Evidence Tools
MCHbest. Postpartum Mental Health Screening.

Overview. Community health workers (CHWs), sometimes called lay health workers, promotoras(es) de salud, community health representatives. (in tribal health programs), or community health advisors, serve a variety of functions, including providing outreach, education, referral and follow-up, case management, support, home visiting services.[1] and collecting data to identify communities’ health needs.[2] CHWs may work autonomously in the community or as part of a multi-disciplinary team in primary or specialty care. Training varies with intended role and location, though it is usually less than three years.[3] CHW services are usually provided to communities with fewer resources and to individuals who experience barriers in accessing healthcare [3, 4] and individuals who were previously incarcerated,[5] as well as providing coverage in rural areas.[6] CHWs provide appropriate care, usually focused on disease education, management, and prevention, and less often, maternal and child health through home visiting programs.[3] CHWs can work in clinics, schools, individuals’ homes, and other community locations.[7] CHWs’ traditional employers are public health departments and community-based organizations, although employment by health systems and insurers is increasing.[8] CHWs can provide a range of maternal and child health services, often as part of home visiting programs.[23] Community health workers appear to enhance access to pre- and post-natal care,[18, 23, 24] can increase breastfeeding initiation and exclusivity[18, 25], and may decrease the severity of postpartum depression symptoms.[25]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

• Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
• Mental Health. This strategy promotes emotional, psychological, and social well-being of individuals and communities.
• Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models 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).