Community Health Workers Training Program Research Articles

Designing a Community Health Worker (CHW) Certificate Training that Centers Marginalized Youth’s Health and Wellness

The genesis of the youth Community Health Worker (CHW) and Citizen/Community Science (CS) training is rooted in interdisciplinary research and the lived experiences of families in Chicago and Urbana-Champaign. Dr. Mendenhall and colleagues’ (Drs. Robinson, Roberts and Rodriquez-Zas) South Chicago’s Black Mothers’ Resiliency Project provide dinsights into Black women’s experiences with genomics, trauma, and community science. Black women’s testimonies highlighted the health impacts of living in neighborhoods with high levels of gun violence and the resilience strategies they employ. This led to the development of a youth-centered CHW and CS training program, aimed at addressing health disparities. The program trained high school students and young adults (up to age 24) as CHWs and CSs, focusing on the objectives of (1) embedding culturally competent health workers in marginalized communities; (2) amplifying community voices; (3) collecting, analyzing, and quantifying observational data to inform policy decision-making; (4) amplifying community voices in healthcare discussions and (5) creating community health care worker training certification for youth. Over three years, the program trained over 50 participants, incorporating elements of wellness, art, and entrepreneurship.Based on ethnographic notes participants reported increases in wellness such as reduced anxiety and increased empowerment. The program’s long-term goals include creating employment opportunities for graduates and contributing to improved community health outcomes. This initiative represents a step towards addressing racial trauma and promoting community healing through youth-led innovation and empowerment.

Training young adults as community health workers specializing in pediatric to adult health care transition to support emerging adults with sickle cell disease

BackgroundTransition to adulthood is a vulnerable time for emerging adults (16–25 years of age) with sickle cell disease (SCD), as there is a seven-fold increase in mortality rates during the transition period. Emerging adults with SCD also have the highest rates of hospitalizations, emergency room visits, and hospital readmissions compared to other age groups. Community health worker (CHW) programs have been developed to address outcomes such as patient activation which includes an individual’s knowledge, skill, and confidence for managing one’s health and healthcare, quality of life, and healthcare utilization for patients with chronic illnesses. However, few programs specifically target transition-age patients with SCD. MethodsThe aims of this study were to (1) create and adapt the existing Penn Center for Community Health Workers IMPaCT model trainings and materials to specifically support CHWs working with transition-age patients with SCD and (2) evaluate the feasibility of this adapted model to improve job readiness of the CHWs and perceived value of the CHWs by patients with SCD. A multidisciplinary workgroup defined specific goal-setting categories and developed a targeted CHW training curriculum. Additionally, the workgroup wrote a job manual including step-by-step guidelines with example talking points and defined an ongoing supervision of CHWs. Measures of implementation and impact on CHW job readiness included CHW training completion, job retention, knowledge evaluation, and patient reported CHW engagement. Results15 individuals completed CHW training with an average employment length of 1 year and 4 months. 7 (47%) CHWs had research experience, 8 (53%) had clinical experience, and 11 (73%) reported SCD experience. On post-training knowledge evaluations, CHWs successfully identified key aspects of SCD, role scope, and research ethics. Patients frequently reported that they reached their goals while working with trained CHWs. ConclusionThis CHW training program provides a novel adaptation to the evidence-based IMPaCT CHW model to support the needs of youth with SCD during the vulnerable time of transition from pediatric-focused to adulthood-focused healthcare.

FEASIBILITY OF A COMMUNITY-BASED NAVIGATOR SUPPORT PROGRAM FOR CARE PARTNERS OF SERIOUSLY ILL VETERANS

Abstract We examined the feasibility and satisfaction of a short-term Veterans Health Administration (VHA)-based care partner support intervention delivered by trained navigators during COVID-19 through a single-arm interventional cohort feasibility study of a telephone-based care partner navigation intervention. Navigators (n=9) received the standard state curriculum online from a local community health worker training program plus an additional eight weeks of online role-specific training by the study team. Subsequently, navigators contacted care partners (n=30) of seriously ill veterans weekly via telephone over a 12-week period to assess social and practical needs, and connect care partners to appropriate community-based or VHA resources. All navigators (9 female; 1 male) and 17% of care partners were African-American (83% were Caucasian or other). Care partners were 90% female and 10% male; age range 41 to 80. In this telephone-based support program delivered to care partners by standard-trained navigators across 12 counties, care partners were overall very satisfied (x̄=4.69 out of 5, sd =.77) with their navigator’s responsiveness and social support throughout the 12-week course of the study. Navigators’ confidence increased over time (x̄=8.2 out of 10 (sd=1.14) to x̄=8.78 (sd=.97)), while their self-assessed effectiveness ratings lowered over time as they encountered real-life scenarios (x̄=8.5 (sd=1.43) to x̄=7.89 (sd=.93)). Navigators documented successful connections to services in the VHA and in care partners’ communities. Using remote navigators with minimal but standard training is a feasible and acceptable model of care partner support.

