About the CDC Community Health Worker (CHW) Certification Study

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In 2016–2017, the CDC Division for Heart Disease and Stroke Prevention and Division of Diabetes Translation completed a study to examine CHW certification approaches, structures, processes, barriers, facilitators, and outcomes.

The objective of this study was to inform the development of technical assistance on the implementation of statewide CHW certification within states.


There were two parts to this study: 1) case study and 2) extant document review.

  1. Case Study: Statewide CHW certification was examined within and across 7 case study states, including:
    • Two states that had carried out statewide CHW certification at least 5 years prior to the study
    • Two additional states that had implemented statewide CHW certification within the last 5 years
    • Two additional states that had decided to implement statewide CHW certification, but were still in the process of developing policies and procedures
    • One additional state that had officially considered CHW certification and decided not to pursue it for the time being
A community health worker taking a blood sample from a patient's finger.

CDC completed a study to examine CHW certification approaches, structures, processes, barriers, facilitators, and outcomes.

States in the process of considering certification officially or informally were included as an audience for this work.

In the summer of 2017, CDC conducted structured 90-minute key informant interviews with 40 key informants—including CHWs, state health officials, payers, and employers—across the 7 case study states. Office of Management and Budget approval was obtained for the interviews (OMB Control No: 0920-0879).

The interview guide included 23 questions about the following aspects of CHW certification: respondent and state government roles; process and current status; CHW qualifications, scope of practice, and training; and sustainability and outcomes. Interviews were audio-recorded, transcribed, and interpreted using applied thematic analysis methods. The team constructed narratives for each of the case study states, themes across the states, and lessons learned.

  1. Extant Document Review: To supplement data collected in the case study, CDC also collected and summarized the following:
    • More than 400 extant documents pertaining to CHW certification from the 50 states, D.C., and Puerto Rico
    • 4 years of data reported by 30 states setting up CHW strategies in two CDC-funded programs1

Individual states’ activities were summarized, and summaries were analyzed for alignment with themes and lessons learned from the case study.


  1. Centers for Disease Control and Prevention. CDC’s Funded State & Local Programs to Address Diabetes. https://www.cdc.gov/diabetes/programs/stateandlocal/index.html. Accessed November 2, 2018.


The following individuals contributed to the development of this technical assistance: Colleen Barbero, Bina Jayapaul-Philip, Erika Fulmer, and Refilwe Moeti (CDC); Sharada Shantharam and Siobhan Gilchrist (IHRC, Inc.); Aunima Bhuiya (ORAU); Carl Rush and Terry Mason (Community Resources, LLC); and Meredith Sugarman and Ashley Wennerstrom (Tulane University). Thank you also to the following reviewers: Magon Saunders, Betsy Rodriguez, Brenda Richards, Debra Sanchez-Torres, and Lazette Lawton (CDC).