Centers for Disease Control and Prevention, Atlanta, GA, United States.
Community Resources, LLC, San Antonio, TX, United States.
Front Public Health. 2021 Jun 24;9:659017. doi: 10.3389/fpubh.2021.659017. eCollection 2021.
The objective of this observational, cross-sectional study was to identify, document, and assess the progress made to date in implementing various processes involved in statewide community health worker (CHW) workforce development initiatives. From September 2017 to December 2020, we developed and applied a conceptual model of processes involved in implementing statewide CHW initiatives. One or more outputs were identified for each model process and assessed across the 50 states, D.C., and Puerto Rico using peer-reviewed and gray literature available as of September 2020. Twelve statewide CHW workforce development processes were identified, and 21 outputs were assessed. We found an average of eight processes implemented per state, with seven states implementing all 12 processes. As of September 2020, 45 states had a multi-stakeholder CHW coalition and 31 states had a statewide CHW organization. In 20 states CHWs were included in Medicaid Managed Care Organizations or Health Plans. We found routine monitoring of statewide CHW employment in six states. Stakeholders have advanced statewide CHW workforce development initiatives using the processes reflected in our conceptual model. Our results could help to inform future CHW initiative design, measurement, monitoring, and evaluation efforts, especially at the state level.
本观察性、横断面研究的目的是确定、记录和评估迄今为止在实施全州社区卫生工作者 (CHW) 劳动力发展计划所涉及的各种流程方面取得的进展。从 2017 年 9 月至 2020 年 12 月,我们制定并应用了一个实施全州 CHW 计划所涉及的流程概念模型。使用截至 2020 年 9 月可获得的同行评议和灰色文献,对每个模型流程确定了一个或多个产出,并在 50 个州、哥伦比亚特区和波多黎各进行了评估。确定了 12 个全州 CHW 劳动力发展流程,并评估了 21 个产出。我们发现每个州平均实施了 8 个流程,其中 7 个州实施了所有 12 个流程。截至 2020 年 9 月,已有 45 个州拥有多利益相关者 CHW 联盟,31 个州拥有全州 CHW 组织。在 20 个州,CHW 被纳入医疗补助管理式医疗组织或健康计划。我们发现有 6 个州对全州 CHW 的就业情况进行了常规监测。利益相关者利用我们概念模型中反映的流程推进了全州 CHW 劳动力发展计划。我们的研究结果可以为未来 CHW 计划的设计、衡量、监测和评估工作提供信息,尤其是在州一级。