Document Type

Capstone Experience

Graduation Date

5-2020

Degree Name

Master of Public Health

Department

Health Promotion

First Committee Member

Dejun Su, PhD.

Second Committee Member

Drissa Toure, MD., PhD., MPH

Third Committee Member

Jennie Hill, PhD.

Abstract

INTRODUCTION: Community Health Workers (CHWs) are a crucial growing component of the health care field in the U.S. According to the US Bureau of Statistics (2018), the CHW workforce is expected to grow 38% in the next ten years. While research has repeatedly shown the success of CHW-led programs and the financial benefits of CHWs, little work has been done to evaluate the training and certification preferences of CHWs in Nebraska. This project aimed to gather and analyze qualitative and quantitative data through an exploratory sequential mixed-methods approach to provide policy recommendations regarding the future training and potential certification of CHWs in Nebraska.

METHODS: Qualitative and quantitative data from nine focus group discussions across Nebraska, a mixed-methods survey available from 142 CHWs, and eight key informant interviews from employers of CHWs was combined to identify the CHW perspective on training and certification and to determine if there are any differences in preferences based on CHW organizational setting. This data also identified key enablers and barriers to training for the CHW workforce in Nebraska. Data was collected and analyzed using computer software (REDCap, SPSS, and NVivo).

RESULTS: The majority of CHWs in Nebraska are female (92.3%), between the ages of 40-59 years old (45.1%), Caucasian or White (54.9%), and not of Hispanic or Latino origin (59.95%) and reside in urban population centers (78.2%). When asked about their previous training, approximately 82.0% focus group participants and 53.5% of survey participants received training prior to becoming a CHW. Survey participants expressed a desire for continuous training every 6 (41.5%) or 12 months (35.9%) to enhance their workforce skills. Overwhelmingly, survey participants expressed an interest in a statewide certification program (84%), stating community benefits, validation of the workforce, and professional advancement as key drivers. There was no correlation between certification desire and employment type (community vs clinical; p-value = 0.195). Concurrently, only three key informants supported certification, three did not support certification, and two were undecided. Identified barriers for certification were time, literacy levels, financial support, and development of requirements.

IMPACT OF THE STUDY: This study has identified the overwhelming desire of CHWs in Nebraska to have a statewide certification program to enhance their work in the community and validate their role within the healthcare system. This, however, did not receive unanimous support from the key informants who participated in the study. Findings from this study can inform policy formulations in Nebraska for successful training and certification of CHWs.

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