Why Teaching About Health Disparities Transforms Communities

By Kellie Woodson

As an instructional designer, I use my expertise in teaching and learning to create learning experiences on a wide variety of health topics. Whether I’m developing a course on breast cancer genetics or oral health , a significant part of the process is partnering with experts in the field to develop courses that are informative, engaging and effective.  Since many of these courses are written for frontline health workers such as community health workers or promotores (CHWs/Ps), they must also motivate participants to make positive changes in their communities.

[RELATED: Improve the mental wellness of your team]

Overcoming Barriers to Healthy Choices

A typical course not only provides information on health conditions; it also teaches strategies to effectively guide others in making healthier choices. To do this, it is important to acknowledge the barriers to healthy living that many people face.

For example, we know that regular health checks and healthy eating are important to overall health. But the truth is, getting to the doctor or grocery store can be very difficult for individuals who are disabled, elderly, or who live in rural areas.

The courses I write challenge participants to acknowledge and reflect on the realities of others that they might otherwise take for granted.

  • How does a person who struggles to get around their own home travel to regular doctor’s visits?
  • How can a person make healthier food choices if they only have access to neighborhood convenience stores? 
  • Does the disproportionate number of tobacco advertisements in low-income communities affect smoking rates in these areas?
  • How does one’s education level affect their ability to complete an application for financial healthcare assistance?

The truth is that for many individuals, factors such as age, disability, geographical location and education level pose significant barriers to staying healthy. These barriers in turn give rise to health disparities, or preventable differences in the rate of disease and access to health services among specific groups of people.  While health disparities can and do affect all people, they are more common among minorities and the socio-economically disadvantaged.

The coronavirus has been a wake-up for many as they see how the pandemic is affecting races differently in this country. Hospitalization and death rates from COVID-19 are highest among American Indian or Alaska Native and non-Hispanic blacks—five times higher than for whites, according to the CDC.

When writing a tobacco cessation course for the state of Washington’s Community Health Worker Training program, I learned that African Americans, Asian Americans, members of the LGBT community and American Indians use tobacco products in disproportionate numbers when compared to other groups in Washington.

Across the nation, individuals with lower income and education levels are also more likely to use tobacco.  These disparities then give rise to tobacco-related illness and disease. Due to the lack of quality health care, individuals living in rural areas, those who are living at or below the poverty line and those who have lower education levels are more likely to die as a result of tobacco-related disease.  

Health Disparities Reach Farther Than You Think

It’s important to understand that health disparities aren’t simply the result of groups of people making bad choices. Disparities are systemic, complex and cyclical in nature. For example, groups of people who migrated to the U.S. have been found to have high rates of mental disorder and trauma due to the hardships they experienced during migration.  Racism and oppression often result in trauma-related mental illness. To make matters worse, marginalized groups of people often avoid diagnosis and treatment which further perpetuates these disparities.

Consider these statistics:

  • Asian-American women over age 65 have the highest suicide rate of all similarly-aged women in the United States.
  • LGBT youth are about 2 1/2 times more likely to attempt suicide than their peers.
  • Only about ten percent of physicians practice in rural America.
  • People who live and work in low socioeconomic circumstances have an increased risk for mortality, unhealthy behaviors, reduced access to health care and low quality of care.
  • Due to trauma experienced before and after immigration to the United States, Southeast Asian refugees have an increased risk for posttraumatic stress disorder.
  • Native Hawaiians and Pacific Islanders are 30 percent more likely to be diagnosed with cancer than whites.
  • Close to a third of Hispanics get regular health care, including those with chronic health conditions.
  • African-American adults with cancer are significantly less likely to survive prostate cancer, breast cancer and lung cancer than their white counterparts.

These alarming statistics only represent a small fraction of the disparities that exist in our country. Remember that health disparities are found in every group in the U.S. and in every part of the body.

Frontline Health Workers and Communities

Being a frontline health worker is not just about giving guidance and advice– it’s a call to action and advocacy. These people and their employers their community members better than anyone else, and they understand the communities’ challenges, weaknesses and strengths.  As they educate and guide clients to achieving better health, they have the responsibility to acknowledge barriers to care and why they exist. This understanding will help them to better anticipate their client’s needs and respond appropriately and effectively.

Frontline health workers take different paths to solving problems. Many take it upon themselves to create much needed resources and programs in their communities. Others see themselves as organizers who unite members of the community to create solutions where none exist. Whatever the response, you are in the position to make a tremendous impact.

At the end of the day, the goal is to build communities where race, sex, sexual identity, age, disability or socioeconomic status never, ever affect one’s ability to be healthy.

Kellie Woodson is an expert in teaching, learning, and instructional design with content area specialization in health, science, and mathematics. She has extensive experience developing curriculum and learning programs for schools, organizations, and national and international publishers.

