Advertisement

Journal of Community Health

, Volume 41, Issue 2, pp 315–325 | Cite as

Do State Community Health Worker Laws Align with Best Available Evidence?

  • Colleen Barbero
  • Siobhan Gilchrist
  • Jamie F. Chriqui
  • Molly A. Martin
  • Ashley Wennerstrom
  • Jennifer VanderVeur
  • Kim Prewitt
  • J. Nell Brownstein
Original Paper

Abstract

Community health workers (CHWs) are expected to improve patient care and population health while reducing health care costs. Law is a tool states are using to build a supportive infrastructure for the CHW workforce. This study assessed the extent existing state law pertaining to the CHW workforce aligned with best available evidence. We used the previously developed Quality and Impact of Component (QuIC) Evidence Assessment method to identify and prioritize those components that could comprise an evidence-informed CHW policy at the state level. We next assessed the extent codified statutes and regulations in effect as of December 31, 2014 for the 50 states and D.C. included the components identified in the evidence assessment. Fourteen components of an evidence-informed CHW policy were identified; eight had best, three had promising, and three had emerging evidence bases. Codified law in 18 states (35.3 % of 51) pertained to the CHW workforce. Fifteen of these 18 states authorized at least one of the 14 components from the evidence assessment (maximum: nine components, median: 2.5). The most frequently authorized component was a defined scope of practice for CHWs (authorized by eight states) followed by a standard core competency curriculum and inclusion of CHWs in multidisciplinary health care teams (each authorized by six states). States could consider the components presented in this article when developing new or strengthening existing law.

Keywords

Community health worker Evidence-informed policy Health policy Health law 

Notes

Acknowledgments

This project was funded by Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

Centers for Disease Control and Prevention (#11IPA1103219).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Ward, B. W., Schiller, J. S., & Goodman, R. A. (2014). Multiple chronic conditions among US adults. A 2012 update. Preventing Chronic Disease, 11, E62.Google Scholar
  2. 2.
    Institute of Medicine. (2003). Unequal treatment. Washington, D.C.: The National Academies Press.Google Scholar
  3. 3.
    American Public Health Association. (2009). Support for community health workers to increase health access and to reduce health inequities. Retrieved from http://www.apha.org.
  4. 4.
    Centers for Disease Control and Prevention. (2014). States implementing community health worker strategies. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  5. 5.
    Centers for Disease Control and Prevention. (2015). Addressing chronic disease through community health workers. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  6. 6.
    The Institute for Healthcare. (2015). Triple aim. Retrieved from http://www.ihi.org.
  7. 7.
    United States Department of Health and Human Services. (2007). Community health worker national workforce study. Washington, D.C.: United States Department of Health and Human Services.Google Scholar
  8. 8.
    Institute of Medicine. (2010). A population-based policy and systems change approach to prevent and control hypertension. Washington, D.C.: The National Academies Press.Google Scholar
  9. 9.
    United States Department of Health and Human Services. (2013). Medicaid and children’s health insurance programs. Final rule. Federal Register, 78(135), 42160.Google Scholar
  10. 10.
    Viehbeck, S. M., Petticrew, M., & Cummins, S. (2015). Old myths, new myths. American Journal of Public Health, 5(4), 665–669.CrossRefGoogle Scholar
  11. 11.
    Institute of Medicine. (2005). Preventing childhood obesity. Washington, D.C.: National Academies Press.Google Scholar
  12. 12.
    Brennan, L., Brownson, R. C., & Orleans, C. T. (2014). Childhood obesity policy research and practice. American Journal of Preventive Medicine, 46(1), 1–16.CrossRefGoogle Scholar
  13. 13.
    Centers for Disease Control and Prevention. (2014). Understanding evidence. Retrieved from http://vetoviolence.cdc.gov/apps/evidence.
  14. 14.
    Spencer, L. M., Schooley, M. W., Anderson, L. A., et al. (2013). Seeking best practices. Preventing Chronic Disease, 10, E207.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Oxman, A., Lavis, J. N., Lewein, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health policymaking. Health Research Policy and Systems, 7(S1), 1–7.CrossRefGoogle Scholar
  16. 16.
    Barbero, C., Gilchrist, S., Schooley, M. W., Chriqui, J. F., Luke, D. A., & Eyler, A. A. (2015). Appraising the evidence for public health policy components using the Quality and Impact of Component (QuIC) Evidence Assessment. Global Heart, 10(1), 3–11.CrossRefPubMedGoogle Scholar
  17. 17.
    Centers for Disease Control and Prevention. (2013). State law fact sheet. A summary of state community health worker laws. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  18. 18.
    Massachusetts Department of Public Health. (2009). Community health workers in Massachusetts. Boston, MA: Massachusetts Department of Public Health.Google Scholar
  19. 19.
    Initiative, The New York State Community Health Worker. (2011). Paving a path to advance the community health worker workforce in New York state. New York, NY: The Community Health Worker Network of NYC.Google Scholar
  20. 20.
    Centers for Disease Control and Prevention. (2014). Policy evidence assessment report. Community health worker policy components. Retrieved from http://www.cdc.gov/dhdsp/pubs/docs/chw_evidence_assessment_report.pdf.
  21. 21.
    Community Guide to Preventive Services. (2015). Cardiovascular disease prevention and control. Interventions engaging community health workers. Retrieved from http://www.thecommunityguide.org.
  22. 22.
    Krieger, J., Collier, C., Song, L., & Martin, D. (1999). Linking community-based blood pressure measurement to clinical care. American Journal of Preventive Medicine, 89(6), 856–861.Google Scholar
  23. 23.
    Levine, D. M., Bone, L. R., Hill, M. N., et al. (2003). The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African American population. Ethnicity and Disease, 13, 354–361.PubMedGoogle Scholar
  24. 24.
    Bate-Ambrus, V. M., Castillo, A., Martinez, E., et al. (2015). Many ingredients, one sublime dish. Journal of Ambulatory Care Management, 38(3), 236–243.CrossRefPubMedGoogle Scholar
  25. 25.
    Association of State and Territorial Health Officials. (2015). Community health workers. Training/certification standards. Retrieved from http://www.astho.org.
  26. 26.
    Brownstein, J. N., Bone, L. R., Dennison, C. R., et al. (2005). Community health workers as interventionists in the prevention and control of heart disease and stroke. American Journal of Preventive Medicine, 29(5s1), 128–133.CrossRefPubMedGoogle Scholar
  27. 27.
    National Academy for State Health Policy. (2015). State community health worker models. Retrieved from http://www.nashp.org.

Copyright information

© Springer Science+Business Media New York (outside the USA) 2015

Authors and Affiliations

  • Colleen Barbero
    • 1
  • Siobhan Gilchrist
    • 2
  • Jamie F. Chriqui
    • 3
  • Molly A. Martin
    • 3
  • Ashley Wennerstrom
    • 4
  • Jennifer VanderVeur
    • 1
  • Kim Prewitt
    • 5
  • J. Nell Brownstein
    • 1
  1. 1.Centers for Disease Control and PreventionAtlantaUSA
  2. 2.IHRC, Inc.AtlantaUSA
  3. 3.University of Illinois at ChicagoChicagoUSA
  4. 4.School of Medicine, Department of Internal MedicineTulane UniversityNew OrleansUSA
  5. 5.Brown School of Social WorkWashington University in St. LouisSt. LouisUSA

Personalised recommendations