Scientific Evidence


How Ethnographic Research Can Inform Positive Relationships Among CHWs, Health Institutions, and Communities

Am J Public Health. 2014 Mar 13. [Pubmed Abstract]

Listening to Community Health Workers: How Ethnographic Research Can Inform Positive Relationships Among Community Health Workers, Health Institutions, and Communities
Maes K, Closser S, Kalofonos I

Many actors in global health are concerned with improving community health worker (CHW) policy and practice to achieve universal health care. Ethnographic research can play an important role in providing information critical to the formation of effective CHW programs, by elucidating the life histories that shape CHWs’ desires for alleviation of their own and others’ economic and health challenges, and by addressing the working relationships that exist among CHWs, intended beneficiaries, and health officials.

We briefly discuss ethnographic research with 3 groups of CHWs: volunteers involved in HIV/AIDS care and treatment support in Ethiopia and Mozambique and Lady Health Workers in Pakistan. We call for a broader application of ethnographic research to inform working relationships among CHWs, communities, and health institutions.


Model for Culturally Competent CHW Training

Health Promot Pract. 2014 Mar;15(1 Suppl):56S-63S. [Pubmed Abstract]

An instructional design model for culturally competent community health worker training
Uriarte JA, Cummings AD, Lloyd LE

The Texas Public Health Training Center (TPHTC) provides quality training and education for the full spectrum of public health workers. As part of this mission, the TPHTC creates continuing education modules for nontraditional public health workers, such as community health workers (CHWs), through a culturally competent curriculum development process. CHWs, like many public health workers, must be certified by the state of Texas to practice within its borders, and continuing education is required to maintain certification.

By involving CHWs and community members in its curriculum development process, the TPHTC is able to produce training modules that are more suitable for this unique and important segment of the public health workforce. The iterative curriculum development process is described here, along with a state-approved curriculum resulting from this method. As the value of the nontraditional public health workforce gains more recognition, sound curriculum design will be increasingly important to support and strengthen these nontraditional professions.


A Church-based Diabetes Prevention Program Delivered by Peers

Diabetes Educ. 2014 Mar-Apr;40(2):223-30. [PubMed Abstract]

Outcomes of a Church-based Diabetes Prevention Program Delivered by Peers: A Feasibility Study
Tang TS, Nwankwo R, Whiten Y, Oney C

This purpose of this study was to investigate the feasibility and potential health impact of a church-based diabetes prevention program delivered by peers. Thirteen at-risk African American adults were recruited to a peer-led diabetes prevention program adapted from the National Diabetes Education Program’s Power to Prevent curriculum. The program consisted of 6 core education sessions followed by 6 biweekly telephone support calls. Components of feasibility examined included recruitment, attendance, and retention. Baseline, 8-week, and 20-week assessments measured clinical outcomes (percentage body weight change, waist circumference, lipid panel, blood pressure) and lifestyle behaviors (eg, physical activity and diet).

Of the 13 participants enrolled at baseline, 11 completed the intervention. Mean attendance across 6 core sessions was 5.2 classes (87%). At 8 weeks, significant improvements were found for physical activity (P = .031), waist circumference (P = .049), serum cholesterol (P = .036), systolic blood pressure (P = .013), and fat intake (P = .006). At 20 weeks, not only did participants sustain the improvements made following the core intervention, but they also demonstrated additional improvements for HDL (P = .002) and diastolic blood pressure (P = .004). Findings suggest that it is feasible to conduct a peer-led diabetes prevention program in a church-based setting that has a potentially positive impact on health-related outcomes.