Purpose: Healthcare access disparities pose an ethical dilemma to academic medical institutions (AMI), yet it is unclear how they partner with Community Health Workers (CHWs) to address these disparities. No reviews on CHW/AMI partnership have previously been published.

Method: CHWs were involved in the formation of our research questions, refining our search strategy, and interpreting the findings. A CHW will co-present at APHA. Literature was searched from the following databases: Pubmed, Web of Science, CINAHL, SocINDEX, and PsychInfo. 1404 articles were originally identified. After de-duplication, 748 titles and abstracts were reviewed for inclusion in the full-text review. 210 full-text articles were reviewed and 126 were included in the final sample.

Findings: We describe CHW/AMI partnership in terms of roles, settings, populations served, and outcomes. CHW/AMI partnership fell into three, non-mutually exclusive categories: 1) community-based participatory research (CBPR) (n= 23), 2) workforce development (n= 19), and 3) intervention implementation and evaluation (n= 106). In CBPR studies, CHW roles included recruitment, community engagement, needs assessment, data collection and community expertise. In workforce development studies, AMIs developed training for CHWs, medical students or residents. Lastly, intervention implementation and evaluation focused on a variety of healthcare settings, populations, and health conditions.

Conclusions: CHWs are a key workforce to addressing health disparities, and AMIs play a critical role in supporting CHW workforce development, training, and self-advocacy. This review underscores CHW value and expertise in community engagement, health promotion and system navigation. We will identify future directions for CHW/AMI partnership that center CHW self-determination and equity.

PAES is a peer network focused on supporting predominantly Spanish-speaking CHWs through continuous training and development, creating more opportunities for them to gain employment, and mobilizing them to be advocates on behalf of the community. PAES is an “enganche,” or hook; network members – mostly immigrant women – pull in others who they see are passionate about health and community building. Regardless of their level of formal education or professional experience, the knowledge and lived experience that they bring is validated and celebrated. Through a diverse array of opportunities, including a bilingual CHW college certificate program that PAES helped establish, they can develop a holistic skill set and engage in a range of activities, including community outreach, health education, mental health peer support, insurance and benefits enrollment, healthcare and social service system navigation, public health research, community organizing, and policy advocacy. They also develop a comprehensive understanding of public health and social justice that allows them to address the issues facing their communities using both an individual and a systems approach; this has positioned PAES and its membership at the center of efforts to address the impact of the pandemic on Spanish-speaking immigrant communities. Ultimately, PAES is a platform for CHWs to build collective power that informs the creation of systems and policies that truly reflect the needs of their communities and support the growth of the CHW movement. What began as a community-based initiative has become an important resource for Spanish-speaking CHWs and communities across the region.

Historically, community health workers (CHWs) have demonstrated positive impacts globally by bridging vulnerable communities with health and social services. As the workforce expands, understanding CHWs’ capabilities is key to designing successful interventions. This study elicits experienced CHWs’ perspectives to describe their work and propose a logic model for CHW success.

This qualitative study involved semi-structured interviews with individuals who held positions that aligned with CHW. Questions focused on participants’ work and factors contributing to their effectiveness. De-identified transcripts were analyzed, and codes were categorized in two pre-determined domains (current work of CHWs and strategies for CHWs to be successful in their role), followed by themes and subthemes. A CHW was critically engaged in data analysis and interpretation and is supporting the presentation’s development.

Fourteen individuals participated in an interview. Five themes were identified regarding CHWs’ work: providing services, building alliance with clients, establishing and maintaining collaborations, collecting data, and experiencing challenges. CHWs’ responsibilities enhanced client care and supported workforce sustainability.

Five themes emerged about strategies for CHW success: CHWs’ background, champions to support CHWs’ work, materials, preparation for the CHW role, and CHW characteristics. These strategies informed a logic model outlining considerations for supporting CHWs at the individual level, including CHW hiring qualifications, sources of support, and CHW trainings to develop competencies necessary to be effective.

CHWs play an increasingly important role in reducing health inequities. This study offers a structural framework for policymakers and community-based organizations to apply to future programming to equip CHWs for success.

The Greater Houston region has historically been systems poor and programs rich when it comes to efforts to improve health equity, and this includes community health worker efforts. Today, the Health Equity Collective (HEC) is a multi-sector coalition of over 180 organizations with the mission of establishing an impactful, collective, sustainable, data-driven system to improve social determinants of health (SDOH) needs and promote health equity. The HEC is focused on developing human, data, technology, and financial capacity for organizational alignment and multi-sector collaboration.

Globally, community health workers (CHWs) have been key to significant population health improvements, when supported in their role. Community health workers have long played an important role in care coordination efforts and this was escalated with the pandemic influx of millions of dollars into the region. The Health Equity Collective is tasked with cultivating collaboration across the funded efforts in order to improve the impact of these investments and to cultivate sustainable, equitable workforce development.

Using collective impact strategies, the HEC has been convening CHW leaders, trainers, employers, and individual CHWs to better understand the opportunities and challenges for CHWs and cultivating sustainable, equitable workforce development. This collaboration includes a landscape scan, journey mapping activities, key informant interviews, and equity evaluation. The combination of activities will inform a multi-stakeholder visioning session to determine the shared focus of this CHW Network. With CHW leader on the team, we will present the tools utilized throughout this process to develop as a guide to assist other CHW networks.

Issue: Recent historical changes in legislation have brought great attention to the century’s old Community Health Workers/Promotores profession. CHW/Ps have unique skills to connect systems and communities because of their lived-experiences, intrinsic motivation, deep sense of community, and eagerness to help others. As recognition and integration efforts in various settings take place, it is evident that gaps such as lack of professional growth opportunities and a need for support still exist. The focus of this presentation is to share the testimony of a CHW/Promotora who navigated through settings and paved a pathway to give her the support needed to elevate her career while maintaining her CHW/P roots and essence.

Description: During this presentation, a CHW/Promotora shares lessons learned and recommendations from her 18 years of work experience in the community. First, as a volunteer providing support to Hispanic mothers in school settings, working with non-profit agencies, and recently transitioning from an in/out-patient healthcare facility, to now working as a full-time CHW/P instructor & mentor.

Lessons Learned: CHW/Ps have the capacity to adjust and embrace various settings wholeheartedly. Nevertheless, systems and CHW/Ps need to identify strengths and gaps to collaborate as interdisciplinary professionals to maximize efforts in all work environments.

Recommendations/Conclusions: As the CHW/P profession grows, it is important that they maintain their identity, and have opportunities to build their leadership and navigation skills in various settings. Finally, CHW/Ps should be encouraged and given opportunities to continue embracing new experiences, cultures, and systems to promote professional growth.

BACKGROUND: In Texas, 64% of CHWs fulfill roles on multi-disciplinary teams. This workforce is especially critical to South Texas, where all 38 counties are medically underserved and marked by high social vulnerability. However, the workforce is aging and many CHWs are not renewing their certification (only 33% renewed in 2019). Expired certifications are higher among those who received training in Spanish (77%). The South Texas CHW Workforce Preparedness Collaborative (STCWPC) identified an opportunity to increase CHW recruitment, training, and retention.

METHODS: STCWPC organized as a network of 12 academic, nonprofit and local government partners to build the CHW workforce by recruiting ethnically and culturally similar community advocates, including younger and/or Spanish-speaking individuals. CHWs are represented in STCWPC and among this abstract’s co-authors. STCWPC provides financial and professional support to reduce barriers to completing training and maintaining certification. In three years, the STCWPC aims to recruit, train, support, and certify 275 CHWs.

RESULTS: Since forming in September 2022, STCWPC has implemented a common application using REDCap to streamline enrollment across six training partners and formalized institutional processes to provide trainees up to $7,500 for tuition and expenses incurred due to training (e.g., transportation, dependent care). As of March 2023, 119 have applied; of these, 12 have been certified, 27 are in training, and 21 are scheduled for training.

