About the Community Health Worker Collaborative

There is a growing interest in leveraging community health worker programs to achieve population health outcomes and transform care delivery. To this end, the Meharry-Vanderbilt Alliance (MVA) convenes the Community Health Worker Collaborative, a group of organizations focused on advancing the Community Health Worker (CHW) profession in Tennessee. In addition to MVA, the CHW Collaborative partners include the Tennessee Department of Health, Le Bonheur Children’s Hospital, Metro Public Health Department – Nashville/Davidson County, Siloam Health, Tennessee Primary Care Association, the YMCA and others. To date, products of the Community Health Worker Collaborative include a national scan of the roles of community health worker statewide associations across the US and a statewide survey focused on CHWs in Tennessee. 
Tennessee Community Health Workers: A Statewide Forum Currently the CHW Collaborative is planning a statewide CHW forum, which will bring together CHWs, CHW employers, payors, health departments, health systems, foundations and others across the state. To our knowledge, the CHW Forum is the first ever statewide convening of CHWs in the state of Tennessee. Tennessee is one of a handful of states that does not have a CHW statewide association, and potentially one outcome of the forum will be beginning to develop an association in Tennessee that will support the development of and support for the CHW profession.  The specific objectives of the forum include raising awareness about the role of CHWs with a broad audience, garnering input on development of a statewide association and providing a networking opportunity for CHWs.

What is a Community Health Worker?

Although there are varying definitions, it is widely accepted that CHWs are individuals on the front lines that serve as a link between health services and communities through culturally relevant means. They do this through promoting individual and community health; improving access to care, providing counseling, social support, advocacy, and education to the communities they serve. They work in a diverse range of settings including hospitals, clinics, family service offices, outpatient care centers, and physician’s offices.

According to a 2007 World Health Organization study entitled “Community health workers: what do we know about them?,” Community Health Workers (CHWs) are defined as  “any health worker carrying out functions related to health care delivery; trained in some way in the context of the intervention; and having no formal professional or paraprofessional certificated or degreed tertiary education”.

The Association of State and Territorial Health Officials states: “while their roles and responsibilities vary across states, CHWs often serve as a liaison between the community and the health services available within that community.”

The American Public Health Association defines them as “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.”


What are the roles of CHWs?

The roles of CHWs typically relate to community outreach through:

  • education
  • at home support care services
  • health coaching
  • case management/coordination
  • serving as a liaison between the community and healthcare systems
  • encouraging cultural competency
  • and much more!


The 2007 WHO study suggests that while the roles of CHWs are broad, they can be divided into generalist and specialist. The former being country wide health programs that are run by government or non-governmental such as faith or community based organizations to provide overall care such as home visits, environmental sanitation, adding in water supply, first aid, communicable disease control, record-keeping…etc. . Specialist CHWs are typically newer and focus on addressing a specific health issues. These programs are often run by NGOs. The literature provides examples of many CHW specialist concerns such as TB care, malaria control, HIV/Aids care etc.


How do I become a CHW?

According to the United States Bureau of Labor Statistics, many CHWs need at least an associate’s degree or comparable work experience with a high school diploma/GED. Other training includes core skills such a cultural competency, community outreach, information about specific health topics, etc. Other qualities like analytical, instructional, interpersonal, problem-solving, and writing skills are also essential to the tasks of a CHW.  There is currently not a Tennessee specific certification standard but it is a potential avenue that a TN CHW association could pursue.


Am I already a CHW?

CHWs go by several names such as health workers, activistas, promotora, health volunteer, outreach educator, rural health motivator, village health helper, patient health navigator, peer educator, recovery coach, patient advocate,…etc.



