there when we’re most needed. Trust towards a CHW, unlike with doctors and other professions, is not just given. It is built. I remember when I contacted a patient over the phone the first time, it was hard to get them to accept the call. Over the course of two weeks, I called about three times before I finally got an answer. When I got through to the patient, it was hard to understand her dialect and learn whether she was comfortable answering questions. The conversation was supposed to be open- ended, but it was pretty reserved. Every question was answered with a quick yes or no.

Trust comes in many different forms. The trust walking into a doctor’s office vs. allowing someone into your own home creates different dynamic forces. Participants have to trust doctors and other professionals because of their expertise, and they are assumed to know their job. Working as a CHW, trust is earned differently. CHWs earn trust by getting to know the participants personally, connecting and sharing their stories and ideas, and being dependable, being there when we’re most needed. Trust towards a CHW, unlike with doctors and other professions, is not just given. It is built. I remember when I contacted a patient over the phone the first time, it was hard to get them to accept the call. Over the course of two weeks, I called about three times before I finally got an answer. When I got through to the patient, it was hard to understand her dialect and learn whether she was comfortable answering questions. The conversation was supposed to be open- ended, but it was pretty reserved. Every question was answered with a quick yes or no.

CHWs don’t just impact participants’ lives through sympathy but by being able to identify with their clients. Many of them receive care from CHWs that they don’t get in most places. Clients acknowledge that they aren’t the only ones going through hardships or life improvements. Just like many members of our community, we CHWs come from the same background and struggle the same struggle to get to where we are today. Putting trust in what just feels right makes the job work wonders.

“Just knowing you have a CHW that got your back just makes life a lot less stressful.”

“It all begins with CHWs reaching out to us and ends with us reaching out to CHWs.”

When someone takes the time to listen to you, you feel valued. Mental health has been and will be a topic of conversation among our communities. To live an optimal life, people must be mentally stable and healthy but, above all, have access to the help they need. Many people in our communities need mental health services to live healthy and optimal lives. However, when they try to find help and resources, they encounter many barriers along the way. CHWs will dedicate time to listening to their needs and helping them overcome possible barriers so they can have access to the services they require. This beautiful picture taken in a Goodwill store in East Harlem shows that having someone to talk to is essential to living an optimal life. Many individuals start a conversation with people they don’t know on the trains, buses, and stores because that random person listens to them with patience and empathy. With their positivity, hope, and a simple helping hand, CHWs can positively change people’s lives. This beautiful photo is an example of the importance of listening and being heard, which is essential to mental health stability in our communities.

An older adult walks accompanied by her home health caregiver. It provides security for our elderly to know that they have a companion to help them with their daily tasks, such as going to the pharmacy, supermarket, and butcher's shop. These caregivers are part of the excellent health of our seniors. They can talk, walk together, and even accompany them to other physical or fun activities at a neighborhood community center. Indeed, it provides peace of mind knowing that someone is taking care of our elderly.

I met a family last summer soon after being allowed back at our clinics and participating medical homes. One family had started the application process for government support services. When I spoke with the mother prior to our meeting, she shared that she needed to send evaluation reports and other medical forms to the government agency via fax. She had asked a local business to print out her material and was going to be charged $1 per page. She didn’t have the money to send 75 pages of documents. At the clinic, we were able to fax the reports. The mother was relieved she didn’t have to pay all that money. The ability to help families with this simple technology makes sure our families obtain the services they so desperately need. CHWs like me often facilitate access to therapy services, financial assistance, and communication with government agencies.

Community centers, adult day care, and food kitchens are places where elderly members in my community gather, not just to socialize but to have a daily nutritional meal. A place where they feel like family, like home. Community centers have a powerful influence on our elderly’s mental health because these are places where they don’t feel neglected or isolated. Elderly people rely on community centers for social support and to maintain their mental health.

I live in the same community where I am trusted to serve as a Community Health Worker! My daily work consists of Resources, Hope, and Trust. YOU... Becoming the connection TO A BETTER QUALITY OF LIFE, @ Any Age... Building STRONG RELATIONSHIPS ONE PERSON AT A TIME. Many Expressing Feelings... INSPIRED to Believe Health is achievable @ Any AGE.

Trust is in every relationship we have during our lives. Building trust with community members is like watering plants, drop by drop, really caring and showing up in the humblest and most transparent way. As a coach for different health programs, I have experienced how trust develops slowly but consistently. Every week while coaching the Diabetes Prevention Program (DPP), which consisted of six months of weekly meetings and six months of monthly meetings, I was able to connect and create a relationship with my clients. At the beginning of the program, some were shy or hesitant to share their thoughts. After a year of committing to the program, my clients were grateful for the tools we offered them to improve their health. They felt supported and glad they found a group of people they feel comfortable with and can trust. Serving as a guide to help them achieve their health goals and improve their lives, we walk through rocky roads and beautiful scenery heading to our better selves. Trust is everything!

