Evaluating Community Health Advisor (CHA) Core Competencies: The CHA Core Competency Retrospective Pre/Post-test (CCCRP)

Background: Health disparities are rampant across many areas of the country, affecting disadvantaged and vulnerable populations including those that are of racial minority underserved, underinsured, and uninsured groups. This widespread issue requires a comprehensive approach and stepping outside traditional health care providers to use community-based resources. Utilizing community health advisors (CHAs) are increasingly being used in community-based participatory research (CBPR) approaches to solving health disparities; however, little attention has been placed on CHA training outcome evaluation including core competencies attainment.

Purpose: This study: (a) identified a common set of CHA core competencies, (b) generated a theoretically-based measure of CHA core competencies: Core Competencies: The CHA Retrospective Pre/Post-test (CCCRP) measure, and (c) explore psychometric properties of the CCCRP.

Methods: Concept synthesis was used to examine scientific literature to determine CHA core competencies and develop the items. Data were collected from 142 participants who had previously received CHA training. Exploratory factor analyses were conducted separately on pre-test and post-test data followed by an analysis of internal consistency for the CCCRP.

Results: Five CHA core competencies (leadership, translation, guidance, advocacy, and caring) were  incorporated in the CCCRP’s  24 items. Exploratory factor analyses revealed a two factor structure underlying the pre-test and post-test data with internal consistency estimates of .965 for the CCCRP.

Discussion: This study indicates that some CHA core competencies may be more interrelated than previously thought and there may be two major competencies instead of five. Additionally, this study supported the use of the CCCRP to evaluate core competency attainment after training.