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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Community Health Workers

Approach. Establish a network of community health workers within communities of low preventive care service utilization.

Source. Robert Wood Johnson Foundation's What Works for Health (WWFH) Database

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Overview. Community health workers (CHWs)—sometimes called lay health workers, promotores de salud, community health advisors, or community health representatives—provide a variety of services that may include outreach, education, advocacy, case management, referral and follow-up, and home visiting services. CHWs may work autonomously in the community or as part of a multi-disciplinary team in primary or specialty care.

Evidence. Moderate/Some Evidence. There is some evidence that CHWs improve patient knowledge, access to health care, and healthy behaviors (AHRQ-Viswanathan 2009), especially for minority women (Andrews 2004*). CHWs can also increase health care utilization for interventions such as screening mammography (Kim 2016*, Wells 2011*, AHRQ-Viswanathan 2009) and cervical cancer screening (Kim 2016*, AHRQ-Viswanathan 2009). Effects are stronger when the CHW and patients have the same racial or ethnic background (Wells 2011*). Read more in the WWFH database report. Read more about WWFH's evidence ratings. (*Links to citations can be accessed through the WWFH database).

Target Audience. Patients.

Outcome. Percent of women, ages 18 through 44, with a preventive medical visit in the past year.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Establish a network of community health workers within communities of low preventive care service utilization,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of women connected to a community health worker.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of women connected to a community health worker.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women who report increase in knowledge regarding importance of preventive care services from education provided by community health worker.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women who report increase in knowledge regarding importance of preventive care services from education provided by community health worker.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


 

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.