Embedding Care in Communities: Mixed-Methods Evaluation of a Community Health Worker Training Initiative in Rural Haiti.

Community Health Workers (CHWs) are valuable members within the communities they serve and increase access to health care by garnering the trust of their fellow neighbors, providing services including facilitating access to care, and improving the quality and cultural competence of service delivery. In Southern Haiti, there is a health care provider shortage with one doctor or nurse per 3,000 persons. CHWs are critical to help close the gap of the lack of access to care and facilitate the provision of basic health care. To describe the CHW training initiative at capra-care, a community-based health care provider in rural Haiti, using survey and focus groups results highlighting key findings and implications for the CHW initiative. A mixed-method approach was used to evaluate capracare's CHW Training program. Focus groups were conducted that documented the lived experience of CHWs following the training program; examined barriers and facilitators to translating the training skills to practice in the community. Pretest and post-test data assessed change in knowledge post the Community Health Worker Training (CHWT) program. Findings included 51 (57%) of the graduates. A significant increase was observed in mean test scores from baseline (n = 51; m = 61.48 ± 1.80) to post-test (m = 76.93 ± 1.73; t-7.69; P < 0.001), indicating that the CHW training was successful in increasing participants' knowledge. Themes that emerged from the qualitative analysis were comprehension of skills learned, community benefit, and empowerment. Results from this CHWT program has implications to increase the health care workforce thus facilitating access to care among community residents in under-resourced regions.

The Laro Kwo Project: A train the trainer model combined with mobile health technology for community health workers in Northern Uganda.

Community Health Workers (CHWs) in low and middle income countries (LMICs) provide invaluable health resources to their community members. Best practices for developing and sustaining CHW training programs in LMICs have yet to be defined using rigorous standards and measures of effectiveness. With the expansion of digital health to LMICs, few studies have evaluated the role of participatory methodologies combined with the use of mobile health (mHealth) for CHW training program development. We completed a three-year prospective observational study aligned with the development of a community-based participatory CHW training program in Northern Uganda. Twenty-five CHWs were initially trained using a community participatory training methodology combined with mHealth and a train-the-trainer model. Medical skill competency exams were evaluated after the initial training and annually thereafter to assess retention with use of mHealth. After three years, CHWs who advanced to trainer status redeveloped all program materials using a mHealth application and trained a new cohort of 25 CHWs. Implementation of this methodology coupled with longitudinal mHealth training demonstrated an improvement in medical skills over three years among the original cohort of CHWs. Further, we found that the train-the-trainer model with mHealth was highly effective, as the new cohort of 25 CHWs trained by the original CHWs exhibited higher scores when tested on medical skill competencies. The combination of mHealth and participatory methodologies can facilitate the sustainability of CHW training programs in LMIC. Further investigations should focus on comparing specific mHealth modalities for training and clinical outcomes using similar combined methodologies.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Development of a “Wawokiya” Palliative Care Community Health Worker Training Program for Great Plains American Indians with Cancer (TH125B)

Development of a “Wawokiya” Palliative Care Community Health Worker Training Program for Great Plains American Indians with Cancer (TH125B)

Community Health Worker Training Program (HRSA)

Federal Grants & ContractsVolume 46, Issue 11 p. 7-7 Grants alerts Community Health Worker Training Program (HRSA) First published: 01 May 2022 https://doi.org/10.1002/fgc.32362Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume46, Issue115 May 2022Pages 7-7 RelatedInformation

The Extent of Integration of Community Health Worker Programs Into National Health Systems: Case Study of Botswana

