Community Health Workers Then and Now

Rosenthal, E. Lee; Wiggins, Noelle; Ingram, Maia; Mayfield-Johnson, Susan; Zapien, Jill Guernsey de

doi:10.1097/jac.0b013e31821c64d7

Cited by 89 publications

(55 citation statements)

References 10 publications

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“…A national study in the US found that more than two thirds of CHWs are paid, while there are also volunteer workers across the country. 21 The study suggests that equitable compensation for their services is an important step towards CHWs' integration within the broader health system of the country. In Canada, CHWs are often compensated by the health organization for which they are working.…”

Section: Education and Trainingmentioning

confidence: 99%

“…21 Health organizational training, such as certificate programs offered by health departments, and educational institution training are also widely discussed in the literature on HICs, although mainly with reference to the US. 21 We identified three types of education and training for CHWs in Canada: organizational training programs, institutional training programs, and on-the-job training. Health organizations in different parts of Canada have initiated training programs for CHWs to meet the needs of their population.…”

Section: Education and Trainingmentioning

confidence: 99%

“…Addressing mainly health issues related to culture, ethnicity, race, gender and language, CHW interventions have mostly tackled health inequities among immigrants, Aboriginals, and lowincome and homeless populations. 21,24,44,45 Finally, because of the focus of CHW interventions on primary health care, health promotion and disease prevention, these interventions have demonstrated both actual and potential control of high costs of medical services and inappropriate use of emergency services when and if CHWs and their interventions are integrated into health care systems. [46][47][48] …”

Section: Evaluation Studiesmentioning

confidence: 99%

“…21,30 In general, CHWs are considered to be a bridge between communities and the health system. On the one hand, they guide community members to appropriate services, thus avoiding unnecessary hospitalization and other acute care while on the other hand they provide necessary cultural and contextual information for professional health care providers to build their cultural competence, helping to improve patientprovider communications.…”

Section: Education and Trainingmentioning

confidence: 99%

See 3 more Smart Citations

Community health workers in Canada and other high-income countries: A scoping review and research gaps

Najafizada

Bourgeault

Labonté

et al. 2015

Can J Public Health

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OBJECTIVES: Community health workers (CHWs) have been deployed to provide health-related services to their fellow community members and to guide them through often complex health systems. They help address concerns about how marginalized populations in many countries experience health inequities that are due, in part, to lack of appropriate primary health care services, possibly resulting in inappropriate use of higher-cost health services or facilities. This paper reviews studies on CHW interventions in a number of high-income countries, including Canada, to identify research gaps on CHW roles. METHODS:A scoping review using 68 sources of interventions involving CHWs was undertaken. The five-step Arksey and O'Malley model guided this review with the aim of summarizing research findings and identifying research gaps in the existing literature on CHWs in Canada (23 sources). A standardized extraction tool was employed to synthesize the literature. SYNTHESIS:We found that CHWs provide a wide range of health-related services but in a manner that, in Canada, is unrecognized and unregulated. In highincome countries, CHW interventions have contributed to health-related issues in communities and demonstrated potential to both reduce health inequity in marginalized populations and reduce the cost of medical services. CONCLUSION:CHWs are an under-recognized, and therefore underutilized, public health workforce, which has a promising capacity to reduce health inequities in marginalized populations in Canada. There is growing support to suggest that CHW roles need to be better integrated within the broader health and social services systems to enable their full potential to be realized.KEY WORDS: Community health workers; human resources; Canada La traduction du résumé se trouve à la fin de l'article.Can J Public Health 2015;106(3):e157-e164 doi: 10.17269/CJPH.106.4747C ommunity health workers (CHWs) have been deployed in most countries (whether low-, middle-or highincome) to provide health-related services to their fellow community members and to guide them through often complex health systems. They help to address concerns about how marginalized populations and communities in many countries experience health inequities that are due, in part, to lack of appropriate primary health care services, possibly resulting in inappropriate use of higher-cost health services or facilities. [1][2][3][4] The World Health Organization (WHO) defines CHWs as "members of communities where they work, selected by and answerable to the communities for their activities, supported by the health system but not necessarily a part of its organization, and have shorter training than professional workers." 5 The 2006 World Health Report identified the use of CHWs as an important strategy to address the growing shortage of health workers, particularly in low-resource settings, as well as to achieve the health-related Millennium Development Goals. 6 The key research priorities related to CHWs in these settings are to know more about their re...

