Community health workers (CHWs) are front-line public health professionals who are trusted members of the communities in which they work. These trusting relationships enable them to “bridge cultural and social gaps between providers of health and social services and the community members they seek to serve.”1(p435)
Therefore, CHWs are extremely valuable given the growth of minority and underserved populations whom health care providers often have difficulty reaching2,3
and are increasingly recognized as effective resources for improving community health. However, little published information exists on CHW training programs and curricula that prepare CHWs involved in community–academic initiatives (CAIs) in which community members and organizations partner and collaborate with academic institutions on research studies, health interventions, and other programs.
We outline the development and implementation of the New York University Prevention Research Center’s (NYU PRC’s) core competency–based CAI–CHW Training Program and report quantitative and qualitative evaluation results from the pilot training.
The impetus for developing this competency-based CAI–CHW training program includes (1) national recognition of the CHW workforce, (2) efforts to identify CHW roles, and (3) a body of literature that stresses diverse training needs for CAI–CHWs.
National organizations, such as the American Public Health Association and the Institute of Medicine, have recognized CHWs as effective and low-cost “community-based resources” that can be utilized to improve community health and well-being, reduce health disparities, and bridge the cultural and social barriers between underserved communities and the health care system.2(p195),4
CHW leaders and supporters submitted a petition that was granted in 2009 by the Bureau of Labor Statistics to identify “community health worker” as a distinct Standard Occupational Classification, reflecting a desire to develop a nationally recognized definition for the work performed by CHWs.
As recognition of the value of the CHW workforce continues to expand, CHW training programs will become increasingly significant and relevant.
In 1998, the National Community Health Advisor Study established benchmarks on CHW workforce development and defined a set of key functional areas for CHW activity that were later fused into 7 essential CHW roles:
- bridging and providing cultural mediation between communities and health and social service systems;
- providing culturally appropriate health education and information;
- ensuring people get services they need;
- providing informal counseling and social support;
- advocating for individual and community needs;
- providing direct service, such as basic first aid and administering health screening tests; and
- building individual and community capacity.5–7
Recent studies have identified additional roles for CHWs, including research.8,9
Community– academic initiatives that seek to better understand and eliminate health disparities have integrated CHWs into their work because of CHWs’ unique “insider” status and access to accurate information in traditionally hard-to-reach communities.10,11
The capacity of CHWs to become integral members of CAIs can be further enhanced by cultivating core competencies and skills that strengthen their understanding of the research process and the context in which health issues emerge.
The movement toward developing a shared understanding of the essential roles of CHWs yields powerful information about the training needs of this workforce. Indeed, CHWs them-selves express a desire for core competency–based training rather than just problem-specific training around particular health issues and populations.12
For instance, in a 2008 qualitative study that sought to gather CHW input on training needs, CHWs indicated receiving primarily problem- and population-specific training, but little or no core competency training. Moreover, CHWs reported that trainings do not often cover broader community and family health issues or the larger context of socioeconomic or political problems.12
The study also revealed training needs in core competencies and specialization topics, including research skills. Similarly, Hardy et al. described a study that identified the need to train CHWs as research partners.11
Terpstra et al. assessed a need to develop skills in basic research design, informed consent, and research ethics including the role of institutional review boards.13
The increased utilization of CHWs in research stresses the need for training that meets the learning needs and interests of the CAI–CHW workforce, including core competencies and research specialization.