BackgroundThe paucity of Human Resources for Health (HRH) is a major global health challenge. The World Health Organization (WHO) recognizes the potentials that Community Health Workers (CHWs) have in closing the gap of an inadequate supply of human resources for health (HRH). However, weak CHW integration into national health systems curtails effective implementation of CHW delivered high impact interventions in resource constrained settings. This study assessed the extent of integration of the CHW Recruitment, Education, and Certification (REC) component into the national health system’s HRH building block, using Botswana’s CHW program as a case study.MethodsThe study used mixed methods. Data collated from CHW training program documentary abstraction, five key informant interviews were analyzed thematically. Data collected through the survey with 123 CHWs were analyzed quantitatively. A recently developed Community Health Workers Program Integration Scorecard Metrics (CHWP-ISM) that comprises of the WHO building blocks and corresponding CHW integration metrics, with process, evidence, and status of integration parameters, was used to determine the extent of integration.ResultsAn analysis of Botswana’s CHW REC component using the CHWP-ISM scale showed that the component was 80% integrated into the national HS. Whereas the CHW training program was fully government sponsored and accredited, some aspects of the program’s selection and recruitment criteria and training modalities were lacking integration. Although CHW training was exclusively offered at a local private training institute, findings from documentation reviews, interviewed KIIs and the survey show that the training accreditation, regulation and funding was the responsibility of the central government.ConclusionThe application of the CHWP-ISM scale to assess extent of CHW program integration into HS identified important CHW human resource integration gaps in CHW selection criteria and recruitment process as well non-inclusion of CHWs post-training accreditation by national accreditation board in government policy documents.

A Community Health Worker Training Program to Deliver Accessible and Affordable Hearing Care to Older Adults.

Community leaders collaborated with human-centered design practitioners and academic researchers to co-develop a community health worker (CHW) training program for delivering community-based hearing care to fellow older adults. When implemented by CHWs, clients' communication function improved comparably with outcomes following professional interventions. Community-based models offer opportunities to advance hearing health.

Integrated care by community health workers in Malawi: Rehabilitation and blood pressure monitoring.

BackgroundCommunity health workers (CHWs) are essential providers of integrated care for people in low-resourced settings with a high burden from noncommunicable diseases (NCDs).AimsThe purpose of this study was to evaluate a CHW training program in rural Malawi integrating blood pressure (BP) monitoring into rehabilitation care.MethodsThis was a retrospective cross-sectional study. The participants were a convenience sample of home-based palliative care CHWs at the local hospital (n = 59). Data collected included: a written pre- and post-knowledge test, skills competency checklist and a post-training program survey. Descriptive frequencies and paired t-tests (a = 0.05) were used for quantitative analyses. Themes in narrative responses in the post-training survey were analyzed qualitatively.ResultsParticipant knowledge regarding BP monitoring procedures improved significantly on the post-test (M = 8.24, SD = 1.654) compared to the pre-test (M = 6.59, SD = 1.683), Z (49) = −5.569, p < 0.001. The pre-and post-tests were scored 0–10 points. All participants demonstrated competency in 100% of the skills. Participants reported the lack of transportation, teamwork and resources as barriers to their work. They reported trainings and opportunities to collaborate as facilitators to their work.DiscussionThis study demonstrated the effectiveness of a training program for CHWs which integrated BP monitoring with rehabilitation care for people with NCDs. This retention of knowledge and application to clinical practice serve as strong indicators of the feasibility and sustainability of the CHW training and care delivery program in resource-limited settings.ConclusionOur findings help demonstrate that training CHWs can be an effective way to help bridge the gap in health care access for people with disabilities in resource-limited countries.

Introduction and Follow Up of Ongoing WiRED International Program

As we write this article, the expanding coronavirus pandemic has crushed healthcare systems around the world. Increasingly, ministries of health, non-governmental organizations and hospitals are turning to their reserve workforces — retired professionals, medical and nursing students, and community health workers (CHWs). In under-resourced regions, where the options are limited, they are reaching out to these CHWs, a quasi-professional corps of people who play a critical role in the last mile of many health systems. This trained force delivers basic health services, provides community members with health and prevention information, and becomes the eyes and ears for the official healthcare systems. The need for CHWs has surged along with the onset of the coronavirus, but CHWs, like everyone in the healthcare system, are in short supply. The CHW training program that we describe in this paper started out with a different set of motivations and a very different timetable. The coronavirus crisis has imposed changes on our training protocols and greatly accelerated the need for CHWs in all regions, but especially, underserved regions. In this paper we describe our plans and approaches developed in a very different global environment. At the end, we speculate about how this program will unfold now that training procedures must change, and how CHWs have become ever more important in community health.

