Community health worker training and certification programs in the United States: findings from a national survey.
OBJECTIVE
To analyze trends and various approaches to professional development in selected community health worker (CHW) training and certification programs in the United States. We examined the expected outcomes and goals of different training and certification programs related to individual CHWs as well as the community they serve.


METHODS
A national survey of CHW training and certification programs. Data collection was performed through personal interviews, phone interviews and focus groups. Data sources included public health officials, healthcare associations, CHW networks, community colleges, and service providers. Initial screening interviews resulted in in-depth interviews with participants in 19 states. We applied human capital theory concepts to the analysis of the rich qualitative data collected in each state.


RESULTS
CHW programs in the U.S. seem to have been initiated mainly due to lack of access to healthcare services in culturally, economically, and geographically isolated communities. Three trends in CHW workforce development were identified from the results of the national survey: (1) schooling at the community college level - provides career advancement opportunities; (2) on-the-job training - improves standards of care, CHW income, and retention; and (3) certification at the state level - recognizes the work of CHWs, and facilitates Medicaid reimbursement for CHW services.


CONCLUSIONS
Study findings present opportunities for CHW knowledge and skill improvement approaches that can be targeted at specific individual career, service agency, or community level goals. Trained and/or certified community health workers are a potential new and skilled healthcare workforce that could help improve healthcare access and utilization among underserved populations in the United States.
School of Rural Public Health, Texas A&M University Health Science Center, TAMU 1266, College Station, TX 77843, USA. bakash@srph.tamhsc.edu
Bita Arbab
BA
Kash
Marlynn Lee
ML
May
Ming
M
Tai-Seale
D002568:Certification; D003150:Community Health Workers / Q000193:education*; D003625:Data Collection; D007407:Interviews as Topic; D013219:State Government; D014481:United States