Community Health Workers (CHW) Inclusion Checklist
Including Community Health Workers in Health Care Settings: A Checklist for Public Health Practitioners
The Community Health Workers (CHW) Inclusion Checklist [PDF – 226 KB] presents a general framework for public health practitioners to lead or assist in including CHWs and integrating the CHW scope of practice in health care settings. Learn more about CHW inclusion.
Public health practitioners and subject matter experts internal and external to the Centers for Disease Control and Prevention (CDC) developed the CHW Inclusion Checklist through an extensive review of peer-reviewed and grey literature.
Including Community Health Workers in Health Care Settings: A Checklist for Public Health Practitioners
Print and share this checklist [PDF – 226 KB] to help include CHWs and integrate the CHW scope of practice in health care settings.
What is the purpose of the checklist?
- The CHW Inclusion Checklist was designed to be a conversation facilitator and can help to establish and strengthen relationships between CHWs and health care providers.
- It can also provide direction for public health practitioners.
- The checklist was designed to be a non-prescriptive tool that highlights potential action steps to include CHWs in health care settings.
- The checklist was not designed to be a comprehensive guide to implementing CHW-based health care interventions, nor does it address the nuances of incorporating CHWs in the day-to-day activities of a health care setting.
Who should use the checklist?
This checklist is for public health practitioners, including individuals and organizations working in a variety of roles and settings, interested in including CHWs in health care teams.
Potential checklist users include:
- Hospitals looking to engage CHWs to carry out nonclinical tasks, such as ensuring patients get to their medical appointments or fill their prescriptions.
- Health care systems looking to engage CHWs to address social determinants of health.
- Public health researchers working with practitioners to analyze how to engage CHWs for specific populations.
- Community organizations seeking to bridge the gap between the health care system and the people they serve.
How do I use the checklist?
CDC encourages public health practitioners to share the CHW Inclusion Checklist with key stakeholders. The checklist was designed for staff who are most knowledgeable about the current policies and practices being implemented in their organization.
This CHW Inclusion Checklist is organized into four phases:
Planning involves designing a thoughtful, systematic, and coordinated approach that is beneficial to CHWs, patients, health care providers, and community members.
Implementation involves taking actions to support or carry out the approach planned for CHW inclusion or CHW scope of practice integration.
Evaluation involves determining how stakeholders, including CHWs, benefit from your program, support quality improvement efforts, detect any unintended consequences, and add to the body of knowledge of “what works.”
Sustainability involves maintaining your CHW programs and the associated benefits over time.
Although these phases are presented as distinct and occurring in a linear fashion, in practice they build on each other in an interdependent manner (e.g., earlier phases might feed into subsequent phases) and might be addressed in nonlinear ways (e.g., you might address elements in the implementation phases and then revisit the planning phase).
Each phase in the checklist is designed to be completed individually or in its entirety. The length of time for completing these action steps will depend on the needs of and resources available to the community and health care setting involved in the CHW program.
In order to ensure buy-in and increase the success of a CHW program, it is important for public health practitioners to collaborate with CHWs and involve them in each of the phases and any decision making.
The CHW program is more likely to be successful if the perspectives of CHWs, who know their own roles and unique challenges within the target populations and the community, are considered.
Action Steps
The checklist consists of 59 potential action steps for evidence-informed strategies and best practices to include CHWs in health care settings. As you are completing the checklist, consider each action step you did not check, and talk with CHWs and other stakeholders about whether it would be beneficial and feasible, either now or in the future, to take the related action steps.
For the purposes of this checklist, several potential action steps related to program financing are listed. Long-term financing is a major determinant of sustaining CHWs in health care systems, and may involve showing the impact of return on investments to stakeholders. However, developing long-term partnerships, ensuring organizational capacity, adapting to changes over time, communicating strategically and frequently with stakeholders, and having a supportive climate are just as important for maintaining a program.
Background
CHWs are a well-recognized workforce who can help to reduce health disparities and improve health equity. In addition, they have improved chronic disease control and prevention, as demonstrated for cardiovascular disease and type 2 diabetes.
There has been a growth of interest in including CHWs in health care settings to help reach patients experiencing health disparities. Although CHWs are not a new workforce, including a non-licensed, patient-centered role that spans both clinical and community settings is new for most health care settings.
Moreover, a lack of awareness, understanding, and respect for CHWs working within care delivery organizations could negatively affect CHWs’ ability to use their unique skillset. Using CHW programs effectively can help health care organizations set the stage for success.
Where can I get help for using the checklist?
For more information and resources related to CHWs, visit the Division for Heart Disease and Stroke Prevention website or contact arebheartinfo@cdc.gov.
