Impact of Community Health Worker Certification on Workforce and Service Delivery for Asthma and Other Selected Chronic Diseases

Ibe, Chidinma A.; Wilson, Lisa M; Brodine, Joseph; Monroe, Dwyan; Boonyasai, Romsai T.; Meza, Benjamin; Tschudy, Megan M.; McArthur, Kristen; Robinson, Karen A.

doi:10.23970/ahrqepctb34

Cited by 8 publications

(7 citation statements)

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“…Other reasons include the loss of CHW identity and job‐specific training requirements. This has been substantiated in the literature, where there is concern that certification will prevent CHWs from obtaining employment or accessing minority populations (CDC, 2019; Clary, 2015; Ibe et al., 2020; Kissinger et al., 2022).…”

Section: Discussionmentioning

confidence: 93%

“…The actual numbers of CHWs might have been underestimated due to various definitions of CHWs that emerge outside of specific BLS occupational codes, and a large portion of the workforce working as unpaid volunteers. As the workforce continues to grow, there have been discussions at the national level to standardize the roles and responsibilities of CHWs, especially considering the lack of workplace validation, accountability, and reimbursement for the services provided by CHWs (Anabui et al., 2021; CDC, 2019; Ibe et al., 2020; Jones et al., 2021; Kissinger et al., 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Closely related to the opposing attitudes toward CHW certification is the lack of evidence on the impact of CHW certification on the performance of CHWs and the clinical outcomes of the patients they serve. In 2020, AHRQ released a report documenting the impact of CHW Certification on workforce and service delivery for chronic diseases (Ibe et al., 2020). The authors in this study reported that they did not find any studies that evaluated the effect of CHW certification on the health outcomes or the quality or consistency of care that CHWs provided to patients.…”

Section: Introductionmentioning

confidence: 99%

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Perspectives on certification of community health workers: A statewide mixed‐methods assessment in Nebraska

Ern

Chaidez

Trout

et al. 2023

Public Health Nursing

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Objectives: While the Community Health Worker (CHW) workforce in the United States has been growing, so far only 19 states certify CHWs. This study sought to identify perspectives on CHW certification among stakeholders in Nebraska, a state that has not established official certification for CHWs yet. Design: A concurrent triangulation mixed methods design. Sample: Study data came from a survey of 142 CHWs in Nebraska and interviews with 8 key informants employing CHWs conducted in 2019. Methods: Logistic regression was used to identify significant factors associated with favoring CHW certification, supplemented by thematic analysis of qualitative data from CHWs and key informants. Results: The majority (84%) of CHWs were in favor of a statewide CHW certification in Nebraska, citing community benefits, workforce validation, and standardization of knowledge as the main reasons. Participant characteristics associated with favoring CHW certification included younger age, racial minority, foreign born, education lower than bachelor's degree, volunteering as a CHW, and employed for less than 5 years as a CHW. Key informants employing CHWs were divided in whether Nebraska should develop a state certification program. Conclusions: While most CHWs in Nebraska wanted to have a statewide certification program, employers of CHWs were less sure of the need for certification. K E Y W O R D S certification, community health, community health workers, health workforce INTRODUCTIONCommunity Health Workers (CHWs) are individuals from the community who have been trained to help fellow community members improve their access to health services, change health behaviors, and reduce health disparities (Katigbak et al., 2015;Sabo et al., 2013).

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perspectives on certification of community health workers: A statewide mixed‐methods assessment in Nebraska

Ern

Chaidez

Trout

et al. 2023

Public Health Nursing

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“…(28) CHW certi cation may provide the necessary support context to enable successful CHW programs within the larger healthcare system, (27) although there is lacking evidence regarding the relationship between certi cation and quality of care or patient outcomes. (32) Although certi cation has several bene ts, there are risks that certi cation and increased regulation may lead to narrow or rigid scopes of practice and over-medicalization of the eld, undermining the community-centric orientation that often make CHWs so successful. In addition, there is a risk that certi cation processes could exclude people who may naturally be very effective CHWs but are turned away by regulatory criteria serving as barriers to entry and due to cost.…”

Section: Growth Of the Chw Workforcementioning

confidence: 99%

Evaluating the Association of State Regulation of Community Health Workers on Adoption of Standard Roles, Skills, and Qualities by Employers in Select States: A Mixed Methods Study