As a CHW, it's essential to listen to clients' experiences and respect their cultures. When clients see that you are actively listening, it shows that you genuinely care. We are expected to keep confidentiality and act in a responsible manner in interactions with clients. It's important to have knowledge on the health topics to be trusted. I feel like it's important to let the client lead the conversation and never assume anything. I’ve had clients tell me personal stories about their health, and they expressed gratitude for listening to them.

A CHW’s role is to build trust not only through training but also with our behavior, the way we express ourselves, empathy, solidarity, respect, passion, and determination to help others. In this beautiful image, we can see how two older adults walk with several children to a park. Children need to socialize, play, have fun, and be active to develop a sense of humanity. CHWs are part of the community, and through trust, they can escort these children to the park, where they can socialize, play, interact, exercise, and make friends. CHWs are essential in our communities, not only because they can play different roles within the communities but also because they can connect people in the communities with a variety of services. The trust that these two older adults have built within the community allows them to escort these groups of children to the park.

CHWs have a special opportunity to meet families where they are. We meet them at their home or in their community, wherever they feel comfortable. We meet families outside their workplace, in their local laundromat, or between jobs at the train station. CHWs like me make sure that the families we serve feel supported, heard, and seen. We meet them where they are because we are like them. We are members of the same communities. We are also parents, and we have dealt with the medical system and the educational system ourselves. And some of our children are children with special healthcare needs as well. We build on that trust by being there and understanding their individual struggles. CHWs stand not above them but with them. We share our personal knowledge and the knowledge we have gained in our training. CHWs and families are equally invested stakeholders in the commitment to improving ourselves and our children’s outcomes. We all benefit when our communities are stronger and healthier. I thought about the question of how we CHWs develop trust with families. I decided to pose the question to one family I worked with. Both parents told me that they felt working with a CHW was like working with an ally. They had found someone who was there to support them and offer guidance through systems that are often hard to navigate. So, the idea that CHWs are partners with families reaching their goals became clear to me. This picture represents how CHWs and caregivers are linked together and how we learn from each other. Sometimes, CHWs lead, and sometimes, CHWs follow the family’s lead. This is how we make our communities stronger and healthier. One family at a time.

"A storm in Astoria during the Pandemic." CHWs are the external eyes and ears of medical teams and the interpreters of the voices of the local communities. We express their needs, navigate the sea of resources, and empower them to be autonomous. My zip code, 11103, doesn't reflect the reality of the scared immigrants hiding in dilapidated basements uncounted on the census. Those clients trust us CHWs with their problems because we care, pay attention, keep them, and ourselves, informed, and most importantly, create solutions! We have the training to diagnose dangerous and costly conditions, saving the medical field tons of money in the long run. When the tree fell down on the corner by my house, my neighbor, who worked for the fire department as a firefighter and was off for the day, put on his uniform and started directing traffic. I came with a KN95 mask and a water bottle for him. Then, other neighbors volunteered to direct traffic, and we started to check house by house to make sure that everybody was okay. That is how trust is built, by genuinely taking care of each other.

Communicating with our community about vaccine education became a new normal for CHWs. We shared information about websites to obtain accurate information about vaccines, talked about vaccine hesitancy, assisted with transportation to vaccine sites, and showed them how to order government-issued free COVID -19 home tests. This also included always reminding our community to wear masks and use hand sanitizers. During this time, it was so important and gratifying to receive messages from our participants who shared that they had received the vaccine and how happy they felt about getting together with loved ones in the near future.

Taxis, vans, trains, buses, and ambulances are all forms of transportation, allowing people to get to and from places more quickly and make everything closer. They give our community access to food, clothing, employment, education, and healthcare. Non-emergency medical transportation and other resources help our low-income community gain free or low-cost access to transportation. This helps ease any economic burden and stress that families in our community may have by helping them to manage all aspects of their health. Health includes the complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity, as stated by the World Health Organization.

For a quarter of a century, Health People has delivered critical, compassionate peer- driven programs and services. A community health agency based in the South Bronx, Health People uses “community-in-reach,” a groundbreaking peer-to- peer community health education model, innovative program curricula, instructive workshops, and referral relationships with other service and health care providers to empower program participants to lead healthier, safer, and more productive lives. Health People has inspired hope, created jobs, and improved the health of thousands of people in need.

