Developing a Standardized Curriculum for Community Health Workers

Community health workers (CHWs) play an important role in the healthcare system, serving as valuable resources to both communities and healthcare organizations. Their unique understanding of the communities they serve has allowed them to facilitate access to and improve overall quality of care for community members.

In recent years, their proven success has led to an increased standardization of the workforce. In 2009, CHWs became recognized as a distinct occupation, and in 2010 the Patient Protection and Affordable Care Act listed CHWs as “health professionals who function as members of health care teams.” Additionally, The United States Department of Labor estimates that there will be a 15% increase in demand for these workers by 2024.

While this potential increase in demand is great news for the workforce, it has also raised concern about the lack of standardized training and certification programs available for workers. Currently, training across the United States varies from program to program, and as CHWs become increasingly recognized as a profession, the development of training standards is vital. Ruth Little, Vice Chair and Assistant Professor at East Carolina University’s School of Public Health agrees. “With any health profession, there has to be certain methods and consistency in place.”

Ruth was recruited to ECU in 2005 to help start the Master of Public Health Program, and has now been there ever since. A public health advocate, she has spent the last several years working to create a uniform curriculum for CHW education and certification in North Carolina. This curriculum will not only help to adequately prepare CHWs for their role in the healthcare team, but also help to promote the profession statewide.

Prior to working at ECU, Ruth was the Public Health Director of Jones County, a rural county near the eastern coast of North Carolina. Her continued work with Jones county while at ECU led to her writing a grant to the Office of Minority Health that would help her establish a standardized curriculum for the county.

After about a decade of work, Ruth and her team moved towards translating the curriculum to the community college system, and in September of 2015, it was approved. Now available in the Edgecombe Community College system, the curriculum is on the cusp of moving to other community colleges that want it.

An important part of developing any kind of new curriculum is testing it, and Ruth and her team have been measuring longitudinal outcomes for their curriculum for almost ten years. “We have data on almost 1,000 people and we’re trying to test an even larger group,” says Little. “We will also continue to look at outcomes so we can provide updates to the curriculum to ensure it is always current and valid.”

Ruth is also excited to have recently partnered with the Eastern Health Stewards group, who will help them continue to evaluate outcomes with an even larger, more diverse population. “Chronic disease does not discriminate,” she says. “There is a high prevalence of it across all socioeconomic classes, and we are looking forward to examining the effectiveness of community health workers in all types of populations.”

Overall, Ruth attributes the success of the development of this curriculum to the hard work and contributions of all the leaders and organizations involved. “The entities that represent and reflect the community have always been on the table and had a lot of input and that’s key,” says Ruth. “It’s not about one person, or a small group of people, it’s about bringing our expertise together.”