Jones

Schulte

Ramanathan

et al. 2021

Preprint

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BackgroundThe occupation of Community Health Worker (CHW) has evolved to support community member navigation of complex health and social systems. The U.S. Bureau of Labor Statistics formally recognized the occupation of Community Health Worker (CHW) in 2009. Since then, various national and state level efforts to professionalize the occupation have been undertaken. The Community Health Workers Core Consensus (C3) project released a set of CHW roles and competency recommendations meant to provide evidence-based standards for CHW roles across work settings. Some states have adopted the recommendations, however, there are a variety of approaches regarding the regulation of the occupation. As of 2020, 19 U.S. states have implemented voluntary statewide CHW certification programs. The purpose of this study was to explore the relationship between state regulation of CHWs and adoption of standard roles, skills, and qualities by employers in select states.MethodsThis mixed methods study used purposive sampling of job ads for CHWs posted by employers from 2017-2020 in select states. Natural language processing was used to extract content from job ads and preprocess the data for statistical analysis. ANOVA, chi-square analysis, and MANOVA was used to test hypotheses related to the relationship between state regulation of CHWs and differences in skills, roles, and qualities employers seek based seniority of state regulatory processes and employer types.ResultsWe observe that the mean job ads with nationally identified roles (F(6, 80549) = 109.43, p = 0.000), skills (F(6, 80549) = 136.13, p = 0.000), and qualities (F(6, 80549) = 257.29, p = 0.000) included varies significantly between individual states, by state type, and by employer type. ConclusionsEmployment of CHWs is increasing as a means to provide culturally competent care, address the social determinants of health, and improve access to health and social services for members of traditionally underserved communities. Employers in states with CHW certification programs were associated with greater adoption of occupational standards set by state and professional organizations. Wide adoption of such standards may improve recognition of the CHW workforce as a valuable resource in addressing the needs of marginalized and difficult to serve groups.

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“… 11 Nonetheless, CHWs have not been consistently integrated into healthcare settings and their role in hypertension prevention is unclear. 12 More importantly, few approaches to prevent hypertension combine multi-level strategies into a pragmatic and sustainable plan, improve patient-centered outcomes in underserved communities, and explicitly address social needs.…”

mentioning

confidence: 99%

Design and Rationale of the Home Blood Pressure Telemonitoring Linked with Community Health Workers to Improve Blood Pressure (LINKED-BP) Program

Commodore‐Mensah

Liu

Ogungbe

et al. 2023

American Journal of Hypertension

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BACKGROUND Disparities in hypertension outcomes persist among Black and Hispanic adults and persons living in poverty in the United States. The “LINKED-BP Program” is a multi-level intervention linking home blood pressure (BP) monitoring with a mobile health application, support from community health workers (CHWs), and BP measurement training at primary care practices to improve BP. This study is part of the American Heart Association RESTORE (AddREssing Social Determinants TO pRevent hypErtension) Network. This study aims to examine the effect of the LINKED-BP Program on BP reduction and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the intervention. METHODS Using a hybrid type I effectiveness-implementation design, 600 adults who have elevated BP or untreated stage 1 hypertension without diabetes, chronic kidney disease, history of cardiovascular disease (stroke or coronary heart disease) and age < 65 years will be recruited from 20 primary care practices including community health centers in the Maryland area. The practices are randomly assigned to the intervention or the enhanced usual care arms. Patients in the LINKED-BP Program receive training on home BP monitoring, BP telemonitoring through the Sphygmo app, and CHW telehealth visits for education and counseling on lifestyle modification over 12 months. The primary clinical outcome is change from baseline in systolic BP at 6 and 12 months. DISCUSSIONS The LINKED-BP Program tests a sustainable, scalable approach to prevent hypertension and advance health equity. The findings will inform implementation strategies that address social determinants of health and barriers to hypertension prevention in underserved populations. ClinicalTrials.gov IDENTIFIER NCT05180045.

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Impact of Community Health Worker Certification on Workforce and Service Delivery for Asthma and Other Selected Chronic Diseases

Cited by 8 publications

References 0 publications

Perspectives on certification of community health workers: A statewide mixed‐methods assessment in Nebraska

Perspectives on certification of community health workers: A statewide mixed‐methods assessment in Nebraska

Evaluating the Association of State Regulation of Community Health Workers on Adoption of Standard Roles, Skills, and Qualities by Employers in Select States: A Mixed Methods Study

Design and Rationale of the Home Blood Pressure Telemonitoring Linked with Community Health Workers to Improve Blood Pressure (LINKED-BP) Program

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