Preserving a Transformative Community Health Worker/Promotor Workforce

COVID-19 not only revealed our vulnerability, but also showed us the strength and resilience that exists within our communities and is embodied by community health workers and promotores (CHWs/Ps). We see a trend of more organizations integrating CHWs/Ps into their operations. These institutions can become partners in preserving the health equity roots of CHWs/Ps by assuming more roles that promote community transformation. Yet, the systems around payment, reimbursement, and integration models for CHWs/Ps that are being developed have attempted to fit CHWs/Ps into existing organizational systems and paradigms. To take advantage of this transformative opportunity, an approach that seeks to understand and embrace the skills, talents, context, and paradigms that the CHW workforce possess is needed. Through this case study of a CHW/P training program in southern California i.e., the El Sol CHW/P Training Center, we sought to build the capacity of organizations to expand their community transformation role as they integrate CHWs/Ps into their operations and mitigate the threat of CHW/P co-optation. We explain how a community-based CHW/P training center applied popular education throughout the CHW/P capacity-building process in order to advance and maintain the roots of the CHW/P movement. By describing the interrelated components of El Sol CHW/P TC theory of change and explaining the application of this guiding principle, this case study generates implications for organizations that aim to integrate CHWs/Ps into their operations. As more organizations are integrating CHWs/Ps into their operations, we hope that this case study can help stimulate reflection, dialogue, and action among CHW/P organizations on how to incorporate these long-standing guiding principles into their operations. In doing so, we can continue to build examples of CHW/P-centered interventions that reflect values and paradigms such as health care for all, health equity, and health as a right.