Objectives. To establish a validated, standardized set of core competencies for community health workers (CHWs) and a linked workforce framework. Methods. We conducted a review of the literature on CHW competency development (August 2015), completed a structured analysis of literature sources to develop a workforce framework, convened an expert panel to review the framework and write measurable competencies, and validated the competencies (August 2017) by using a 5-point Likert scale survey with 58 participants in person in Biloxi, Mississippi, and electronically across the United States. Results. The workforce framework delineates 3 categories of CHWs based upon training, workplace, and scope of practice. Each of the 27 competencies was validated with a mean of less than 3 (range = 1.12–2.27) and a simple majority of participants rated all competencies as “extremely important” or “very important.” Conclusions. Writing measurable competencies and linking the competencies to a workforce framework are significant advances for CHW workforce development. Public Health Implications. The standardized core competencies and workforce framework are important for addressing health disparities and maximizing CHW effectiveness.

AcknowledgementsThe community members of Panaillo taught me so much that extends far beyond this research and have inspired me to work harder and to be better. I deeply appreciate their friendship, their faith, and their endless supply of paranta shui. The quality, scope and meaning of this research are a direct result of their hard work. I am extremely grateful to my supervisor, Dr. James Ford, for serving as an invaluable mentor to me for several years. He introduced me to the concepts and politics surrounding climate change adaptation and has inspired me to continue working in this field for many years to come. He taught me to think critically about my own work and the work of others and I admire his commitment to community engagement and to resolving these 'wicked' problems. Through his guidance and example, I have learned how to make meaningful impacts in climate change adaptation research and I truly appreciate the freedom he has given me in carrying out this research.

Institution-oriented, top-down and community-oriented, bottom-up stakeholder approaches are evaluated for their ability to enable or constrain the implementation of adaptation in developing nations. A systematic review approach is used evaluate the project performance of 18 adaptation projects by three of the Global Environment Facility's (GEF) adaptation programmes (the Strategic Priority for Adaptation (SPA), the Special Climate Change Fund (SCCF), and the National Adaptation Programs of Action (NAPA)) according to effectiveness, efficiency, equity, legitimacy, flexibility, sustainability, and replicability. The ten SPA projects reviewed performed highest overall, especially with regards to efficiency, legitimacy, and replicability. The five SCCF projects performed the highest in equity, flexibility, and sustainability, and the three NAPA-related projects were the highestperforming projects with regards to effectiveness. A comparison of top-down and bottom-up approaches revealed that community stakeholder engagement in project design and implementation led to higher effectiveness, efficiency, equity, flexibility, legitimacy, sustainability, and replicability. Although low institutional capacity constrained both project success and effective community participation, projects that hired international staff to assist in implementation experienced higher overall performance. These case studies also illustrate how participatory methods can fail to genuinely empower or involve communities in adaptation interventions in both top-down and bottom-up approaches. It is thus crucial to carefully consider stakeholder engagement strategies in adaptation interventions. Policy relevanceWhile adaptation is now firmly on the policy and research agenda, actual interventions to reduce vulnerability and enhance resilience remain in their infancy, and there is limited information on the factors that influence the successful implementation of adaptation in developing areas. Engaging stakeholders in assessing vulnerability and implementing adaptation interventions is widely regarded to be an important factor for adaptation implementation and success. However, no study has evaluated the effects of stakeholder engagement in the actual implementation of adaptation initiatives. Effective stakeholder engagement is challenging, especially in a developing nation setting, due to high levels of poverty, inadequate knowledge on adaptation options, weak institutions, and competing interests to address more immediate problems related to poverty and underdevelopment. In this context, this article documents and characterizes stakeholder engagement in adaptation interventions supported through the GEF, examining how top-down or bottom-up stakeholder approaches enable or constrain project performance.

Community‐based adaptation (CBA) has emerged over the last decade as an approach to empowering communities to plan for and cope with the impacts of climate change. While such approaches have been widely advocated, few have critically examined the tensions and challenges that CBA brings. Responding to this gap, this article critically examines the use of CBA approaches with Inuit communities in Canada. We suggest that CBA holds significant promise to make adaptation research more democratic and responsive to local needs, providing a basis for developing locally appropriate adaptations based on local/indigenous and Western knowledge. Yet, we argue that CBA is not a panacea, and its common portrayal as such obscures its limitations, nuances, and challenges. Indeed, if uncritically adopted, CBA can potentially lead to maladaptation, may be inappropriate in some instances, can legitimize outside intervention and control, and may further marginalize communities. We identify responsibilities for researchers engaging in CBA work to manage these challenges, emphasizing the centrality of how knowledge is generated, the need for project flexibility and openness to change, and the importance of ensuring partnerships between researchers and communities are transparent. Researchers also need to be realistic about what CBA can achieve, and should not assume that research has a positive role to play in community adaptation just because it utilizes participatory approaches. WIREs Clim Change 2016, 7:175–191. doi: 10.1002/wcc.376For further resources related to this article, please visit the WIREs website.