Make the Case for CHWs: 7 Return on Investment Studies

Making the case for community health workers is an uphill battle — but it is always worth the effort.

You’ve seen the data: a University of Pennsylvania School of Medicine report is one of many that show how the CHW model can reduce admissions and lead to better health outcomes for hospitalized patients and outpatient settings.

Unfortunately, too many organizations still find it difficult to make the business case for hiring, using and training community health workers. They offer excuses about the expense, or they vastly underuse their existing CHWs.

Convincing decision-makers to deploy groups of frontline health workers may not be easy, but hopefully this round-up of return on investment studies will put you a small step forward. It’s a collection of some of the best ROI studies I’ve seen on why to hire and educate people working in the CHW role.


More Soldiers in the Battle Against Tobacco

By Monique I. Cuvelier

The fight against smoking, chewing, and vaping just became a little fiercer.

From April 4-10, front-line health workers refined their health education skills via the online course Supporting Tobacco Cessation.

The course was sponsored by CHWTraining, a health care-focused division of Boston-based educational company Talance, Inc., and was produced in observance of National Public Health Week and offered at no charge. The weeklong, interactive course was facilitated by tobacco-cessation health educator Mary Etna Haac. She guided participants through practical tips and strategies they can use in their efforts to help more people quit or reduce using tobacco.

National Public Health Week logo

“[Supporting Tobacco Cessation was] very interesting,” said participant Ana Rubiano, a certified community health worker in an agricultural region of Florida who helps patients control diabetes, cancer, obesity, and other chronic illnesses and preventable diseases. “It let me learn new things to help the community. The facilitator’s communication was so good.”

Topics included a look at the biology of addiction, types of tobacco products, and the health effects of using tobacco. The program also provides common barriers to stopping and how to address those barriers through such methodologies as Stages of Change, the 5 R’s (Relevance, Risks, Rewards, Roadblocks, and Repetition), and the 5 A’s (Ask, Advise, Assess, Assist, and Arrange). Students were given a chance to try out their new skills in interactive activities and through forum discussions with Haac and other participants.

Tobacco Case Studies screenshot

An important part of the course is the Quit Day Action Kit, a set of handouts, resources, and tools that participants take with them to use with clients and patients. It includes methods to cope with triggers and withdrawal symptoms, journals and worksheets for planning for Quit Day, and tips on how to cope with stress, slips, and relapses. The kit combines with the Tobacco Cessation Toolbox, which contains additional local resources to use on the job.

The online class, which hosted approximately 20 individuals from states including California, Maryland, Nevada, and more, is part of a catalog of courses from CHWTraining that focus on providing essential skills in changing community health outcomes. Students ranged from community health workers and case managers to registered nurses and health educators.

[This article is for publication in The Nation’s Health from APHA.]

Tobacco Cessation Barriers Flashcards

The line between using and quitting tobacco can be so narrow. Many barriers prevent people from conquering their addictions. They include anything from a high-stress environment and a simple lack of support.

Understanding and addressing tobacco cessation barriers is vital for any effective intervention, but with so many variables, it’s hard to keep track. We wanted to find a simple way to remind staff and volunteers about common barriers and the best ways to respond, so we created these Addressing Tobacco Cessation Barriers flashcards. We made these printable cards free for your team.

CHWTraining Tobacco Cessation Barriers flashcards

The cards include tips on how to address tobacco cessation barriers including:

  • Social factors
  • Stress
  • Lack of support
  • Mental health
  • Fear of failure
  • Competing priorities

Download Tobacco Cessation Barriers Cards

Let others know that these cards are available!

Patient Navigator/Community Health Worker Conference, May 12, Norwood, MA

Our friends at have just announced its annual conference is open for registration.

I’m excited about this, as I am every year, because it brings together all kinds of people who work in this area of public health. Every year it’s gotten bigger, no wonder.

It’s also incredibly affordable: $25 for CHWs, students, and patient navigators and $40 for general admission. If your pockets aren’t that deep, they give scholarships. It’s worth attending even if you’re not in Massachusetts.


Preparing the Workforce: The 7th Annual Patient Navigator/Community Health Worker Conference

Thursday, May 12, 2016
Four Points by Sheraton Norwood
1125 Boston-Providence Turnpike (Route 1), Norwood, MA


You are cordially invited to Preparing the Workforce: The 7th Annual Patient Navigator/Community Health Worker Conference on May 12, 2016. In the last few years, we have watched community health workers (CHWs) and patient navigators (PNs) become a vital part of today’s healthcare system. In this 7th annual conference, we will focus our attention on the development of the CHW and PN workforce. The conference offers interactive skills-based learning in a variety of topics through breakout sessions, networking, and resource and poster sessions. This invitation is extended to PNs, CHWs, supervisors, and those involved in developing PN programs throughout Massachusetts and other parts of the country. Come join us for this exciting conference designed by and for PNs and CHWs!