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Section: Education and Trainingmentioning

confidence: 99%

Section: Education and Trainingmentioning

confidence: 99%

Section: Evaluation Studiesmentioning

confidence: 99%

Section: Education and Trainingmentioning

confidence: 99%

See 2 more Smart Citations

Community health workers in Canada and other high-income countries: A scoping review and research gaps

Najafizada

Bourgeault

Labonté

et al. 2015

Can J Public Health

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show abstract

“…Table 2 outlines CHW roles, using categories guided by previous literature. [41][42][43][44][45] Several patient-facing roles were common: outreach and navigation to increase access, education and coaching, social support, facilitating communication with the health care system, and linkage to referrals and community resources. Clinic-specific roles appeared to depend upon perception of patient need and the extent to which CHWs functioned as an extension into the community.…”

Section: Team Structure and Chw Rolesmentioning

confidence: 99%

Integrating Community Health Workers Into Medical Homes

Rogers

Manser

Cleary³

et al. 2018

Ann Fam Med

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PURPOSE Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team. METHODSWe conducted 51 semistructured, key-informant interviews of clinic leaders, clinicians, care coordinators, CHWs, and staff from 9 clinics (5 with community health workers, 4 without). Qualitative analysis consisted of thematic coding aligned with interview topics.RESULTS Four key conceptual themes emerged as facilitators and barriers to utilizing a CHW model: the presence of leaders with knowledge of CHWs who championed the model, a clinic culture that favored piloting innovation vs maintaining established care models, clinic prioritization of patients' nonmedical needs, and leadership perceptions of sustainability. These health care workers performed common and clinic-specific roles that included outreach, health education and coaching, community resource linkage, system navigation, and facilitating communication between clinician and patient.CONCLUSIONS We identified facilitators and barriers to adopting CHW roles as part of PCMH care teams in Minnesota and documented their roles being played in these settings. Our findings can be used when considering strategies to enhance utilization and integration of this emerging workforce. 2018;16:14-20. https://doi.org/10.1370/afm.2171. Ann Fam Med INTRODUCTIONC ommunity health workers (CHWs), trusted frontline health workers who have a close understanding of the community served, 1 can be valuable contributors to the team-based and patient-centered care promoted through the patient-centered medical home (PCMH) model. 2 CHWs complement roles played by traditional health professionals through culturally sensitive outreach, patient education, resource identification, case management, care coordination, and patient support. [3][4][5][6] Interventions by CHWs supporting chronic disease self-management and preventive services show improved health care utilization, knowledge, self-care, adherence, health outcomes, and quality of life, particularly when these workers are integrated into primary care teams. 4,[7][8][9][10][11][12][13][14][15][16][17][18][19][20] Their interventions are most often directed to and studied in underserved communities (racial and ethnic minority and low-income populations, federally qualified health care [FQHC] settings), where the integration of these workers show benefit. 3,4,12,[21][22][23] Health authorities have called for expanding interventions by CHWs among clinics serving these populations, and recent policies create a platform for greater community health worker integration. [24][25][26] Researchers have explored the experience of ...

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Establishing a health profession: What oncology patient navigators can learn from the National Association of Community Health Workers

Rush¹,

Smith²,

Fox³

et al. 2022

Cancer

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Persons who identify as community health workers (CHWs) may hold other titles and/or certifications, including the title of patient navigator (PN). PN roles first emerged from Dr. Harold Freeman's initiative at Harlem Hospital as a strategy to reduce disparities in access to health care, whereas CHW roles extend beyond health systems and are predominantly found in community-based organizations and nonprofits. Although CHWs' origins in the United States predate those of PNs, the growth of CHWs' professional identity and national representation trails that of PNs despite evidence of CHWs' effectiveness since the 1960s. Barriers to progress have included a pattern of short-term and inequitable funding for CHW positions, a lack of employer support for participation in association business, and broad diversity in CHW roles and work settings. The National Association of Community Health Workers (NACHW) was launched in 2019 and built on earlier organizing efforts by multisector, multicultural CHWs and allies in the CHW section of the American Public Health Association and on efforts to create the American Association of Community Health Workers (2006Workers ( -2009. Trends in health care financing, increasing calls for racial equity, and the coronavirus disease 2019 (COVID-19) pandemic have amplified the unique abilities and trust that CHWs apply to underresourced, marginalized, and multiethnic populations to address both the social determinants of health and health system access, cost, and quality. As a result, the NACHW has been at the forefront of efforts to improve federal funding for COVID responses, to sustain funding for CHWs and their organizations beyond the pandemic, and to drive equity in the rebuilding of public health infrastructure and the transformation of payment models and health systems. Lessons learned from this process that have implications for the oncology patient navigation field include the persistent need to reinforce the value of self-determination for the profession in matters of policy; the importance of actively cultivating unity among diverse cultural and practice groups within the profession; the essential roles of active volunteer leadership, early staffing, and substantial financial support over an extended startup period; the ongoing need for leadership development within a workforce with limited exposure to a professional association culture; the vital importance of ongoing efforts to collaborate with and build capacity among state-level CHW networks; and the value of opportunistic national collaborations in a rapidly evolving policy environment.

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Community Health Workers Then and Now

Cited by 89 publications

References 10 publications

Community health workers in Canada and other high-income countries: A scoping review and research gaps

Community health workers in Canada and other high-income countries: A scoping review and research gaps

Integrating Community Health Workers Into Medical Homes

Establishing a health profession: What oncology patient navigators can learn from the National Association of Community Health Workers

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