Community Health Worker Training

Our evidence-based community health worker (CHW) training program was developed in direct response to the needs of CHWs themselves, CHW employers and leaders from all relevant CHW stakeholder sectors who contributed to the publication of "Paving a Path to Advance the Community Health Worker Workforce", a landmark report that establishes workforce standards for the CHW scope of practice, CHW training and credentialing, and for CHW financing. The training content and methods in this curriculum were informed by market analyses conducted by the Community Health Worker Network of NYC in partnership with the Columbia University Mailman School of Public Health and published in the Journal of the American Public Health Association (Findley, Matos, Hicks, Campbell, Moore, Diaz, 2012) and in Progress in Community Health Partnerships (Catalani, Findley, Matos, Rodriguez, 2008).   

This training program is designed to provide CHWs with the specific skills they need to conduct the tasks and accomplish the roles that have come to describe the CHW practice.

New and emerging professions generally attempt to establish themselves as different from existing practices by emphasizing differences with those endeavors. As a practice matures, they are generally more willing to embrace the theoretical underpinnings of existing disciplines with which they share philosophies. The CHW practice is no different. At first, most of our efforts were focused on identifying and highlighting those elements that make us different from other disciplines. As our practice matures, we are increasingly excited to recognize the disciplines which have contributed to our own practice. The CHW training program developed by the Community Health Worker Network of NYC recognizes the contributions of other disciplines to our own practice and embraces theories and practices from a number of other disciplines including Humanistic Psychology, Cognitive-Behavioral Theory, Compassionate Communication, Adult Learning, Popular Education, Human Development, Behavior Change Theory, Informal Counseling, and Motivational Coaching.

Research has shown that CHWs must be trained appropriately and respected by the health care system for their unique role and identity.  CHWs can be effective health workers provided they are taught skills that have come to describe their practice and are supportively and educationally supervised (Hammond & Burch, 1986). Very importantly, this same research reveals that CHWs trained in irrelevant hospital settings, trained by nurses with no connection to the community or removed from community for training suffer loss of credibility in their communities and lose the very quality for which they were originally sought out. When forced to look and sound like traditional members of the health care delivery system, they lose their access and the trust they enjoy in their communities. 

Appropriate training of CHWs is vital to their effectiveness. This is a significant challenge for health care systems interested in integrating CHWs in that the dominant culture of health care training focuses on the acquisition of knowledge. CHWs, on the other hand, focus on empowerment and development for individuals, families, and communities. Furthermore, CHW training is neither pedantic in nature or didactic in methodology.  CHW education seeks to enable citizens to assume responsibility for their own, and their community's, health through understanding their community's health problems and the societal influences that act upon them. When one adds the cultural considerations, ethnic and religious diversity, and the adaptations needed to meet ever-changing political and societal needs, CHW education becomes a movement for social transformation. This attention to social justice is at the core of the CHW practice and must be reflected in their training.  

The Community Health Worker Network of NYC curriculum is available as a 35-hour and 70-hour course of study. In addition to the core competencies, training in disease-specific topics is available in modules of up to 35 additional hours. The disease-specific training includes Diabetes, Asthma, Hypertension, Cardio-Vascular Disease and Nutrition. 

Upon completion of the training in core competencies and disease-specific topics (as desired), CHWs typically receive additional training in working within the specific concentration of their programs during an internship/mentoring period. 

This curriculum has been used to train over 1,000 CHWs in NYC and across the state, Washington DC, Arkansas, Hawaii, Georgia, Delaware, and the member nations of the organization of Eastern Caribbean States. Here in NYC it has been used with numerous different groups, and the feedback from these groups has been uniformly positive. Following are selected comments from people who have participated in the training.

  • "This program changes your heart, mind and soul. It satisfied the craving to become a better person, not just a CHW."
  • "This training qualifies us as professionally trained CHWs. It allows you to continue striving with excellence. For years this work was a burden, and now I am free."
  • "Keep up the good work. You changed my life. I am a new person in the way I think and how I will talk to my clients, relatives and friends."
  • "I want to thank you all for making these last five days so life-saving. Thank you for saving my life! I am not easily impressed but I must say that I am - in a profound way. This training helps you to look at yourself and clean up any problems. Then you can help others and that is something you need to do for a lifetime."
  • "This training is needed for all health workers. We are a very fortunate few. I wish the government would commission you to train all workers. I'm sad that just so few of us were exposed to you all."