Expanding Medical Education for Local Health Promoters Among Remote Communities of the Peruvian Amazon: An Exploratory Study of an Innovative Program Model.

PurposeCommunity health workers (CHWs) play integral roles in primary health care provision in low- and middle-income countries (LMICs). This is particularly true in underdeveloped areas where there are acute shortages of health workers. In this study, we evaluated the development and community utilization of a CHW training program in the Loreto province of Peru. Additionally, a community-oriented training model was designed to augment access to basic health information in underserved and isolated areas of the Amazon.MethodsHealth resource utilization was compared in each community by surveying community members before and after implementation of the CHW training program, which utilized a community participatory program development (CPPD) model.ResultsAll communities demonstrated significantly increased CHW utilization (p = 0.026) as their initial point of contact for immediate health concerns following CHW training implementation. This increase in CHW utilization was accompanied by trends toward decreased preferences for local shamans or traveling to the closest health post as the initial health resource.ConclusionThe community-focused, technology-oriented model utilized in this study proved an effective way to promote the use of CHWs in the Amazon region of Loreto, and could prove valuable to CHW capacitation efforts within other Peruvian provinces and in other LMICs around the world.

Bridge Builders to Health Equity: The High School Community Health Worker Training Program

Bridge Builders to Health Equity: The High School Community Health Worker Training Program

A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers: A Feasibility Study.

Cancer screening uptake among South Asian ethnic minorities is reported to be relatively low. An outreach program, led by community health workers (CHWs), may increase the minority group's awareness of the importance of cancer screening. The aim of this study was to assess the feasibility and effectiveness of a theory-based, culturally sensitive program to train South Asian women in Hong Kong as CHWs. A CHW training program, guided by the Empowerment Model and the Health Belief Model, was developed and implemented. Its feasibility was evaluated through the recruitment of South Asian women to the program and their satisfaction with it. Its effectiveness was assessed by a test of knowledge, the participants' self-efficacy and competence, and their readiness to work as CHWs. Five South Asian women were recruited to the training program. Outcomes included increased participants' knowledge of cancer and improved self-efficacy and competence in working as CHWs. All participants were highly satisfied with the program, although the addition of practical sessions in the South Asian community was suggested as a further improvement. It seems to be feasible to train South Asian CHWs to deliver interventions to promote their peers' awareness of breast and cervical cancer prevention, although challenges exist in recruitment of trainees. More hands-on practical opportunities as CHWs would likely increase their effectiveness. The theoretical framework of our CHW training program and the incorporated cultural components could be useful for the development of future programs for training South Asian CHWs in delivering interventions on cancer prevention.

Extension for Community Healthcare Outcomes (ECHO): a new model for community health worker training and support.

More than 50,000 community health workers (CHWs) are employed in the United States (US), a country with no national accreditation or certification program. In the US, CHWs are trained, formally and/or on-the-job, and rarely is long-term mentoring included. We developed a CHW training program using the Extension for Community Healthcare Outcomes (ECHO) model™, distance education using video teleconferencing to support case-based learning, and mentoring of healthcare providers from medically underserved communities. We describe the ECHO model for CHW training and mentoring using case examples and pre/post-surveys from our obesity prevention and addiction recovery programs. Using the ECHO model to train and support CHWs offers advantages over traditional training methods, and can be adapted in other countries to support CHWs to improve health in their communities.

Strengthening the Healthy Start Workforce: A Mixed-Methods Study to Understand the Roles of Community Health Workers in Healthy Start and Inform the Development of a Standardized Training Program

Introduction Healthy Start (HS) is dedicated to preventing infant mortality, improving birth outcomes, and reducing disparities in maternal and infant health. In 2014, the HS program was reenvisioned and standardization of services and workforce development were prioritized. This study examined how HS community health workers (CHW), as critical members of the workforce, serve families and communities in order to inform the development of a CHW training program to advance program goals. Methods In 2015, an online organizational survey of all 100 HS programs was conducted. Ninety-three sites (93%) responded. Three discussion groups were subsequently conducted with HS CHWs (n = 21) and two discussion groups with HS CHW trainers/supervisors (n = 14). Results Most (91%) respondent HS programs employed CHWs. Survey respondents ranked health education (90%), assessing participant needs (85%), outreach/recruitment (85%), and connecting participants to services (85%) as the most central roles to the CHW’s job. Survey findings indicated large variation in CHW training, both in the amount and content provided. Discussion group findings provided further examples of the knowledge and skills required by HS CHWs. Conclusions The study results, combined with a scan of existing competencies, led to a tailored set of competencies that serve as the foundation for a HS CHW training program. This training program has the capacity to advance strategic goals for HS by strengthening HS CHWs’ capacity nationwide to respond to complex participant needs. Other maternal and child health programs may find these results of interest as they consider how CHWs could be used to strengthen service delivery.

