Core Competencies and a Workforce Framework for Community Health Workers: A Model for Advancing the Profession

Abstract

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.

A mixed methods evaluation of the feasibility, acceptability, and impact of a pilot project ECHO for community health workers (CHWs)

“…A national survey of the CHW workforce revealed variations in role definition and training criteria to support their professional development [12]. Online and in-person training resources for CHWs also vary considerably in content, quality, and access [15][16][17].…”

Effect of Community Health Workers on 30-Day Hospital Readmissions in an Accountable Care Organization Population

“…This represents an area of opportunity to more completely categorize and describe CHW outreach as part of an evidence base. 42 , 43 , 44 , 45 …”

The Development of a Novel, Standards-Based Core Curriculum for Community Facing, Clinic-Based Community Health Workers

“…One of the first groundbreaking efforts to develop CHW competencies came in 1998 with the report from the National Community Health Advisor Study (23). Another effort came in the form of a strategic initiative of the California Endowment's Building Healthy Communities partnering with the organization Visíon y Compromiso, which resulted in a framing paper highlighting roles and 10 defining characteristics and values that make a successful promotora de salud (24). This effort emphasized the importance of CHW qualities of having similar life experiences as the community being served, being trusted members of the community, and communicating community needs to organizations and compassion-based service, describing it as "servicio de corazón" (service from the heart) (24).…”

“…Another effort came in the form of a strategic initiative of the California Endowment's Building Healthy Communities partnering with the organization Visíon y Compromiso, which resulted in a framing paper highlighting roles and 10 defining characteristics and values that make a successful promotora de salud (24). This effort emphasized the importance of CHW qualities of having similar life experiences as the community being served, being trusted members of the community, and communicating community needs to organizations and compassion-based service, describing it as "servicio de corazón" (service from the heart) (24). A more recent research initiative attempted to establish a validated, standardized set of 27 core CHW competencies and a linked workforce framework, delineating three categories of CHWs based upon training, workplace, and scope of practice (25).…”