Community health workers recruitment from within: an inner-city neighborhood-driven framework

Authors: Hosseinali Shahidi, Cindy Sickora, Sharon Clancy and Roxanne Nagurka

Community health workers (CHWs) are frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served. Among other roles, they are effective in closing critical communication gap between healthcare providers and patients as they possess key abilities to overcome cultural barriers, minimize disparities, and maximize adherence to clinical directions. In previous descriptions of the selection of CHWs, the role of community is clearly emphasized, but residence in the community is not indicated.

Empowering a community to take a leading role in improving the health and well-being of its members is critical; especially in communities that are marginalized, experience cultural incongruence with their healthcare providers, and/or mistrust the healthcare system. The Centers for Disease Control (CDC), Community Preventative Services Task Force identified evidence gaps in CHW recruitment methods. Many CHW recruitment efforts begin with healthcare providers initiating recruitment without involvement of the community being served.

One way to provide a framework for empowerment is to request the community’s direct involvement. The implementation of such decisions are not well described or documented in the literature and attempts in giving communities the leading roles are not well described. The authors provide a way that community empowerment plays the introductory role in identification and selection of CHWs, and describe successes and challenges to this process. This project review provides a five step framework for direct community involvement with the recruit- ment and subsequent training of CHWs from within that same community.