The community health advocate.

This article reviews the development of an academic training program for rural and urban community health workers. A needs assessment and job task inventory are described. The organizational and cost factors involved in the design of a decentralized training model are presented along with an outline of the formal curriculum established after pilot testing. The one-year curriculum includes three to four days per month of classroom work with equal attention paid to assessment of common medical problems and to health education and counseling. Integrated with the didactic work is a full year of practical community health training under the guidance of a licensed practitioner (physician, physician assistant, or nurse practitioner). Three program goals are identified: establishment of health career entry level training, service to minority populations, and certification for career mobility. These goals are discussed and evaluated in relation to current progress of the program.