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Employers will hire CHWs if outside funding is available or if they can expect a significant return on their investment, but they will also want assurances that resources will be available for training new CHWs. The availability of these resources will depend on establishing clearly stated standards for the skills required of CHWs, a function of the occupational definitions and standards process.
Historically, in the absence of standards and standardized training programs, most CHWs were trained on the job by their employers. When funding is short-term and wages are low, employers try to provide the least amount of training necessary for the job. Furthermore, without a functioning job market for experienced CHWs, most employers have recruited inexperienced candidates and trained them post-hire. Thus, candidates have had little incentive to seek CHW training first and then look for a job, and few entry-level CHWs with training have been available for hire. Demand is minimal for open-enrollment CHW courses from community colleges in most states at the current time, and when colleges have successfully recruited students, the students have often struggled to find job opportunities.
We will be asking the following questions about the emerging structure of training programs for CHWs:
- What are the basic areas of skill, or core competencies, required for CHW practice?
- What level of skill in each of these areas should be required at the time of hire, or at the stage of becoming a “fully qualified” CHW?
- How much should a generally qualified CHW know about working in a specific field, such as diabetes, heart health, or cancer?
- What do we know about effective instructional methods in CHW education?
Stragies are necessary for the formal preparation of CHWs since: