Peer Training of Community Health Workers to Improve Heart Health Among African American Populations

PURPOSE: African Americans suffer disproportionately from heart disease mortality and morbidity.  Trained community health workers (CHWs) can help to close this disparity gap. There is a dearth of research delineating the implementation and evaluation of peer-to-peer training of CHWs as heart health educators.  We evaluated a highly replicable CHW training program designed to reduce heart disease risk among high-risk African American populations. METHODS: We used a Learning Circle approach to train CHWs. The curriculum blended web-based training, self-directed learning and in-person peer coaching.  CHWs learned through: 1) peer-to-peer sharing; 2) problem-solving and brain-storming; 3) leadership and experiential activities. Training evaluation measures were CHW: 1) self-confidence; 2) heart health knowledge; 3) satisfaction with training; 4) training retention; and 5) replication of training within 90 days after training.  FINDINGS: This training resulted in appreciable effects on four of five outcome measures.  Heart health knowledge increased significantly among experienced CHWs (p=0.011). CHWs were highly satisfied with training.  Retention over the 4-day training period was 100%. CHWs initiated and subsequently delivered 122 person hours of community-based heart health education and CHW training sessions in their communities. DISCUSSION/CONCLUSION: The Learning Circle approach is easily tailored and closely simulates CHWs’ typical teaching/coaching style. The preliminary evaluation of this training model suggests that the methodology may work best for increasing heart health knowledge among experienced CHWs and CHWs who have some prior familiarity with heart health education content. Using the Learning Circle method to train CHWs is a practical and replicable method of training CHWs, and holds significant potential for building organization training capacity in resource-poor, community-based organizations.