Journal of Community Health

, Volume 39, Issue 6, pp 1140–1149 | Cite as

Community Health Workers Leading the Charge on Workforce Development: Lessons from New Orleans

  • Ashley Wennerstrom
  • Liljana Johnson
  • Kristina Gibson
  • Sarah E. Batta
  • Benjamin F. Springgate
Original Paper


Academic institutions and community organizations engaged community health workers (CHWs) in creating a community-appropriate CHW workforce capacity-building program in an area without a previously established CHW professional group. From 2009 to 2010, we solicited New Orleans-based CHWs’ opinions about CHW professional development through a survey, a community conference, and workgroup meetings. Throughout 2011 and 2012, we created and implemented a responsive 80-h workforce development program that used popular education techniques. We interviewed CHWs 6 months post-training to assess impressions of the course and application of skills and knowledge to practice. CHWs requested training to develop nationally-recognized core competencies including community advocacy, addresses issues unique to New Orleans, and mitigate common professional challenges. Thirty-five people completed the course. Among 25 interviewees, common themes included positive impressions of the course, application of skills and community-specific information to practice, understanding of CHWs’ historical roles as community advocates, and ongoing professional challenges. Engaging CHW participation in workforce development programs is possible in areas lacking organized CHW groups. CHW insight supports development of training that addresses unique local concerns. Trained CHWs require ongoing professional support.


Community health workers Training Community academic partnership Community leadership Community health 