DISCUSSION: Initial results indicate the model for harmonized recruitment and provision of financial support is an effective strategy for increasing training enrollment. Data collection and analysis using an implementation science framework is planned.

Capacity building among CHWs is an important way to expand health education into underserved communities. We developed a train-the-trainer curriculum to train CHWs to deliver an educational workshop teaching community members about the fundamentals of research, and the importance of participation of underrepresented populations to overcome social challenges and advance health equity. This training program builds upon the vast literature supporting the effectiveness of the CHW model in providing education, improving access to services, and influencing behavior change in underserved communities. It is further supported by the Community Based Participatory Research framework which promotes the principles of power sharing, co-learning, community partnerships, equitable engagement, trust, and capacity building.

This is a 12 hour training comprised of 5 lessons, each with its own key learning objectives, and can be delivered virtually or in-person. This training is evaluated with a pre and-post test, and satisfaction survey. All participating CHWs will also complete a follow-up survey quarterly for a year to assess the reach and impact of this training in the communities they serve.

We are training 100 CHWs from four different community-based organizations. To date, 59 CHWs have been trained. Preliminary data show a 20% increase in knowledge about clinical research, a 40% increase in knowledge about ethics and the rights of participants, and a 50% increase in knowledge about the impact of underrepresentation of minority populations in research.

This training was co-developed, and is led by, the CHWs on our team. A CHW from our team may also be a presenter.

Background: Opioid use disorder (OUD) and substance use disorder (SUD) adversely impact individuals regardless of race, gender, and socio-economic background. Despite the growing number of opioid-related deaths and overdoses, treatment capacity has failed to adequately address the growing need for services aimed at combatting this public health epidemic. Methods: To address these community-based needs, we developed an interdisciplinary behavioral health two-level training program. Level-one is an educational OUD certificate program, and level-two is a Community Health Worker (CHW) Federal Registered Apprenticeship. The program, funded through a federal grant, will provide 200 students with specific education and training to work within the OUD/SUD communities. All students complete level-one training and 10-20 percent will matriculate to the CHW apprenticeship. The first cohort of students is entering CHW registered apprenticeships. We will present process evaluation results for this program, challenges, and lessons learned. Results: Evaluation measures include program: implementation; maintenance and sustainability; engagement; communication; knowledge; readiness; and, health equity. Fifty-three percent of program participants are white and represent a mix of undergraduate (36.5%), graduate (35.1%), and non-degree (28.7%) seeking students (N=152). The program has maintained a 76 percent student retention rate for level-one. We have seen a 12.5 percent relative increase in student OUD/SUD knowledge between pre- and post-assessments of level-one training. Through a post-program completion survey, 83 percent of respondents indicated that the knowledge gained from the level-one program benefitted their education and/or career. Conclusion: Initial process evaluation results show the program shows promise for expanding the CHW behavioral health workforce.

In 2019, the Franklin County Public Health Care Coordination Program included one CHW and one non-CHW Supervisor. Today the program includes ten CHWs, one CHW Program Coordinator(non-CHW), one Administrative Assistant(CHW), two CHW Supervisors(CHWs), and one Division Manager(non-CHW). Under the leadership of our Division Manager, this growth is attributed to the work of the CHWs on the team utilizing the Pathways HUB model of care and state and federal grants. Two CHWs now lead the team of CHWs within the program and this has shown to be effective for team morale, community and client engagement, and professional development. CHW career ladders were drafted and proposed to our HR department for review in partnership with CHWs. If approved, the career ladders will serve to provide opportunities for professional growth within the CHW profession, continued CHW leadership development, and mentorship for new CHWs entering the profession. Some CHW positions in the program are grant-funded and this has provided CHW Supervisors with the opportunity to lead grants which are often a source of funding for the CHW position. To lead these efforts, CHW Supervisors are coached and mentored by the Division Manager who equips them with responsibility and empowers them with leadership opportunities to grow within the CHW profession. The foundation of this work is us, the CHWs, and we've been at the table throughout the growth process.