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. Method: 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. Conclusion: 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 CHWs are a potential new and skilled healthcare workforce that could help improve healthcare access and utilization among underserved populations in the United States.