CHWs might be known by other names, such as promotores de salud, coaches, lay health advisors, community health representatives, peer mentors, or peer navigators. By these names or simply Community Health Worker (CHW), the person is a trusted member of the community with a passion for helping others prevent or manage disease or other physical/behavioral health issues. They help bridge cultural, linguistic, knowledge and literacy differences among individuals, families, communities and providers. They help improve communications involving community members and agency or institutional professionals. CHWs understand and share information about available resources, and support planning and evaluation to improve health services.

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Studies have shown that CHWs have a positive impact on patients’ keeping appointments, taking their medications, reducing risk by improving access to primary care and preventative services, and by helping individuals manage chronic conditions.  While some CHWs may have minimal formal training in medicine or health, they tend to have an intimate knowledge of their communities and local resources.  CHWs use that knowledge and passion to help individuals overcome barriers to care such as those associated with language, culture, transportation, scheduling, and finances. They are a good neighbor. 

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CHWs fill a multiple of roles, from coordinating care to community capacity building. They are advocates, sometimes speaking up on behalf of their clients and their communities within their own agencies, with other service providers, and to support changes in public policies.  More importantly, CHWs support clients and communities in raising their own voices to create meaningful changes – including changes in public policies – that influence health and well-being. (Berthold, 2009)

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CHWs have historically been employed by community-based organizations and social agencies, although they are increasingly being used in clinical settings, such as federally qualified health centers (FQHCs), health departments, and hospitals (Malcarney et al. 2017). They provide a variety of services, which are mostly aimed at bridging the gap between patients and the health care system but also include social supports. These may include: 

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• health promotion, wellness coaching, and self-management education

• cultural mediation (e.g., communicating norms and perspectives) 

• interpretation or translation services

• health system navigation (e.g., scheduling appointments, accompanying beneficiaries to office visits)

• advocacy on behalf of patients and their families

• outreach before appointments, including appointment reminders

• outreach to ensure adherence to treatments and medications

• home visits

• individual, community, and environmental assessments

• arranging transportation

• making connections to community resources or social services, and

• providing care coordination and case management

During the COVID-19 pandemic, CHWs took on roles conducting outreach to community members who isolated in their homes, providing education on prevention measures, connecting people with COVID-19 testing and treatment resources, and those experiencing financial hardship with social services (CDC 2021, Peretz et al. 2020). CHWs have also participated in community-focused vaccine education and outreach efforts (Cohen Marill 2021).

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