Evaluating the impact of a community health worker training program | Journal of Health, Population and Nutrition

CHW participant characteristics

Of the 349 participants, participants were female (82%), 16% held high school diplomas, 26% had some college, 10% held associate degrees, 30% held a bachelor’s degree, 16% held master’s degrees, and 2% held doctoral degrees. The mean age was 47.27 years (SD ± 16.26; range 19–88). Over 75% of participants identified as Black or African American, 13% as White, 6% as Asian, 4% as multiracial, 1% as Native Hawaiian or Pacific Islander, and 1% as American Indian or Alaskan Native. Ten percent identified as Hispanic/Latino. Over 80% of participants were new to the CHW role, with 19% reporting that they were currently either working or volunteering as CHWs.

Online module results

Throughout the program, 349 participants (100% response) rated the 55 ARCHWAy online modules as 4.5 or better on a scale of 1 to 5 as helping participants reach their learning objectives, ease of use of online modules, and visual appeal as shown in Table 1. The in-person sessions received positive evaluations as listed in Table 2, underscoring the program’s ability to deliver content effectively through various instructional modes. The selected trainings presented in Tables 1 and 2 are representative of the entire curriculum.

Experiential learning encounter logs

The CHW trainees were asked to complete encounter logs for their individual and group encounters as described above. This was a required activity for their experiential field placements. The top 10 services provided based on encounters, in order, were: (1) resource and referral education, (2) individual assessment, (3) education, (4) care coordination, (5) community assessment, (6) community education, (7) mental health first aid, (8) service coordination, (9) SDOH, and (10) chronic disease management. CHWs were most likely to report independently providing resource or referral education and collaboratively with other providers coordinating care. Activities that CHWs most often reported observation only included individual assessments and mental health first aid.

The top 10 SDOH discussed by CHWs based on encounters, in order, were: (1) access to care, (2) access to nutritious food, (3) health literacy, (4) access to primary care provider, (5) housing situation, (6) utilities, (7) language barriers, (8) level of education, (9) occupation, and (10) immigration status.

Reflections

Fifty percent of ARCHWAy participants submitted reflections. Four themes were identified: (1) personal impact and application of training, (2) bridging communities and accessing resources, (3) overcoming challenges and cultivating strengths, and (4) expanding role of CHWs on engaging communities.

Personal impact and application of training: Participants shared that “The CHW training is a reminder of the techniques that I am required to exercise. I am required to use open-ended questions to provoke discussion or clarity of the client’s situation. Open-ended questions can sometimes be challenging to present, but maintaining focus on the intended outcome is helpful. The exercises have provided good narratives to enhance this skill.” One participant reflected that “The most recent study about HIV/AIDS has profoundly awakened my sensitivity to victims of sexual assault. Heretofore, I focused on victims of drug/alcohol addiction or persons infected through blood transfusions. The course expanded my awareness to sexually abused individuals whose lives are forever changed.” While some reflections focused on applying specific topics in the field, one commented on the impact of the CHW role that “I have a better understanding of what it means to be a CHW. I have a family member that is dealing with mental health, for example. Now I can see myself using a different approach when suggesting resources for him.” “I can see myself using this content I have learned each day as a healthcare worker and in my everyday life, especially communicating with patients and understanding their needs and reasoning.”

Bridging communities and accessing resources: Participants revealed the impact of CHWs on removing barriers to support access to care in when one stated that “Having worked in underserved communities that lacked access to quality healthcare, I am now more empowered to work with faith-based institutions and churches, helping them create health initiatives and bridge the gap between residents and health professionals.” A participant remarked that “The module on Caring for the LGBTQI + Community was very informative and raised my level of sensitivity regarding the needs and lack of access to healthcare due to discriminatory practices in this population.” Another participant recognized the importance of coordinating community resources to access culturally appropriate care “One key area where I am already using this training is navigating community resources and systems to assist families with state benefit applications, food assistance, and healthcare access. Understanding how to build trust, engage diverse populations, and bridge language and cultural barriers has been invaluable in serving non-native English speakers and individuals with disabilities.”

Overcoming challenges and cultivating strengths: CHWs encounter many challenges when trying to provide services and some are able to change those to strengths. One participant stated that “A success that stands out is how this training has strengthened my ability to collaborate with healthcare providers, such as Two Rivers Health Clinic, to provide culturally competent health education. At the same time, a challenge I continue to navigate is ensuring sustainable access to care and resources, particularly in communities with limited transportation and financial barriers.” A second participant reflected that “By using the content that I have learned, I have become better at serving the people I come in contact with facing the challenges that come with helping people.” Another participant shared that “I see myself as a connector by bridging the gap between individuals in need and the resources that can support their well-being. My lived experiences have given me a deep understanding of the challenges people face, especially in areas like mental health, addiction recovery, and disability services.”

Expanding role of CHWs on engaging communities The role of CHWs continue to grow as unmet individual and community needs increase, and CHWs are seen as trusted members of healthcare teams. For example, one participant shared that “I’ve learned a lot about being a Community Health Worker, but the most important thing to me is learning how to go out into the community and be a listening ear—building trust among the people so I can advocate, inform, persuade, build relationships, and provide them with the resources they need.” Another stated that “This training has ignited the energy within me to be an advocate for socioeconomic justice, human rights, and just plainly caring for people.” This participant said it best that “One of the most important things I have learned is the power of culturally responsive care and advocacy. Many individuals in underserved communities, especially non-native English speakers and those with disabilities, struggle to access the resources they need due to language, financial, or systemic barriers. Through my training and experience, I have learned how to navigate these systems, build trust, and empower individuals to advocate for their own health and well-being.”