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Rural Health Information Hub
Rural Health Information Hub

Designing Rural Community Health Worker Programs that Meet Community Needs

Careful program planning and design is essential for implementing a successful and sustainable community health worker (CHW) program. CHW programs typically incorporate characteristics from multiple program models. When selecting models, programs should consider the scope, priorities, mission, and vision of the program, as well as community health priorities and how they align with potential CHW roles.

To identify community health priorities, programs can conduct a comprehensive community health needs assessment. CHW programs are most effective when tailored to address the needs of the population, as demonstrated by the Program Clearinghouse examples below:

  • Working to reduce cardiovascular risk among rural African-American women by conducting community-wide educational classes on nutrition, physical activity, and smoking cessation (Delta Health Alliance)
  • Conducting outreach to rural migrant and seasonal farmworkers (Family Health Centers)
  • Providing education and resources to help address social determinants of health including access to healthy food, housing, and transportation (University of Kentucky)

Recruitment and retention are key elements of successful CHW programs. CHW programs should define staff roles and responsibilities and ensure they align with the community health priorities addressed by the program. CHWs may perform a combination of roles, depending on community needs. Programs should convey CHW roles and responsibilities to other program staff to ensure organizational support for the CHW. Programs should also research and be aware of the extent to which state and local policies and laws apply to CHW programs.

When designing a CHW program, it is also beneficial to identify and engage partner organizations and individuals from the community. Partners may include community members; individuals and organizations that work with the population or health issue of focus, such as faith-based organizations, community-based organizations, and social workers; government agencies; and other interested parties. Partners can help identify community needs, support planning efforts, and ensure the program is reflective of community preferences, needs, and culture. Involving partners can also help to build broader support for the program. It may also be beneficial to conduct regular discussions with partners to support program implementation, valuation, and sustainability.

For an overview of the basic steps in rural program planning, design, and implementation, see our Rural Community Health Toolkit.