The evolution of the Community Health Worker program in Papua New Guinea

New Guinea (PNG) has a special history in regard to the training of Community Health Workers (CHWs) and is currently preparing its frontline health workforce to serve the 85% of the total PNG population of 7.3 million people who live in rural and remote settings. This article identifies and explains the five major developmental stages in the current CHW training program, as well as the changes that have occurred over the past century. The developmental stages are: (1) traditional; (2) early contact; (3) innovation; (4) the 1980s; and (5) new millennium. These developmental stages are discussed in the context of the early literature and investigation by the primary author and examination of the lived experiences of early missionary health workers and local people. This paper documents the development of a CHW program in PNG from the colonisation period, which began in 1883, to the present day. As a developing nation, PNG has gone through many challenges and changes to its healthcare system and has gradually developed an effective program to train its frontline primary health care (PHC) workforce. This article contributes new information with regard to the past and current development of CHW programs in PNG as well as in other developing countries. The training of competent CHWs with the essential skills and knowledge may help deliver quality and cost-effective PHC services to the rural majority and the urban disadvantaged, thereby fulfilling the PNG government's National Health Plan for 2011-2020. Systematic evaluation of the effectiveness of the CHW program will provide guidance for continued development of this frontline health workforce. Improving and introducing a competency-based curriculum is an essential step towards building a healthier nation.

Diabetes training for community health workers on an American Indian reservation.

To improve the knowledge and skills of community health workers (CHWs) on an American Indian (AI) Reservation related to the management of diabetes to allow CHWs, with no prior formal diabetes education to work more effectively with individuals in the community with diabetes. Training was provided in six "face-to-face" sessions with the CHWs using the Centers for Disease Control and Prevention CHW Training Resource on Heart Disease and Stroke. This is a quality improvement program guided by the Model for Improvement: Plan, Do, Study, Act and using a pre-post evaluation design. Ten AI CHWs were recruited for the training. Knowledge and attitudes, participation rates, and participant satisfaction were measured. Knowledge increased overall with largest changes in diabetes, depression and cholesterol. Diabetes attitudes were high and consistent with those found in caregivers who support patient-centered care. Participants reported learning, liking the class, and finding the materials helpful. This QI program provided by a public health nurse improved CHW's knowledge of diabetes and the management of diabetes. Next steps include formalizing the Reservation's CHW training program, expanding this training to other AI Health Service areas, and measuring the impact of CHWs in the community.

Applying the community health worker model in dermatology: a curriculum for skin cancer prevention education training.

Incidence of skin cancer is rising in Hispanic populations and minorities often have more advanced disease and experience higher mortality rates. Community health worker (CHW) programs to promote primary and secondary prevention show promise for many diseases, but an adequate training program in skin cancer prevention is not documented. We present a model for CHW specialty certification in skin cancer prevention for underserved, Hispanic communities. We designed a culturally appropriate CHW training program according to an empowerment model of education for skin cancer prevention and detection in underserved Hispanic communities. We partnered with a large nonprofit clinic in South Florida. Nineteen CHWs completed the 2-h training course. After the course, 82.4% (n=14) strongly agreed with the statement "I feel confident I can educate others on the warning signs of melanoma." Eighty-eight percent (88.2%, n=15) strongly agreed that they felt confident that they could educate others on the importance of sun safety. One hundred percent (n=19) answered each question about how the sun affects the skin correctly while 84.2% (n=16) were able to identify the "ABCDEs" of melanoma. Nearly 90% strongly agreed with "I plan to change my personal sun safety behaviors based on what I learned today". Our results indicate successful transfer of information and empowerment to CHWs with high levels of confidence. Disease specific "specialty certifications" are a component of effective CHW policies. An appropriate training tool for skin cancer education is an important addition to a growing list of CHW specialty certifications.