  1. 1.
    American Public Health Association. (2013). Policy statement database. Policy # 2009-1. Support for community health workers to increase health access and to reduce health inequities. Retrieved March 10, 2014, from
  2. 2.
    Wiggins, N., & Borbon, A. (1998). Core roles and competencies of community health advisors (Chapter 3). The national community health advisor study: Weaving the future. Tucson, AZ: University of Arizona Press.Google Scholar
  3. 3.
    U.S. Department of Health and Human Services. (2007). Health Resources and Services Administration Bureau of Health Professions. Community health worker national workforce study. Retrieved on March 10, 2014, from
  4. 4.
    Two Feathers, J., Kieffer, E. C., Palmisano, G., et al. (2007). The development, implementation, and process evaluation of the REACH Detroit partnership’s diabetes lifestyle intervention. Diabetes Educator, 33(3), 509–520.CrossRefGoogle Scholar
  5. 5.
    Culica, D., Walton, J. W., Harker, K., & Prezio, E. A. (2008). Effectiveness of a community health worker as sole diabetes educator: Comparison of CoDE with similar culturally appropriate interventions. Journal of Health Care for the Poor and Underserved, 19(4), 1076–1095.PubMedCrossRefGoogle Scholar
  6. 6.
    Levine, D. M., Bone, L. R., Hill, M. N., et al. (2003). The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population. Ethnicity and Disease, 13(3), 354–361.PubMedGoogle Scholar
  7. 7.
    Hansen, L. K., Feigl, P., Modiano, M. R., et al. (2008). An educational program to increase cervical and breast cancer screening in Hispanic women: A southwest oncology group study. Cancer Nursing, 28(1), 47–53.CrossRefGoogle Scholar
  8. 8.
    Brown, H. S., 3rd, Wilson, K. J., Pagán, J. A., et al. (2012). Cost-effectiveness analysis of a community health worker intervention for low-income Hispanic adults with diabetes. Preventing Chronic Disease, 9, E140.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Allen, J. K., Dennison Himmelfarb, C. R., Szanton, S. L., & Frick, K. D. (2013). Cost-effectiveness of nurse practitioner/community health worker care to reduce cardiovascular health disparities. Journal of Cardiovascular Nursing. doi:10.1097/JCN.0b013e3182945243.
  10. 10.
    Margellos-Anast, H., Gutierrez, M. A., & Whitman, S. (2012). Improving asthma management among African-American children via a community health worker model: Findings from a Chicago-based pilot intervention. Journal of Asthma, 49(4), 380–389.PubMedCrossRefGoogle Scholar
  11. 11.
    Centers for Disease Control and Prevention. (2011). Diabetes public health resource. Community health workers/promotores de salud: Critical connections in communities. Retrieved March 10, 2014, from
  12. 12.
    U.S. Department of Health and Human Services. (2011). HHS action plan to reduce racial and ethnic health disparities. Retrieved March 10, 2014, from
  13. 13.
    Public Law 111-148. (2010). Patient Protection and Affordable Care Act. Retrieved March 10, 2014, from
  14. 14.
    U.S. Department of Labor. (2014). Bureau of Labor Statistics. Occupational outlook handbook, 2014-14 edition, health educators and community health workers. Retrieved January 19, 2014, from
  15. 15.
    Congressional Budget Office. (2014). Insurance coverage provisions of the Affordable Care Act—CBO’s February 2014 baseline. Retrieved March 10, 2014, from
  16. 16.
    Martinez, J., Ro, M., Villa, N. M., Powell, W., & Knickman, J. R. (2011). Transforming the delivery of care in the post-health reform era: What role with community health workers play. American Journal of Public Health, 101(12), e1–e5.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Centers for Medicare and Medicaid Services. (2012). Health care innovation award profiles. Retrieved January 2, 2014, from
  18. 18.
    Federal Register. (2013). Medicaid and children’s health insurance programs: Essential health benefits in alternative benefit plans, eligibility notices, fair hearing and appeal processes, and premiums and cost sharing; exchanges: Eligibility and enrollment. July 15, 2013. Retrieved March 10, 2014, from
  19. 19.
    Dower, C., Knox, M., Lindler, V., & O’Neil, E. (2006). Advancing community health worker practice and utilization: The focus on financing. San Francisco, CA: National Fund for Medical Education. Retrieved March 10, 2014 from
  20. 20.
    Kash, B. A., May, M. L., & Tai-Seale, M. (2007). Community health worker training and certification programs in the United States: Findings from a national survey. Health Policy, 80(1), 32–34.PubMedCrossRefGoogle Scholar
  21. 21.
    Mason, T., Wilkinson, G. W., Nannini, A., Martin, C. M., Fox. D. J., & Hirsch, G. (2011). Winning policy change to promote community health workers: Lessons from Massachusetts in the health reform era. American Journal of Public Health, 101(12), 2211–2216.Google Scholar
  22. 22.
    Community Health Worker National Education Collaborative. (2008). Key considerations for opening doors: Developing community health worker education programs. Retrieved March 10, 2014, from
  23. 23.
    Christopher, S., Burhansstipanov, L., & Know His Gun-McCormick, A. (2005). Using a CBPR approach to an interviewer training manual with members of the Apsáalooke Nation. In B. A. Isreal, E. Eng, A. J. Schultz, & E. A. Parker (Eds.), Methods in community-based participatory research for health (pp. 128–145). San Francisco, CA: Jossey-Bass.Google Scholar
  24. 24.
    Harvey, I., Schulz, A., Israel, B., et al. (2009). The healthy connections project: A community-based participatory research project involving women at risk for diabetes and hypertension. Progress in Community Health Partnerships, 3(4), 287–300.PubMedCrossRefGoogle Scholar
  25. 25.
    Parker, E. A., Israel, B. A., Robins, T. G., et al. (2008). Evaluation of community action against asthma: A community health worker intervention to improve children’s asthma-related health by reducing household environmental triggers for asthma. Health Education & Behavior, 35(3), 376–395.CrossRefGoogle Scholar
  26. 26.
    Ingram, M., Reinschmidt, K. M., Schachter, K. A., et al. (2012). Establishing a professional profile of community health workers: Results from a national study of roles, activities and training. Journal of Community Health, 37(2), 529–537.PubMedCrossRefGoogle Scholar
  27. 27.
    U.S. Department of Labor. (2010). Bureau of Labor Statistics. Standard Occupational Classification. 21-1094 Community Health Workers. Retrieved January 19, 2014, from
  28. 28.
    Goode, W. J. (1960). Encroachment, charlatanism, and the emerging profession: Psychology, sociology, and medicine. American Sociological Review, 25(6), 902–965.Google Scholar
  29. 29.
    Matos, S., Findley, S., Hicks, A., Legendre, Y., & Do Canto, L. (2011). Paving a path to advance the community health worker workforce in New York State: A new summary report and recommendations. Retrieved March 10, 2014 from
  30. 30.
    American Public Health Association. (2014). Community health workers. Retrieved January 19, 2014 from
  31. 31.
    Eng, E., & Young, R. (1992). Lay health advisors as community change agents. Family & Community Health, 15(1), 24–40.CrossRefGoogle Scholar
  32. 32.
    Kent, J. A., & Smith, C. H. (1967). Involving the urban poor in health services through accommodation—The employment of neighborhood representatives. American Journal of Public Health, 57(6), 997–1003.PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Beam, N., & Tessaro, I. (1994). The lay health advisor model in theory and practice: An example of an agency-based program. Family & Community Health, 17(3), 70–79.CrossRefGoogle Scholar
  34. 34.
    Witmer, A., Seifer, D., Finocchio, L., Leslie, J., & O’Neil, E. H. (1995). Community health workers: Integral members of the health care workforce. American Journal of Public Health, 85(8 Pt 1), 1055–1058.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Perez, L. M., & Martinez, J. (2008). Community health workers: Social justice and policy advocates for community health and well-being. American Journal of Public Health, 98(10), 11–14.PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Sabo, S. J., Ingram, M., Reinschmidt, K., et al. (2013). Predictors and a framework for fostering a community advocacy as a community health worker core function to eliminate health disparities. American Journal of Public Health, 103(7), e67–e73.PubMedCrossRefGoogle Scholar
  37. 37.
    Wennerstrom, A., Vannoy, S., Allen, C., et al. (2011). Community-based participatory development of community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans. Ethnicity & Disease, 21(3, Suppl 1), S45–S51.Google Scholar
  38. 38.
    Common Ground Health Clinic. (2009). New Orleans Community Resource Guide. New Orleans, LA: Common Ground.Google Scholar
  39. 39.
    Berthold, T., Miller, J., & Avila-Esparza, A. (Eds.). (2009). Foundations for community health workers. San Francisco, CA: Jossey-Bass.Google Scholar
  40. 40.
    Freire, P. (1970). Pedagogy of the oppressed. New York, NY: Continuum.Google Scholar
  41. 41.
    Corbin, J. M., & Strauss, A. C. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Thousand Oaks, CA: Sage.Google Scholar
  42. 42.
    The New England Comparative Effectiveness Public Advisory Council. (2013). Community health workers: A review of program evolution, evidence on effectiveness and value, and status of workforce in New England. Retrieved July 31, 2013 from

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ashley Wennerstrom
    • 1
  • Liljana Johnson
    • 2
  • Kristina Gibson
    • 3
  • Sarah E. Batta
    • 4
  • Benjamin F. Springgate
    • 1
    • 5
  1. 1.Department of MedicineTulane University School of MedicineNew OrleansUSA
  2. 2.Urban Strategies, Inc.New OrleansUSA
  3. 3.Kingsley HouseNew OrleansUSA
  4. 4.Department of Global Community Health and Behavioral SciencesTulane University School of Public Health and Tropical MedicineNew OrleansUSA
  5. 5.RAND CorporationNew OrleansUSA

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