Community health workers are trusted individuals who improve health within their own communities.
This unique model not only builds trust with the people served, but also improves health outcomes. In Appalachian counties where access to health care services is limited and social determinants of health create additional barriers, community health workers are bridging the gap between community members and the services they need to live healthy lives.
What is a Community Health Worker?
How to Become a Community Health Worker
Community health workers complete 100 hours of didactic classroom content that is competency-based and designed for adult learners. Participants are then placed in a community setting to fulfill 130 hours in a field practicum. Participants earn eligibility for certification through the Ohio Board of Nursing. In 2020, the training curriculum was converted from an in-person format to an online hybrid format in response to the COVID-19 pandemic, expanding the reach and flexibility of the program.
Training opportunities are available each semester at different Ohio University campuses. Please note that each training cohort includes both online classes and mandatory in-person classes. See the application for upcoming training locations.
YES! Participants must have a high school diploma or the equivalent as the minimum requirement to become certified CHWs and to complete our program.
The class takes one semester (15 weeks) to complete. Once participants successfully complete the classroom portion, they will complete 130 hours of experiential learning at a community-based health-care or social services organization. We recommend that they complete the field portion in 15 weeks, as well, but there is flexibility for participants who need longer.
Cohorts meet online two times each week for two hours each class, in synchronous groups. This means that all participants attend class at the same time, with an instructor in live, real-time sessions over TEAMS or Zoom. They will also meet three to four times in-person for MANDATORY classes on an Ohio University campus, where they receive their class supplies, meet each other in person, complete vitals training and check-offs, Basic Life Support training, and more.
Thanks to grant and university funding, the CHW training program is available at no cost to participants. The only expenses that participants will pay for is the background check (approximately $65) and the application cost for certification ($35).
All participants will receive a textbook, a vitals kit (blood pressure cuff and stethoscope), 100 hours of classroom/didactic training, and 130 hours of experiential learning in the field.
Participants learn how to take vitals and become certified in Basic Life Support through the American Heart Association. They learn about basic anatomy and physiology, medical terminology, human development, trauma-informed care, and motivational interviewing. They learn about home visit and field safety, cultural humility, and how to administer Narcan. Finally, they learn about resources and build a network of other CHWs to access as resources.
A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker 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. A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy (APHA, 2009).
Community health workers work under many different job titles and perform a variety of duties to address upstream factors in health care. A CHW working in a local health department may educate patients with chronic diseases about the importance of nutrition and lifestyle, monitor their vitals, and strive to reduce emergency room visits. They might also advocate for local policies to address health issues such as smoking in public areas. In a community action agency, a CHW may link clients with complex interconnected health and social risks with resources such as housing, transportation, and medical insurance. A CHW working in behavioral health may serve as a supportive listener and implement motivational interviewing skills to support behavior change, coordinate a needle exchange program, and accompany clients to the gym to practice healthy living.
CHWs can be integrated within a local health department, health care systems, academic-community partnerships, community-based nonprofit organizations, and management organizations. Funding sources include grants, a Pathways Community Based Care Coordination HUB, or employment at a Managed Care Organization. HUBs bill Medicaid managed care plans and other funding partners for successfully completing Pathways. (i.e. Education, Employment, Housing, Medical Home, Pregnancy, and Tobacco Cessation.) HUBs distribute payments to the organizations that employ CHWs and keep a small administrative fee.
Community health workers are making a difference around the world, in high- and low-income countries. In addition to making significant positive impacts on health behaviors and outcomes, they also have economic consequences including savings in health care costs due to more efficient use of the health system and increased labor productivity of healthier patients.
A Social Return on Investment (SROI) analysis completed by Wilder Research for the American Cancer Society concluded that investing $41,184 per year in CHWs for 10 years generates net economic benefits of $481,920. With an estimated 62% of CHWs in the Midwest working in cancer outreach, these CHWs will generate more than 5.8 billion dollars in net benefits in the next 20 years through reduced years of life lost, benefits for taxpayers, and increased health care efficiency.
Another study of pregnant women participating in the CHAPS Pathways model indicated that “structured community-based care coordination coupled with standardized and accountable tracking tools and payment for outcomes may reduce LBW delivery among high-risk pregnant women.”
Within Appalachia Ohio, CHWs reported an increase in clients’ knowledge and awareness of health issues, increases in clients’ well-being due to feeling supported, increases in clients’ empowerment/confidence in being able to access the resources they need, stigma reduction, and improvements in community resiliency.
The Social Return on Investment study (2023) found that every $1 invested in Jackson County Health Department’s CHW CDC-CCR initiative (including naloxone distribution) generated $24.63 of social impact for the clients at highest risk for poor health outcomes, local health departments involved in the initiative, individuals employed as CHWs, and the general public. Excluding naloxone distribution, the SROI found that every $1 invested generated $1.80 of social impact.
In the Ohio University CHW Training Program from January 2021 – January 2023, the majority of the CHWs (67%) indicated that they identify as Appalachian, and the home region of the majority of CHWs (81%) is Southeast Ohio. Most CHWs trained through the OU CHW program are parents (75%) and nearly all are U.S. Citizens (98%).
Some Community Health Workers in Appalachia Ohio have been trained through an evidence-based communication model of Facilitating Attuned Interactions (FAN) Model by the collaboration between Ohio University and the Erikson Institute Chicago to utilize practical tool tools that provide parameters and guardrails within the CHW scope of practice and the Appalachian cultural context. FAN provides a shared language among administrators, supervisors, staff, and clients towards a common experience as CHWs work with community members in Appalachia Ohio. FAN has helped with strategies for self-care when working with challenging clients or situations, including trauma exposure.
The Self-Care Society is a helpful resource for community health workers, with podcasts designed to improve mental and physical health.
American Public Health Association. (2021). Community health workers. https://www.apha.org/apha-communities/member-sections/community-health-workers
Diaz, J. (2021). Social return on investment: Community health workers in cancer outreach. Wilder Research. https://www.wilder.org/sites/default/files/imports/ACS_ROI_in_CHWs-6-12.pdf
Robert Wood Johnson Foundation. (2016). Community health workers and population health: Lessons from US and global models.
Redding, S., Conrey, E., Porter, K., Paulson, J., Hughes, K., & Redding, M. (2015). Pathways community care coordination in low birth weight prevention. Maternal and Child Health Journal, 19(3), 643–650. https://doi-org.proxy.library.ohio.edu/10.1007/s10995-014-1554-4