Common Institutions that fund Community Health Worker Related Research

  • Grants for research, grants for stuff like CASTLES or look at places that have already given funds to programs or papers
  • National Heart, Lung, and Blood Institute
  • NIH National Institute of Child Health and Human Development
  • NIH National Institute of Diabetes and Digestive Kidney Diseases
  • National Institute of Mental Health
  • Fellowship for the Intentional Community
  • CDC - National Center for Chronic Disease Prevention and Health Promotion
  • NIH National Institute on Drug Abuse
  • National Institute of Environmental Health Sciences
  • National Cancer Institute
  • National Institute of Allergy and Infectious Diseases
  • US National Library of Medicine
  • National Institute of General Medical Sciences


Grant Funders for CHW Programs



Defining the Scope of CHWs

CHW National Workforce Study by Bita A. Kash of Texas A&M School of Public Health

In response to the community health workforce that developedfrom several factors such as cost challenges of providing service to an increasing and diverse population as well as a shortage of providers, the study sought to greater define the role of a CHW. Their method included a 27 month research project that surveyed and interviewed verified CHW employers in all fifty states;a comprehensive literature review, and estimates from the Census and U.S. Department of Labor, Bureau Statistics on the history of the workforce’s development, the training required, typical employers and employees; current trends, and more.

Read More Here: https://www.ncbi.nlm.nih.gov/pubmed/16569457


Efficacy of a CHW Collaborative

Developing Health Promotion Programming in Rural West Virginia by Nick Fadley of Future Generations and Dr Joy Buck of West Virginia University School of Nursing

This project sought to use the West Virginia Community Health Workers Network to collaborate with partner organizations in developing health education and promotion programs. It also served as a model to prove the efficacy of CHW networks in improving care to rural communities.

Read More Here: pdf to be attached


Value and Effectiveness of CHWs

New England An Action Guide on  Community Health Workers (CHWs): Guidance for the CHW Workforce

As stated in the introduction, their investigation served as a way to guide persons considering becoming a community health worker. They pulled from the literature, interviews with stakeholders, survey results benchmarking the use of CHWs in New England, and public testimony in order provide evidence on the effectiveness and value of CHWs

Read More Here: http://icer-review.org/wp content/uploads/2014/01/CHW-Action-Guide.pdf


Creating a CHW Collaborative

Massachusetts Community Health Worker Survey Report

According to the grant abstract, the purpose of this project was to “develop and implement a state wide CHW system that includes ongoing mechanisms for training, leadership and financing.” They did this through a CHW needs assessment, created CHW network activities that included broad participation, and providing other informational support. They then evaluated the effectiveness of the project and presented the outcomes. This resource may provide a very value blueprint in terms of creating a Tennessee CHW Network.

Read More Here: http://www.mass.gov/eohhs/docs/dph/com-health/com-health-workers/comm-health-workers-append.pdf




Indiana CHW Association



Purpose: Provide sources of information to the community, provide education, and enhance the healthcare system.


  • Enhance access and coordinated client/patient-centered care
  • Support client/patient engagement in care
  • Facilitate cultural brokering
  • Case management
  • Teaching
  • Support community mobilization and advocacy


Ohio CHW Association

no website available at this time


Purpose: Provide a comprehensive link to community resources through family-based services.


  • Counties grouped into regions for CHWs
  • Applications to apply to be a CHW


New England

Massachusetts Association of CHWs



Purpose: Strengthen the professional identity of CHWs, foster leadership, and promote integration of CHWs into the healthcare, public health, and human services workforce


  • Job opportunities
  • Education and training
  • Policy (local, state, employer)
  • 1-day forums
  • Conferences


West Virginia CHW Network



Purpose: Aims to build the capacity of rural community-based organizations to develop sustainable health education and promotion programs based on the CHW model.


  • Provides partners technical assistance in:
  • Project Planning
  • Budgeting & Marketing
  • Partnership Development
  • Evaluation
  • Fundraising
  • CHW best practices



Texas Gulf Coast CHW Association



Purpose: Bringing together area services providers, CHWs, and continuing education opportunities.


  • Training and Education
  • Career opportunities
  • Annual summit


Arkansas CHW Association



Purpose:  Provide training, continuing education, and career advancement,  advocate for steady and reliable funding, increase awareness of CHWs, and convene CHWs from across the state.


  • Annual Summit
  • Education and Training
  • Recruitment
  • Development networking across the state
  • Research on CHWs
  • Programs with funders and roles within those programs



California Association of CHW



Purpose: Increasing access to care, reducing costs, promoting happy, healthy, communities.


  • How to recruit and train
  • Forming relationships with community partners
  • Research, Policy Analysis
  • Model programs (IEHP)


CHWs of Nevada



Purpose: Bridge between communities and the traditional health care and human service systems.


  • CDC resources (CHW handbook and toolkits)
  • Job opportunities
  • Education and Training  
  • Policy Development