Evaluation of a community health worker training program in rural Appalachia, USA

  • Authors

    • Wayne C. Miller
    2015-03-27
    https://doi.org/10.14419/ijm.v3i1.4508
  • Community Health Worker, Rural Medicine, Community Health Educator, Health Education, Rural Healthcare.

  • Background: Limited support for healthcare services is one reason rural Appalachia is among the unhealthiest regions in the United States.

    Objective: Evaluate Level 1 of a multi-level community health worker (CHW) training program designed to train CHWs easily so they can affect community health.

    Methods: 198 CHWs evaluated their training curriculum. CHW activities were tracked for 19 months. Group data were analyzed with t-tests and ANOVA using mean ± SEM comparisons. Correlation coefficients and rank sum difference analyses were used to evaluate ranked variables. Statistical significance was set at p<0.05.

    Results: Excellent or good rankings were given by 100% of CHWs for their instructor’s knowledge, 100% being treated fairly, 99% overall class rating, 97% fairness of exam, 96% course objectives met, and 92% course manual. CHW test performance did not affect any variable. CHWs were only asked one question every two months they could not answer. CHWs talked to four new people each month, two people a month for multiple visits, and three people a month for follow-up visits.

    Conclusions: No need to change the CHW curriculum, training materials, or testing procedures. A 15-hour CHW training program is adequate enough to provide valid healthcare service support in rural Appalachia, USA.

  • References

    1. [1] Baronowski T, Cullen KW, Nicklas T, Thompson D, Baronowski J. (2003) Are current health behavioral change models helpful in guiding prevention of weight gain? Obesity Research 11 Suppl: 23S-43S. http://dx.doi.org/10.1038/oby.2003.222.

      [2] Center for Health Law and Policy Innovation: Harvard Law School (2014) Community Health Worker Credentialing: State Approaches. 1-24.

      [3] Center for Rural Health (2012) Report on Community Health Worker Programs. Area Health Education Center, University of North Dakota School of Medicine and Health Sciences, 1-58.

      [4] Centers for Disease Control and Prevention (2011) The Community Health Worker’s Sourcebook: A Training Manual for Preventing Heart Disease and Stroke. Available at: http://www.cdc.gov/dhdsp/programs/spha/chw_sourcebook/pdfs/sourcebook.pdf Accessed March 20, 2015.

      [5] Griffith BN, Lovett GD, Pyle DN II, Miller WC (2011) Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors. BMC Public Health 11:229. http://dx.doi.org/10.1186/1471-2458-11-229.

      [6] Miller WC, Heinsberg HB (2012) Community Health Education Resource Person (CHERP) Level 1: Wellness. Central Printing, Beckley, WV.

      [7] National Cancer Institute, Center to Reduce Cancer Health Disparities. Patient Navigation Program. Available at: http://crchd.cancer.gov/pnp/what-are.html Accessed March 20, 2015.

      [8] National Center for Chronic Disease Prevention and Health Promotion: Division for Heart Disease and Stroke Prevention (2011) Addressing Chronic Disease Through Community Health Workers: A Policy and Systems Level Approach, A Policy Brief on Community Health Workers. Available at: http://www.cdc.gov/dhdsp/docs/chw_brief.pdf Accessed March 20, 2015.

      [9] National Human Services Assembly: Family Strengthening Policy Center (2006) Community Health Workers: Closing Gaps in Families’ Health Resources. Policy #14:1-20.

      [10] United Health Foundation. America’s Health Rankings. Available at: http://cdnfiles.americashealthrankings.org/SiteFiles/StateProfiles/WestVirginia-Health-Profile-2014.pdf Accessed March 20, 2015.

      [11] United States Department of Health and Human Services: Health Resources and Services Administration, Bureau of Health Professions (2007) Community Health Worker National Workforce Study. 1-269.

      [12] Viswanathan M, Kraschnewski J, Nishikawa B, Morgan LC, Thieda P, Honeycutt A, Lohr KN, Jonas D. (2009) Outcomes of Community Health Worker Interventions. Evidence/Technology Assessment No. 181 (Prepared by the RTI International-University of North Carolina Evidence-based Practice Center under Contract No. 290 2007 10056 I.) AHRQ Publication No. 09-E014. Rockville, MD: Agency for Healthcare Research and Quality.

  • Downloads

  • How to Cite

    Miller, W. C. (2015). Evaluation of a community health worker training program in rural Appalachia, USA. International Journal of Medicine, 3(1), 33-37. https://doi.org/10.14419/ijm.v3i1.4508