Innovative approaches to implementing a community health worker-led curriculum: An evaluation of the national heart, lung, and blood institute's community health worker health disparities initiative

Heart disease disparities continue to exist among ethnic and minority groups. Research shows that the elimination of health disparities requires locally-driven solutions. The National Heart, Lung, and Blood Institute's (NHLBI) Community Health Worker (CHW) Health Disparities Initiative funded nine “Strategic Champions” to implement a CHW-led heart health curriculum among minorities who are disproportionately affected by heart disease. The Champions, which include universities, community-based organizations, tribal entities, and area health education centers, adapted and implemented one of NHBLI's twelve session manuals in various innovative ways. Champions were given flexibility in terms of how they built partnerships, how they taught the curriculum to and supported CHWs, and how the curriculum was implemented by CHWs in the community.

Quantitative surveys are employed to assess changes in CHWs heart health knowledge, attitude, and teaching confidence before and after being trained on the curriculum, as well as community member knowledge, behavior, and confidence change before and after completing the curriculum. Qualitative data such as video/photo voice, focus groups, and key-informant interviews are collected to characterize each Champion's unique implementation approach.

Preliminary results demonstrate an improvement in CHW knowledge, attitude and teaching confidence and community member knowledge, behavior and confidence. Final results showcasing the differential impact and reach of the innovative strategies will be presented.

There must be a careful balance of maintaining curriculum fidelity while also fostering community-driven strategies. By using a cross-site evaluation with a core set of metrics, the impact that various approaches had on CHWs capacity and community participants' is documented.