Community Health Workers: Roles and Opportunities in Health Care Delivery System Reform

A number of states have adopted certification programs for community health workers (CHWs) to improve recognition of CHWs as members of health care teams, increase oversight, and to provide sustainable funding. There has been little research into the impact of state CHW certification on the diffusion and adoption of CHWs into existing health care systems. This study examined the impact of state CHW certification on the perceptions of team climate among registered nurses (RNs) who work with CHWs in states with and without CHW certification programs. The study recruited RNs using a purposeful sampling method and used an online survey, which included the Team Climate Inventory (TCI), and
compared the perceptions of team climate between the two
groups. The study found no significant differences in the
overall mean TCI score or TCI subscale scores between
RNs who work in states with CHW certification programs
(n = 81) and those who work in states without CHW
certification programs (n = 115). There was a statistically
significant difference on one survey question regarding
whether RNs believe state certification of CHWs improved
the ability of their health care team to deliver quality care.
More research is needed to assess impact of state certification of CHWs and other factors that influence the diffusion and adoption of CHWs into the current health care
system. Keywords State certification, Community health
worker, Diffusion, Registered nurses, Team climate