"A storm in Astoria during the Pandemic." CHWs are the external eyes and ears of medical teams and the interpreters of the voices of the local communities. We express their needs, navigate the sea of resources, and empower them to be autonomous. My zip code, 11103, doesn't reflect the reality of the scared immigrants hiding in dilapidated basements uncounted on the census. Those clients trust us CHWs with their problems because we care, pay attention, keep them, and ourselves, informed, and most importantly, create solutions! We have the training to diagnose dangerous and costly conditions, saving the medical field tons of money in the long run. When the tree fell down on the corner by my house, my neighbor, who worked for the fire department as a firefighter and was off for the day, put on his uniform and started directing traffic. I came with a KN95 mask and a water bottle for him. Then, other neighbors volunteered to direct traffic, and we started to check house by house to make sure that everybody was okay. That is how trust is built, by genuinely taking care of each other.

CHWs not only offer reliable and credible information to families, we also bring them to places where things look and feel different. Even more importantly, those places are free of charge. Through our work, families understand how important it is to look outside their boundaries and become better advocates for themselves. I remember on one occasion, I met a family who needed a school placement, and my job as a CHW was to assist with finding an appropriate fit. I realized that the mother needed to see the school before sending her child there. As a mother myself, I would have liked that too. I scheduled a tour, and we visited the school. The mother asked all the questions she needed to know and saw the place where her daughter would be spending many hours every day. This simple act of assistance created the opportunity for the mother to see that a high-quality program was available for her daughter. She met staff members who spoke her language and felt that there was a friendly face at the school she could contact when needed. She realized her daughter would be in a place she could trust. The mother’s trusting relationship with me, her CHW, allowed her to go beyond what was comfortable and known to her and ensured that her daughter would get the services she needed and deserved. This was a lesson the mother was happy to learn and apply in the future.

CHWs have the most valuable experience related to our clients' “lived experience.” We are part of the community, and the community knows we can relate to and understand its difficulties without judgment. It requires a great deal of trust to open up to a stranger. However, patients are more likely to disclose information to someone who shares their culture, language, and life experiences or simply looks more like them. Trusting relationships are key to our work as CHWs because they allow us to effectively facilitate information that will ultimately have a positive impact on an individual's health. CHWs understand that confidentiality must be a priority while building trust. As CHWs, we also understand that our patients are the ones who need to feel reassured on this fact to eliminate ambivalences. As Mahatma Gandhi said, “be the change you wish to see in the world.” I am proud to be a community health worker.

Trust is one of the most genuine conscious attitudes that an individual or community can develop through a reciprocal relationship. In my opinion, trust is to believe in oneself, in yourself, and in what others may expect from you as a resource person. Therefore, our behavior as CHWs may influence whether or not others believe in what we assert, and that a matter will be as factual as possible. As a resource person, a CHW must be respectful, compassionate, reliable, and keep their clients’ and patients’ confidentiality. Most importantly, a CHW needs to be a good listener, paying attention to people’s needs and concerns. Always speaking with the truth and not being judgmental. My photovoice shows the three referrals to community-based organizations I provided to one of my patients, who was enrolled in the hypertension intervention program that I proudly facilitated with the support of Montefiore Medical Group and Bronx Community Health Network (BCHN). These three referrals represent not just available community resources but one of the most prevalent issues–food insecurity–during the first wave of COVID-19 in New York City. As the NYC Department of Health was concerned about the spread of the coronavirus in the population, similar concerns developed among individuals and communities who were warned to stay in their homes to avoid contracting COVID-19. This situation created a lot of confusion and exacerbated concerns that people would be losing their jobs and family members while the coronavirus was spreading so rapidly.

I believe that the hypertension intervention program helped patients manage their blood pressure and find someone who was always there to listen to them and provide them with feedback when they requested help for any of their immediate needs for concrete services. That is how trust is developed. It is not something automatic but needs to be cultivated, by which I mean it needs to be nurtured by the interacting parts. Finding community resources for clients and patients is an integral part of my daily work. I provide referrals to community- based organizations, and when people requesting the services have given their verbal consent to me as the CHW, I send the documentation via text messages or emails. I believe that trust is reliability, efficiency, and mutual respect.

In some cases, however, patients and clients also expressed concerns about the lack of reliability of medical providers during the height of COVID-19. Many patients with chronic diseases such as diabetes and hypertension were very affected by not being able to schedule their follow-up appointments or refill their prescriptions. In the interim, most of the patients enrolled in the hypertension intervention program relied on me as their facilitator to request help to get essential services from their primary care physicians, such as new medication refills for their chronic conditions. In these instances, when patients and clients had an urgency to fulfill their immediate needs, they openly expressed their gratitude for having someone they could trust and rely on during these tough times of COVID-19 in New York City.