Research has documented the work and outcomes of community health workers since the field emerged in the U.S. in the 1960s as part of anti-poverty and public health initiatives. For example, between 2001 and 2006 nine literature reviews of CHW intervention research were published, according to HRSA’s 2007 Community Health Worker National Workforce Study. Early studies, many focused on CHW community-based prevention projects, did not have the level of funding nor pursue methodologies that are more common in healthcare research today.
In recent decades one trend in the literature has been toward increasing focus on CHWs in healthcare settings and research using randomized controlled trial methodologies. As a result, there is increasingly robust evidence in the scientific literature about the effectiveness of community health workers in improving health outcomes as well as reducing cost, in different roles within the CHW scope of practice as well as in distinct health and disease areas. Through activities such as culturally-appropriate health education, patient navigation, and psychosocial support, CHWs have been shown to be effective in the prevention and management of asthma, diabetes, hypertension and other chronic diseases. Maternal and child health interventions have been a consistent area of CHWs’ positive impact for decades. CHWs have also been shown to be effective as members of patient care teams and in care coordination and case management, particularly with high-risk populations.
As this emerging field evolves, developing common measures to be used in research and evaluation is critical to support a more clearly defined scope of practice for CHWs and to bolster existing efforts to integrate CHWs into the healthcare workplace. Currently, there are efforts underway to create national databases of relevant literature to assist decision-making around this nascent profession.
- “Community Health Workers: Part of the Solution,” Health Affairs, 2010
- 2009 DPH Massachusetts Report to the Legislature on CHWs
- “Effectiveness of Community Health Workers in the Care of People with Hypertension,” American Journal of Preventive Medicine, 2007
- Texas Department of State Health Services CHW Research Materials
- New England Comparative Effectiveness Public Advisory Council (CEPAC)
- Agency for Health Research and Quality (AHRQ) “Outcomes of CHW Interventions”
- “Patient Centered Community Health Worker Intervention to Improve Post-Hospital Outcomes,” Journal of the American Medical Association, 2014
- “The Role of Community Health Workers in Diabetes: Update on Current Literature,” Current Diabetes Reports, 2013