Integration of Community Health Workers into Public Health Initiatives for Rural and Urban Communities

Context: As medical costs continue to escalate, the demand for community health workers (CHWs) will also continue to rise in order to teach the public about healthy habits and behaviors to avoid costly chronic conditions or medical procedures. In fact, overall employment of community health workers is projected to grow 13 percent from 2019 to 2029. While the CHW field is burgeoning, both in interest and demand, the practice lacks openly available training opportunities.

Objective: To inform the statewide expansion of a CHW training program, we sought perspectives from multiple CHW stakeholders to glean insights on job satisfaction, performance observations, and training/curriculum feedback

Study Design and Analysis: We conducted a qualitative research study of one-time, one-on-one interviews with past/present/prospective CHWs and CHW supervisors. Participants had the option to choose an interview that was conducted in-person, by phone, or through teleconferencing. Interviews were audio recorded and transcribed verbatim. We analyzed the interviews using principles of thematic analysis.

Setting or Dataset: This research represents a community-academic partnership between the Medical College of Wisconsin and Milwaukee Area Health Education Center.

Population Studied: We conducted interviews with past, present, and prospective CHWs. We also conducted interviews with CHW supervisors.

Intervention/Instrument: We used a semi-structured interview guide to ask participants open-ended questions related to their experiences as CHWs or CHW supervisors. Question prompts spanned the following areas: 1) job satisfaction, 2) performance observations, 3) value of CHWs, 4) curriculum/training feedback, 5) support need as a CHW supervisor.

Outcome Measures: The outcomes of interest are the qualitative themes emerged from thematic analysis of the data.

Results: Thematic categories included: 1) strategies for how CHWs learn their role(s), 2) CHW impact, 3) CHW challenges/opportunities, 4) CHW tools, and 5) CHW training needs.

Conclusions: CHWs serve diverse community members across many sectors of primary care. This, coupled with demand to increase the CHW workforce, builds a compelling case to create rigorous and responsive CHW training programs that align with the needs of CHWs and CHW supervisors.