Community Health Workers in Hawai’i: A Scoping Review and Framework Analysis of Existing Evidence

Authors: David A. Stupplebeen MPH; Alexis T. Barnett-Sherrill MPH, MS; and Tetine L. Sentell PhD
Year: 2019
State: HI
Website link:
Publicly Available: Yes
Certification: CHW role scope of practice, Competencies, Process and development, Training and training programs
Evidence Generation: Documentation of how CHWs can work within care teams, Evidence-based interventions, Results from pilots studies etc. that aren't published in formal literature
Policy: General language around CHW WD
Sustainable Financing: Expand evidence base, Including community-based CHWs, Reimbursement TA for FQHCs Medicaid etc., Documentation of how CHWs can work within care teams, Results from pilots studies etc. that aren't published in formal literature, ROI and bundled payment successes/challenges, Surveys and assessment tools to define and develop workforce
Workforce Development: Chronic Disease, CHW training programs (not cert.), Outreach campaigns to identify CHWs, Training- Content modes delivery

Community health workers (CHWs) play a vital role in health across Hawai‘i, but the scope of this work is not comprehensively collated. This scoping review describes the existing evidence of the roles and responsibilities of CHWs in Hawai‘i. Between May and October 2018, researchers gathered documents (eg, reports, journal articles) relevant to Hawai‘i CHWs from health organizations, government entities, colleges/universities, and CHWs. Documents were reviewed for overall focus and content, then analyzed using the Centers for Disease Control and Prevention’s 10 Essential Public Health Services as well as the Community Health Worker Core Consensus Project roles to identify workplace roles and gaps. Of 92 documents received, 68 were included for review. The oldest document dated to 1995. Document types included curricula outlines, unpublished reports, and peer-reviewed articles. Documents discussed trainings, certification programs, CHWs’ roles in interventions, and community-, clinical-, and/or patient-level outcomes. Cultural concordance parity between CHWs and patients, cost savings, and barriers to CHW work were noted. Most roles named by the Community Health Worker Core Consensus Project were mentioned in documents, but few were related to the roles of “community/policy advocacy” and “participation in research and evaluation.” Workplace roles, as determined using the 10 Essential Public Health Services, focused more on “assuring workforce competency” and “evaluation,” and less on “policy development,”and “enforcing laws.” CHWs are an important part of Hawaii’s health system and engage in many public health functions. Although CHW roles in Hawai‘i mirrored those identified by the CHW Core Consensus Project and 10 Essential Public Health Services frameworks, there is a noticeable gap in Hawai‘i CHW professional participation in research, evaluation, and community advocacy.

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