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Planning and Designing a Rural Community Health Worker Program

Careful program planning and design is essential for success. Basic program planning and design tasks for rural community health worker (CHW) programs include the following:

  • Determine program scope, for example, community to be served, health issue(s) of focus. (See Conducting a Needs Assessment in the Rural Community Health Toolkit for guidance.)
  • Research jurisdictional policies and laws for CHW programs that apply in the community
  • Define program coordination responsibilities and CHW roles and responsibilities; convey CHW roles and responsibilities to existing staff
  • Identify appropriate CHW program models
  • Determine funding source(s)
  • Identify potential barriers and enablers to implementation (see Implementation Challenges for more information)
  • Describe short- and long-term goals and intended outcomes
  • Make a plan for program evaluation and identify appropriate evaluation measures
  • Develop a timeline for program planning, implementation, and evaluation (see Module 5 for information on CHW program evaluation)
  • Create a sustainability plan (see Module 6 for information on CHW program sustainability)

When planning a CHW program, communities should identify and involve partner organizations and individuals. 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 stakeholders. Involving partners will help to build broader support for the program and make sure that the program reflects community preferences, needs, and culture. It may also be beneficial to conduct regular discussions with stakeholders as the program progresses in order to change and improve implementation plans and processes.

Resources to Learn More

Building a Community Health Worker Program: The Key to Better Care, Better Outcomes, & Lower Costs
Document
Demonstrates the benefits of CHW programs in improving patient health and provides information on implementing CHW programs in hospitals and healthcare systems.
Author(s): Brooks, B.A., Davis, S., Frank-Lightfoot, et al.
Organization(s): American Hospital Association
Date: 7/2018

Five Steps to Design a Community Health Worker Program: Tools for Implementing a Sustainable and Effective Program
Document
Offers best practices and resources for designing a sustainable CHW program.
Organization(s): Advisory Board
Date: 2019

Best Practice Guidelines for Implementing and Evaluating Community Health Worker Programs in Health Care Settings
Document
Offers healthcare administrators, providers, and others guidance and recommendations when developing CHW programs. Addresses hiring, training, supervision, evaluation, and integration of CHWs into healthcare systems.
Author(s): Kapheim, M.G. & Campbell, J.
Organization(s): Sinai Urban Health Institute
Date: 1/2014

Community Health Worker (CHW) Toolkit
Website
Lists resources relevant for CHW program implementation, including policy resources, implementation and evaluation resources, training and educational resources, and peer-reviewed journal articles.
Organization(s): U.S. Centers for Disease Control and Prevention
Date: 6/2019

Including Community Health Workers (CHWs) in Health Care Settings: A Checklist for Public Health Practitioners
Document
Provides a framework for implementing CHW programs and integrating CHWs into a healthcare setting. Includes CHW program planning, implementation, evaluation, and financial sustainability.
Organization(s): U.S. Centers for Disease Control and Prevention
Date: 9/2019

Community Health Worker (CHW) Toolkit: A Guide for Employers
Document
Provides employers in clinical settings guidance for CHW program planning and practice integration. Includes information on CHW scope of practice, education and training opportunities, hiring, evaluation and financial sustainability for CHWs programs.
Organization(s): Minnesota Department of Health, Office of Rural Health and Primary Care
Date: 2016