Using Community Health Workers to Improve Linkage and Retention in Care

This project sought to increase the utilization of community health workers (CHW) to strengthen the health care workforce and improve access to health care and health outcomes for racial and ethnic minority people with HIV (PWH). The project focused on assisting medical care provider sites to integrate CHWs into an HIV multidisciplinary team model through training, technical assistance, and collaborative learning.

Project Team

The Center for Innovation in Social Work in Health at Boston University assembled a multi-organizational team for implementation and evaluation for this initiative. The team included staff from BU Medical School’s Center for Implementation and Improvement Sciences (CIIS), BU Center for Innovation in Social Work in Health's Activist Lab, Multnomah County Health Department (MCHD) Community Capacitation Center (CCC), MCHD HIV Health Services Center (HHSC), University of Texas School of Public Health (UT Health), the Center for Social Innovation/T3, and Impact Marketing + Communications.

Activities

The project focused on assisting 10 Ryan White HIV/AIDS Program (RWHAP) HIV medical provider sites with the support needed to integrate CHWs into the HIV multidisciplinary team model through training, direct technical assistance, and collaborative learning sessions. The Center for Innovation in Social Work in Health and its multi-organization team developed CHW curricula, trained CHWs and supervisors, and provided technical assistance as these providers develop and implement the CHW model developed. The Center for Innovation in Social Work in Health also evaluated the effectiveness of the CHW model in improving linkage and retention in care, collect data on select clinical outcomes and assessed the interventions implemented by the 10 RWHAP HIV medical provider sites.

Access resources by this project (also listed below)

Initiative Products

Implementation Manual

Implementation Manual: A Guide to Implementing a Community Health Worker (CHW) Program in the Context of HIV Care

Guide detailing how to implement a Community Health Worker (CHW) program in various HIV health care settings. Sections cover organizational infrastructure, recruiting, hiring, training, supervision, service delivery, evaluation, and more. The appendices include multiple templates and tools.

View and Download Implementation Guide

Fact Sheet

The Community Health Worker Role on the HIV Care Continuum Fact Sheet

This fact sheet explains what a CHW is, how they enhance HIV care teams and serve as a bridge between organizations, the 10 core roles that CHWs most frequently fill, and how those roles support advancement along the HIV care continuum.

Download Fact Sheet

Training CHWs Curriculum (& en Espanol)

Training Community Health Workers in HIV Care - Curriculum / Un plan de capacitación para las promotoras de salud

Free, accessible training resource to support the integration of the Community Health Worker (CHW) workforce into HIV and other primary care teams. The curriculum addresses topics related to core competencies of CHWs as well as topics about HIV.

View and Download Curriculum

CHW Supervisor Curriculum

Community Health Worker Supervisor Curriculum

A curriculum for supervisors of Community Health Workers (CHWs).

View and Download Curriculum

Webinars: Insights and Lessons Learned

Webinar 1: Using Community Health Workers to Improve Linkage and Retention in HIV Care

During this interactive webinar course, the first in a series and presented on July 27, 2017, participants learned why community health workers (CHWs) could be key to reducing barriers to care faced by underserved and hard-to-reach populations, specifically in HIV systems. The course defines the role of CHWs, how they are integrated into health care teams, and how they function as an integral part of the health care system. Experts share real-world illustrative examples of CHWs working in HIV care. Participants learned about building—and expanding—internal capacity for CHWs.

Download Presentation Slide Set

Q&A from the Webinar

Webinar 2: Community Health Workers in HIV Services, Insights from Virginia

Community Health Workers have the potential to improve outcomes on the HIV care continuum, but what does that look like in a Ryan White HIV/AIDS Program (RWHAP) funded agency? What is their scope of work and how can they be funded? During this interactive webinar course, the second in a series and presented on November 16, 2017, Leonard Recupero and Susan Carr from the Virginia Department of Health, HIV Services Unit, shared their experiences integrating CHWs into these RWHAP services; working with CHWs to enhance HIV prevention and care services; and improve outcomes along the HIV care continuum. The webinar discussed funding, program planning, and the scope of work for CHWs in HIV care.

Download Presentation Slideset

Webinar 3: Improving Linkage and Retention in HIV Care: Insights from Community Health Workers

Review of the role of Community Health Workers (CHW) and how they serve as an integral part of the HIV health care system in bridging health providers and communities and helping to increase access and improve the quality of HIV care services.

DOWNLOAD PRESENTATION SLIDESET

Webinar 4: Improving Linkage and Retention in HIV Care: Lessons from Implementing a CHW Program in HIV Care

This webinar, the fourth in a series, reviewed the roles and skills that community health workers (CHWs) need to be effective in their work. The webinar also featured lessons learned from representatives from two RWHAP sites: the McGregor Clinic, an AIDS service organization in Fort Myers, FL, and CrescentCare, a dually funded HRSA Health Center in New Orleans, LA.

DOWNLOAD PRESENTATION SLIDESET

DOWNLOAD Q & A

Publications

Davoust, M., Drainoni, M. L., Baughman, A., Campos Rojo, M., Estes, T., Rajabiun, S., ... & Sprague Martinez, L. (2021). “He gave me spirit and hope”: Client experiences with the implementation of community health worker programs in HIV care. AIDS patient care and STDs, 35(8), 318-326. https://www.liebertpub.com/doi/full/10.1089/apc.2021.0085
Rajabiun, S., Baughman, A., Sullivan, M., Poteet, B., Downes, A., Davich, J. A. W., ... & Sprague Martinez, L. (2021). A participatory curricula for community health workers and supervisors to increase HIV health outcomes. Frontiers in public health, 9, 689798. https://www.frontiersin.org/articles/10.3389/fpubh.2021.689798/full
Sprague Martinez, L., Davoust, M., Rajabiun, S., Baughman, A., Bachman, S. S., Bowers-Sword, R., ... & Drainoni, M. L. (2021). “Part of getting to where we are is because we have been open to change” integrating community health workers on care teams at ten Ryan White HIV/AIDS program recipient sites. BMC Public Health, 21(1), 1-11. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10943-1
Wolfe, H. L., Baughman, A., Davoust, M., Sprague Martinez, L. S., Rajabiun, S., & Drainoni, M. L. (2021). Client satisfaction with community health workers in HIV care teams. Journal of Community Health, 1-9. https://link.springer.com/article/10.1007/s10900-021-00978-1
Drainoni, M. L., Baughman, A. L., Bachman, S. S., Bowers-Sword, R., Davoust, M., Fortu, K., ... & Sprague Martinez, L. (2020). Integrating community health workers into HIV care teams: Impact on HIV care outcomes. Journal of HIV/AIDS & Social Services, 19(3), 204-219. https://www.tandfonline.com/doi/abs/10.1080/15381501.2020.1785364

Contact Information

Project Contacts

Allyson Baughman, MPH

Senior Program Manager

Boston University Center for Innovation in Social Work in Health

[email protected]

Linda Sprague Martinez, PhD

Principal Investigator

Boston University Center for Innovation in Social Work and Health

[email protected]

HRSA Contacts

Brian Fitzsimmons, LCSW-C

Public Health Analyst, Division of Community HIV/AIDS Programs

[email protected]

Funding

Funding Mechanism: Cooperative Agreement

Recipient Organization: Boston University School of Social Work Center for Innovation in Social Work and Health

Grant number: U90HA31449

Project Period: August 2016 - July 2019