Within the broad framework of those objectives, participant discussions centered on several themes and concepts. This report summarizes the insights and opinions of the participants around those themes.
This report is not a consensus document— that is, the forum discussion was not intended to achieve agreement among all participants— nor does it represent official recommendations endorsed by CDC. Rather, it offers the perspective of diverse CHWs, allies, supporters, and states on what they believe is needed to build an infrastructure for CHW sustainability and financing.
Defining CHWs’ Roles and Developing the Workforce
Increasing Integration of CHWs in Health Care Systems and Community-Based Organizations
Improving CHW Compensation and Documentation of CHWs’ Contributions
Promising Practices and Lessons Learned about CHWs’ Roles in CDCrecognized lifestyle change programs for type 2 diabetes prevention and/or ADArecognized/AADE-accredited DSMES services for diabetes management
This CHW forum provided many helpful insights that will inform future work. CDC will consider how to incorporate this information in a training and technical assistance guide for working with CHWs in this arena, which is currently under development, and explore development of other materials such as job aids to distill key information and foster communication with and support for state health departments.
Understanding Scope and Competencies: A Contemporary Look at the United States Community Health Worker Field Progress Report of the Community Health Worker (CHW) Core Consensus (C3) Project: BUILDING NATIONAL CONSENSUS ON CHW CORE ROLES, SKILLS, AND QUALITIES
Project Focus: to help advance consensus in the U.S. Community Health Worker (CHW) field by producing recommendations for consideration and adoption on common elements of CHW Scope of Practice and Core Competencies. It is anticipated these recommendations, building on foundational work in the field, will be useful in various settings including in the design of training curricula and CHW practice guidelines for use at the local, state, and national levels.
defines CHWs as
“…a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.”
CHWs, also known as Promotores de Salud, outreach workers, lay health advisors and other titles, have been contributing to public health for decades, but have come to greater prominence in recent years through a growing body of research attesting to their contributions, recognition as an occupation by the U.S. Department of Labor and prominent mention in the Patient Protection and Affordable Care Act. State and federal policy, however, have not kept pace with the growing interest in this workforce. At least a dozen states are seeing significant movement toward more supportive policies around CHWs.
Community Health Advisors (CHA) help people take greater control over their health and their lives. They promote healthy living by educating about how to prevent disease and injury as well as how to access health and human service systems. The National Community Health Advisory Study identified steps to strengthen outreach services of CHAs across the country. The study was funded by the Annie E. Casey Foundation.
Table of Contents
3. Core Roles and Competencies of Community Health Advisors (pp. 11-17)
Study Chapter written by Noel Wiggins, MSPH (Assisted by Angelina Borbon, PHN)
4. Evaluating CHA Services (pp. 18-24)
Study Chapter written by J. Nell Brownstein, PhD (Assisted by E. Lee Rosenthal, MPH)
5. Community Health Advisors - A Career in Development (pp. 25-33)
Study Chapter written by E. Lee Rosenthal, MPH
Study Youth Supplement written by Roberta Rael, et al.
6. Community Health Advisors in the Changing Health System (pp. 34-41)
Study Chapter written by Sarah Johnson, MSW, MPH
7. Conclusion (pp. 42-44)
Study Chapter written by E. Lee Rosenthal, MPH
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Wadge H, et al. Brazil’s Family Health Strategy: Using Community Health Care Workers to Provide Primary Care. The Commonwealth Fund, Dec. 13, 2016. https://www.commonwealthfund.org/publications/case-study/2016/dec/brazils-family-health-strategy-using-community-health-care-workers
Zulliger R. The Community Health Agent Program of Brazil. CHW Central. 2018. http://www.chwcentral.org/blog/community-health-agent-program-brazil(opens new window)