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Community Health Worker Network of NYC

In Healthcare Teams of the Future

  • The Community Health Worker Network of New York City was founded in 2001 to serve as a place for community health workers (CHWs) to share best practices, resources, and gain training and professional development.
  • The Network developed a CHW training program that has been used to train over 1,000 community health workers.
  • The Network advocates for legislation and policies that support the advancement of CHW practice, such as through their participation in the New York State Community Health Worker Initiative, which sought to develop recommendations to sustain the CHW workforce.
  • Summary
  • Analysis

Summary

The Community Health Worker Network of New York City was formed in 2001 as a place for community health workers (CHWs) to come together and share resources, develop friendships, and gain training and professional development. The Network, which represents over 1,000 members over 250 organizations, advances CHW practice through education, advocacy, and research.

Regarding education, The Community Health Worker Network of NYC has developed CHW training standards and has implemented CHW training programs. The evidence-based training offers 35-hour and 70-hour curricula. While the 70-hour version offers more in-depth training, both curricula are designed to help CHWs develop the skills and competencies necessary to successfully do their jobs. They include training in communication, cognitive behavioral theory, positive psychology, and behavior change. “Disease-specific” topical training is also available for CHWs working in disease-specific settings and is conducted in modules that total up to 35 additional hours. The modules include training on diabetes, asthma, hypertension, cardiovascular disease, and nutrition.[1] Beyond CHW-specific training, the Network also offers organizational development training for organizations looking to integrate CHWs into their workforce.

The Network also works to advocate for policies that advance the CHW practice. For example, it worked with the New York State Community Health Worker Initiative to develop a report with recommendations on how to advance and sustain the CHW workforce in New York, though lessons from the report can be applied to other contexts.[2] The report included a definition of the Scope of Practice of CHWs to standardize job descriptions and recommendations for training, certification, and financing. The CHW Scope of Practice, as detailed in the report, includes seven main roles: outreach and community mobilization, community/cultural connections, case management and care coordination, home-based support, health promotion and coaching, system navigation, and participatory research.

Analysis

While the role of community health worker has formally existed for decades in the United States, there has been minimal standardization around the specific role and training of the community health worker in practice. Founder and Executive Director of The Community Health Worker Network of NYC, Sergio Matos, has done substantial work in bringing CHWs to national attention, standardizing definitions and scope of practice and developing training. For example, Mr. Matos led the national coalition that developed The American Public Health Association’s official definition of community health workers (CHWs) as being, “frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served. This trusting relationship enables workers to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.”[3]

The Network’s work to advance CHW practice in New York and nationwide is exciting given the proven impact that CHWs can have on their clients’ health, particularly in the realm of chronic conditions like hypertension and diabetes.[4] For example, one study analyzing the impact of a 6-month intervention focused on diabetes self-management education with African American and Latino adults with type 2 diabetes, found that participants who worked with a CHW had statistically significant decreases in mean HbA1c values (8.6% at baseline to 7.8% at 6 months), while those who did not work with a CHW had no change in mean HbA1c.[5] Other studies have supported the observed improvements in HbA1c levels in patients who work with CHWs, with particular benefits to high-risk patients with HbA1c levels greater than 9%.[6] These results would support the expanded use of community health workers in diabetes education and management efforts.

  1. “Community Health Worker Training,” Community Health Worker Network of NYC, n.d., http://www.chwnetwork.org/Default.aspx?ssid=80&NavPTypeId=1297.
  2. Sergio Matos et al., “Paving a Path to Advance the Community Health Worker Workforce in New York State: A New Summary Report and Recommendations” (CHW Network NYC, Columbia University Mailman School of Public Health, 2011), http://secureshopper.bisglobal.net/_templates/80/chw_initiative2011report.pdf.
  3. “Community Health Workers,” American Public Health Association, 2017, https://www.apha.org/apha-communities/member-sections/community-health-workers.
  4. J Nell Brownstein et al., “Effectiveness of Community Health Workers in the Care of People with Hypertension,” American Journal of Preventive Medicine 32, no. 5 (2007): 435–47.
  5. Michael S Spencer et al., “Effectiveness of a Community Health Worker Intervention among African American and Latino Adults with Type 2 Diabetes: A Randomized Controlled Trial,” American Journal of Public Health 101, no. 12 (2011): 2253–60.
  6. Regina Otero-Sabogal et al., “Physician–Community Health Worker Partnering to Support Diabetes Self-Management in Primary Care.,” Quality in Primary Care 18, no. 6 (2010); Kenneth S Babamoto et al., “Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial,” Health Education & Behavior 36, no. 1 (2009): 113–26.

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New York City, New York

http://www.chwnetwork.org/

New York State Community Health Worker Association, Columbia University Mailman School of Public Health

Access/Affordability, Community Outreach/Engagement, Interprofessional/Interdisciplinary Teams, Peer Support

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Insights

Our interviews with experts in and around revealed challenges and opportunities in medical education and healthcare delivery, as well as what these might mean for people living with, or at risk for, type 2 diabetes and prediabetes.
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  3. There is increasing emphasis on the importance of understanding how the daily life of a patient impacts their health and healthcare
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