This project was terminated by awardee request.

Background: Community health workers (CHWs) are trusted community members who reduce inequities and improve patient care and clinical outcomes through a variety of strategies. To date, PCORI has invested $300 million in 79 projects that involve CHWs, some of which explore their contributions to clinical care and research. Despite evidence of CHWs’ effectiveness, three factors impede widespread engagement of CHWs in clinical care and research: a lack of understanding of CHWs’ unique contributions to clinical care; a lack of common indicators to measure CHW program effectiveness; and inconsistent involvement of CHWs in all phases of research.

Proposed Solution to the Problem: NACHW, a program of HRiA, will coordinate the National CHW PCOR Collaborative. The collaborative recognizes both patients and CHWs as PCORI stakeholders whose knowledge and perspectives drive health improvements and healthcare innovations, not simply as actors within interventions.

The collaborative strengthens patient, CHW, and researcher relationships (facilitating a collaborative for shared learning and implementing a convening), supports engagement in PCORI-funded research (with CHWs as stakeholders in all study phases, in patient and researcher presentations, and group analysis of PCOR CHW studies), promotes dissemination and uptake of PCOR research findings by payers and health systems (with payers, health systems, through our national CHW networks and newsletter, and with patient advocacy organizations), and generates strategies to sustainably implement them into clinical practice and policy.

Objectives: The collaborative’s objectives are:

• To form a collaborative of CHWs, patients, and PCORI-funded researchers, and a steering committee that will guide the work
• Host virtual meetings of the collaborative to build a common understanding of PCOR models, CHW roles, and CHW/patient partnerships in clinical research
• Host a virtual national convening with collaborative stakeholders and guests to present and gather input on the collaborative process, themes, learnings, and recommendations from pre-convening virtual sessions
• Develop a capacity-building agenda and roadmap, as well as a communication strategy and dissemination plan for the collaborative’s materials among researchers, CHWs, and other stakeholders

Activities: The collaborative will develop recommendations to advance the science of assessing CHW processes and outcomes that will ultimately sustain CHW evidence-based interventions and improve patient engagement, satisfaction, and outcomes. All activities will use participatory education principles to build and sustain trust and promote equitable participation. Quarterly activities include:

Q1: Collaborative stakeholders’ recruitment following PCORI Engagement Rubric Principles; development of group norms, timeline, objectives, and evaluation processes.

Q2: Planning meetings to build consensus and create a national convening agenda on PCOR with CHWs.

Q3: Virtual national convening that offers stakeholder perspectives and strategies to advance the evidence to support uptake of CHW interventions that improve patient engagement, satisfaction, and outcomes.

Q4: Development and dissemination of short- and medium-term project deliverables described below, which build toward long-term outcomes.

Projected Outcomes and Outputs: The outcomes of the collaborative will advance authentic participation in and/or dissemination of PCOR/CER.

Short term: Stakeholder recruitment and outreach guide; planning meeting and national convening agendas, materials, and proceedings (video and written documentation); participant roster and pre-convening surveys; collaborative facilitation guide and roadmap.

Medium term: Post-convening survey results; recommendations from collaborative stakeholders to: apply indicators that measure CHW influence on patient engagement, satisfaction, and outcomes; build capacity to increase authentic CHW/patient engagement in PCOR/CER (including updated PCOR training guide for CHWs).

Long term: A report series with strategies to improve dissemination and sustainability of CHW research results with health systems and payers and to build researchers’ capacity to authentically engage CHWs in research study capacity. Systematic analysis of CHW engaged PCOR funded projects.

Patient and Stakeholder Engagement Plan: Patients and stakeholders for the CHW/PCOR collaborative include, first and foremost, CHWs, who play dual roles as patient advocates and stakeholders for their professional workforce. In addition to CHWs, the project team will also recruit members who identify as patients in clinically oriented CHW programs with support from the team’s national partner, the National Patient Advocate Foundation, and researchers with support from the American Board of Internal Medicine Foundation. Researchers and evaluators of CHW programs (including PCOR researchers) and health system partners in CHW programs will complete the collaborative membership.

Once the collaborative has been formed, members will receive biweekly email updates from the steering committee that will summarize progress toward deliverables and logistical coordination. Virtual collaborative sessions will take place every three to six weeks to advance the agenda for the national convening. CHWs, patients, and collaborative members will develop an agenda, date, presenter roster, participant recruitment plan, and marketing activities to engage additional CHWs, patients, researchers, and health policy and health system influencers. Detailed agenda, presentation slides, and supportive materials are developed with all collaborative members. After the convening, participants will receive notes, a version of the roadmap revised based on their suggestions, and other information about next steps for sustainability and opportunities for future partnership via email.

The collaborative recruitment will be guided by PCORI Engagement Principles, NACHW values, and popular education principles. It will be led by CHWs from NACHW and steering committee members, the National Patient Advocate Foundation, patients, and researchers from the PCORI portfolio, and the project steering committee. The collaborative will be promoted to CHWs through monthly NACHW e-newsletters, during capacity-building webinars produced by NACHW, and during the bimonthly meetings of the CHW Common Indicators Project. Following formation of the collaborative and development of a systematic outreach plan, collaborative members will use their own connections and networks to recruit others to participate in the convening. Given the current pandemic, outreach will occur primarily by phone, email, over Zoom, or via other video conferencing platforms.

Project Collaborators: NACHW has confirmed participation of several leading researchers who seek to advance CHW-engaged research and evidence of CHW intervention effectiveness through fuller realization of CHW roles and partnerships with patients.

• Kelly Rand, National Patient Advocate Foundation
• Ashley Wennerstrom, Louisiana State University Center for Healthcare Value and Equity
• Susan Mayfield-Johnson, University of Mississippi, College of Nursing and Health Professions
• Noelle Wiggins, Wiggins Health Consulting
• Kenny Maes, Oregon State University School of Language, Culture and Society
• Leticia (Letty) Rodriguez Avila, Los Angeles County Department of Health Services
• Bowen Chung, Associate Professor-in-Residence, UCLA David Geffen School of Medicine
• Brendaly Rodriguez
• Shreya Kangovi, Penn Center for Community Health Workers