Dr. Alex Green will be joining us as our keynote speaker. Dr. Green is the Associate Director at the Disparities Solutions Center at Massachusetts General Hospital and an Assistant Professor at Harvard Medical School. He has authored articles on topics including cross-cultural education, culturally competent healthcare systems, and language barriers and interpreters. Dr. Green speaks nationally on improving cross-cultural communication and providing effective care to patients from diverse sociocultural backgrounds. 

In addition to the keynote by Dr. Green, this year’s conference features 15 breakout sessions to choose from. Visit the website for more information and to view the preliminary program

Registration Rates:
General Admittance – $40
PNs/CHWs/Students – $25
Vendors – $100 (table only); $125 (table + conference attendance)
Payments are accepted by credit card (Visa, MasterCard, or Amex).  To apply for a scholarship, please fill out this application by April 14.

Registration will close on Friday, April 22.

Family Health History Initiative Starter Kit

Family Health History Initiative Starter KitUnderstanding and addressing the health history of a client is the best way of knowing what kind of treatment he or she needs. Digging a little deeper into family health history is even better, especially as part of National Cancer Prevention Month. Your health staff can recommend screenings and referrals based on what kind of conditions patients are genetically predisposed to.

Gathering family health histories can easily be added to any at-home or in-clinic visit. Your staff can fill in a form based on patient responses, or they can give them a worksheet to complete at home.

We’ve made it even easier by creating a Family Health History Initiative Starter Kit, a free collection of resources and worksheets to simplify the process at your organization. This download will give your team everything it needs to help clients build a health family tree.

The starter kit includes:

  1. Instructions on how to take personal and family health histories
  2. Talking-point tip sheet for gathering health histories
  3. Health history form for individuals and their family members
  4. Additional digital resources


Download the Health History Kit

Food for Thought

A container of yogurt six months past its “expiration date” might be one of the oldest things I’ve eaten. Then again, that piece of cheddar, carefully pruned of mold, I had last week might have been older. My husband will tell you with a cringe that I’m much more likely to excavate something from the back of the fridge, give it a sniff, and decide to eat it only if the smell doesn’t knock me out.

“Better By,” but Still Good

I don’t give much weight to meaningless dates. All you need to do is look at the inconsistency of these labels to know how little they mean: “Best Before,” “Sell By,” “Use By,” “EXP,” or my favorite, “Enjoy By.” These ambiguous terms are not a reliable indication of how long food will keep, but they do mean that 90 percent of consumers say they toss food because of safety concerns.

The truth is that these dates are really a “best guess.” Most are invented by food manufacturers, many of which are small companies that don’t have the means to conduct food-longevity studies. They pick a date, maybe based on some knowledge (but maybe not), and slap it on the package.

Better by, but still good after

No Food Date Regulation

They do this because the U.S. government doesn’t regulate expiration dates on anything but infant formula, although the Department of Agriculture admits that dates aren’t a guide for safe use of a product. But why would anyone know to ignore the date on the package? Most reasonable people would read an expiration date on food the way they would the expiration date on a coupon. The upshot is that stores and consumers throw food away on a mass scale, contributing to the estimated 40 percent of food that goes uneaten in the United States.

Look at Montana’s strict milk policy, which says that stores need to remove milk from shelves – and dump rather than donate it – just 12 days after pasteurization. Most milk producers recognize that milk is good for three weeks after pasteurization, and most people who drink milk know that it’s still good for a while after that, as long as it’s not left on the counter for too long.

Never mind the miserable thought of all that milk going into the sewer; milk in Montana is significantly more expensive, as much as dollar or two more per gallon than in neighboring states. That’s a shame, given that people are hungry – one in seven Americans, according to the USDA. Food is expensive enough as it is, without people and stores throwing away perfectly edible items because of a meaningless date.

Grassroots Grocery Efforts

Thankfully, there are a few efforts to avoid this kind of waste, notably Daily Table, a nonprofit that sells “expired” groceries to people in Dorchester, Mass. Doug Rauch, the former president of Trader Joe’s, decided to do something about all the food he saw going into dumpsters. So, in 2014, he started rescuing groceries and selling them at a reduced price.

Sustainable America is another organization that’s pushing for better education about the longevity of food, especially via its consumer-focused I Value Food website. It includes tips like how to use extra garden vegetables, how to host a “salvaged dinner party,” and resources like the Produce Storage Cheat Sheet.

Efforts like these are a start, and with the lack of any reliable government guidelines, they’re about all we have to cut down on food waste and help more people eat right while reducing their grocery bills. Community health workers and other front line health workers have an important role to play here, both in connecting individuals to resources like those on IValueFood or stores like Daily Table, and also in educating people in how long food will actually last. Or, as my mom taught me, trust your nose. If it smells OK, it probably is.

