Using Implementation Science to Promote Integration and Sustainability of Community Health Workers in the HIV Workforce

Authors: Serena Rajabiun, PhD, MA, MPH, Kate Killion, MPH, RD, Robin Lennon-Dearing, PhD, MSW, Brandon Bernard Williams, LMSW, LSSW, and Melissa Hirschi, PhD, MSW
Year: 2022
State: NatDoc: National Document
Website link:
Publicly Available: Yes
Certification: CHW role scope of practice, Competencies, Training and training programs
Evidence Generation: Documentation of how CHWs can work within care teams, Evidence-based interventions
Policy: General language around CHW WD, Identifying policy expertise within state
Sustainable Financing: Expand evidence base, Including community-based CHWs, Evidence-based interventions
Workforce Development: CHW training programs (not cert.), Data sharing between social services and clinical teams, General other (including mention of “employment practices”), Training- Content modes delivery, Training- Continuing education

Community health worker (CHW) interventions are an evidence-based practice adopted by health care settings to increase retention in care and viral suppression for people living with HIV(PLWH) from racial/ethnic minority communities. However, disparate funding, unclear roles vis a vis other care team members, limited training and promotion opportunities, and a lack of standards for wages and tasks limit the ability to effectively use CHWs as part of the health care team. Guided by the Exploration, Preparation, Implementation, and Sustainment and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks, this study describes the key determinants for CHW integration and sustainability at 3 agencies in Shelby County, TN, to improve viral suppression and reduce disparities among rural and urban people living with HIV. The setting for this study was Memphis Transitional Grant Area (TGA) which includes 8 rural and urban counties in west Tennessee, Arkansas, and Mississippi. Seventeen key informants were identified using purposeful and snowball sampling techniques, including community and agency leadership staff, frontline staff, and faith leaders. Key determinants of CHW integration include establishing clear and standardized CHW roles within and across organizations, facilitating inter-organizational networks, and leveraging funds for livable CHW wages and sustainable positions. Training strategies that strengthen the CHW workforce include content related to trauma-informed care, managing stress, and cultural humility. Several inner and outer settings and innovation and bridging factors affect CHW positions. Data collected will inform the implementation and sustainment of future policies and interventions intended to improve HIV care continuum outcomes and reduce disparities for PLWH.

Download from original source

Download from DRC website