Community-Clinical Linkages With Community Health Workers in the United States: A Scoping Review

Authors: Lohr A, Ingram M, Nuñez A, Reinschmidt K, Carvajal S
Year: 2018
State: NatDoc: National Document
Website link:
Publicly Available: Yes
Billing and Reimbursement:
Certification: CHW role scope of practice
Evidence Generation:
Policy: Lessons learned from other states
Sustainable Financing: How to engage and work with Medicaid, Including community-based CHWs, Reimbursement TA for FQHCs Medicaid etc., Documentation of how CHWs can work within care teams, Evidence-based interventions, Surveys and assessment tools to define and develop workforce
Workforce Development: CDC expand CHW work into SDOH, Chronic Disease, Data sharing between social services and clinical teams, General other (including mention of “employment practices”), Outreach education and TA to employers on CHW generally

Despite the proliferation of community–clinical linkage (CCL) interventions with community health workers (CHWs), little is known about the components of these programs or how linkages are realized. In this scoping review, we synthesize evidence concerning the role of CHWs in creating and sustaining CCLs aimed at improv- ing individual health outcomes. Our inclusion criteria included peer-reviewed articles that described a CHW intervention in the United States that used a CCL model. A total of 2,776 titles and/or abstracts were screened and 47 articles underwent full text review. Two independent reviewers rated the screened articles based on additional criteria including the CHW connection to community and evidence of linkage follow up rather than simple referral. For the 11 peer-reviewed articles included in the final review, we describe the CHW’s relationship to the community, training, and role within the intervention, linkage, and outcomes. We used a standardized framework to determine commonalities in CHW roles across the interventions. CCLs with CHWs positively affect the delivery of both clinical care and community resources across a range of disease areas in a variety of contexts. To identify effective CCL models, additional information on CHW training, CCL follow-up methods, and the CHW role in CCLs is recommended.

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