Certificate in Diabetes and Prediabetes

Give your CHW and nonclinical staff a certificate in diabetes and prediabetes with a learning track. One month, key skills, success for your organization.

Get started now

Check It Out, Ohioans: Free Patient Navigator Course from Komen

Our friends at Susan G. Komen Columbus have announced a fantastic and free breast cancer training opportunity for clinical or community-based patient navigators. If you’re in Ohio, you can apply for this blended-learning program to “increase your patient needs assessment skills and learn about resources to help support patients through the continuum of care.” Read more below, and apply by Feb. 11:

Patient Navigator Course for Laypeople and Clinical Professionals

Komen Columbus is excited to announce we are accepting applications for a free course for community-based or clinical patient navigators interested in increasing their patient needs assessment skills and learning about resources to help support patients through the continuum of care. Though this training focuses on patient navigation after an abnormal screening result, it may be appropriate to build skills for navigation to screening as well.

The deadline to apply is February 11. The course will begin March 1st, and continue for 10 weeks. Twenty-two CNE credits are available through the Oncology Nursing Society.

Participants for the first training will be selected from submitted applications. Complete an application by Feb.11. There are the following requirements to participate:

  • Located in Ohio
  • Supervisor letter of recommendation and support
  • Baseline measurements submitted before course. Measurements will be collected upon applicant’s selection. For example, the number of patients with abnormal screening results who completed diagnostic testing.
  • Follow-up measurements
  • Participation in in two live webinar sessions
  • Completion of a module and quiz each week to move on to the next module

March 1, 10 am-noon: webinar course introduction and welcome module
Week 1: Organizational and Documentation Skills
Week 2: Disparities and Social Determinants of Health
Week 3: Assessment Skills
Week 4: Breast Continuum of Care Part 1
Week 5: Breast Continuum of Care Part 2
Week 6: Navigating Health Insurance
Week 7: Service Coordination
Week 8: Genetics
Week 9: Health Coaching and Motivational Interviewing
May 10, 10 am-12 pm: Live webinar course conclusion

Need Core Skills Training?

Involve your team in high-quality online education in health insurance, health literacy and motivational interviewing in the Core Skills Learning Track.

Request information now

Three Easy Steps for Asthma Education

Young woman using spirometry asthma device

Helping community members manage asthma can be as easy as sharing a few key pieces of knowledge—even if you don’t have a dedicated asthma care team.

According to the American Lung Association, asthma is one of the main reasons that students miss school due to illness. Making a few changes can significantly change those statistics.

Changes that work for people with asthma or their caregivers don’t have to be about major lifestyle overhauls. They can be as simple as:

  • Remove your shoes at the door
  • Ventilate your home
  • Clean green

These are three tips from CHWTraining’s Improving Asthma Outcomes program, which aims to instruct peer educators on guiding patients and clients to making easy changes that improve the quality of their life.

The program, which is available as an Express Course or as part of the Asthma Learning Track, shows participants how to recognize asthma symptoms, identify and use asthma medications and reduce asthma triggers in the home. The online program consists of about three hours of online instruction and is a complement to existing home visit programs, or a supplement to organizations without any.

Express courses are available for 15 days and take a few hours to complete. Learning Tracks are training bundles that are available for about a month. The Asthma Learning Track includes the courses Improving Asthma Outcomes, Health Literacy and Tobacco Cessation.

For more information, read about Improving Asthma Outcomes or the Asthma Learning Track.

[Photo credit: International Asthma day 2011 in Malmö, Hans Hansson on Flickr]

Certificate in Improving Asthma Outcomes

Improve health in your community by giving your employees and volunteers a certificate from our Improving Asthma Outcomes learning track. One month, key skills, success for your organization.

Get started now

Does your staff know enough about health coaching and motivational interviewing?

As health-based organization, you already know that motivating community members to change is tough. Make sure your CHWs, patient navigators, promontoras and other health workers are doing all they can to empowered clients and patients to live a healthier life.

The course Health Coaching and Motivational Interviewing helps you see greater results from client interactions.

This on-target course covers the essentials your staff needs to know for coaching and MI. This course defines health coaching activities, why and how it is done and how patients or clients might view self-care. It also covers stages of change, and techniques for motivational interviewing and goal-setting.

Best of all, you can enroll up to 20 people for the same low price.

Read about Health Coaching and Motivational Interviewing.

Free On-Demand Webinar: Introduction to E-Learning for AHECs

Length: 60 minutes

Everyone talks about online learning, but what does it really mean? We’ll cut through the jargon to explain the basics of health-based e-learning, and discuss why offering online courses can help you boost your enrollment numbers. We’ll identify the elements you’ll need to structure your online training program.

Watch this on-demand webinar to learn how to get the whole team on board, what the technology requirements are, and why your learners are probably asking for online module delivery. You’ll walk away with knowledge about online training that will help energize your organization and help you increase participation in your program.

View the webinar now >>