How CHW Teams Improve Breast Cancer Screening

Contributors Monique Cuvelier and Wajeeh Khan

Breast cancer doesn’t come from one obvious cause, and it doesn’t affect everyone equally. That makes it challenging to address and manage though breast cancer screening. When 1 in 8 U.S. women will develop invasive breast cancer in the course of her life—it’s an urgent problem. And it’s one that managed care agencies, healthcare systems, and communities have struggled with for decades. How do you systematically address something so unsystematic?

[RELATED: CHWTraining Opens New Course on Breast Cancer Screening for 2020]

The Role of CHWs

Community health workers are one part of the answer. They have a knack for making paths through hard-to-reach areas and populations. They’re powerful allies in the battle against breast cancer, especially in underserved communities, where they live, work, or understand deeply.

The WHO highlights that CHWs must respond to the local, cultural, and societal norms to ensure community ownership and approval.

Their impact on women with breast cancer or at high risk is broad. They can connect people directly with providers for treatment. They can give clients and patients resources about disease management. They can bust myths about breast cancer (no, mammograms don’t cause cancer) and provide other education about lowering risk. They can also be there just to listen and provide social support and advise on health insurance and financial assistance.

In a recent study, participants that took part in a CHW intervention reported increased rates of screening mammography. Mammography is the standard screening procedure for breast cancer in developed countries, but this is not feasible for population-based interventions.

CHWs have a positive effect in increasing mammography rates. A meta-analysis of 18 studies reported that CHW interventions related to breast cancer screening resulted in a significant increase in mammography rates and clinical visits. These results were strongest for urban and medical settings and where communities and CHWs were ethnically similar (Wells et al., 2011). In another study that compared the screening rates in Vietnamese women by lay health workers and media education, lay health workers significantly increased clinical breast examination and mammography rates.

If you’re not sure if CHWs can help improve breast cancer screening in your agency, or what kinds of job skills are needed, take a look at some of these benefits below to give you an idea.

6 Ways CHWs Improve Breast Cancer Outcomes

  1. Increase breast cancer screening
  2. Connect people directly to providers for treatment
  3. Reduce barriers to screening and healthylifestyle changes
  4. Give clients and patients resources about disease management
  5. Bust myths about breast cancer
  6. Provide guidance about lowering risk

1. Increase Breast Cancer Screening

Promoting breast cancer screening is the top boost CHWs can give clients to catch breast cancer early. Making CHWs part of cancer interventions can increase breast cancer screening rates.  The Community Preventive Services Task Force recommends CHWs because they “increase demand for screening services using group education, one-on-one education, client reminders, or small media” and “improve access to screening services by reducing structural barriers.”

Research shows that CHW interventions work. In a study conducted on rural African-American women, CHWs intervention reported an 11 percent increase in clinical mammography rates compared to women who were not contacted by CHWs.

An ASTHO study shows that patient navigator and CHW efforts have led to increases in cancer screening rates between 11-17 percent. They also led to increases in rates of adherence to diagnostic follow-up care up to 29 percent.

2. Connect People Directly to Providers for Treatment

CHWs are links or bridges between the community and local health systems. They can act as patient navigators in the continuum of breast cancer screening, diagnosis, and treatment. The role of CHWs is highly effective in increasing access to local health services. This helps significantly reduce potential delays in diagnosis.

For example, in South Africa, CHWs act as treatment buddies for HIV patients, similarly they can act as navigators for breast cancer patients. They can provide support both emotional and logistic, increasing access to healthcare.

3. Reduce Barriers to Screening and Healthy Lifestyle Changes

Breast cancer screening programs have been introduced worldwide, but many hurdles stand between clients and success. Clients don’t get screened for reasons ranging from lack of knowledge regarding the disease, low income, and no prior history of breast cancer. CHWs can help address and remove those barriers and provide education.

Some examples how:

  • Lack of health insurance –provide information on signing up for insurance and resources such as the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for free or low-cost breast and cervical cancer screenings.
  • Geographic barriers – help find sources of transportation or mobile screening vangs
  • Guidelines education – provide proper information regarding screening, including when and how often
  • Structural and interpersonal barriers – give social support and advice to promote screening

4. Give Clients and Patients Resources About Disease Management

Linguistic and health literacy interventions from CHWs are helpful to address breast cancer screening in racial and socioeconomic minority groups. These interventions have been cost-effective and successful.

For example, Kin Keeper Cancer Prevention trained female CHWs to provide at-home education in selected communities in English, Spanish and Arabic. They conducted surveys with enrollees, and the literacy rates improved in all participants.

5. Bust Myths About Breast Cancer

CHWs can clear up many of the myths about breast cancer through education. Myths range from fuzzy misunderstandings to directly harmful. For example, some people think lifestyle choices such as maintaining a healthy diet, exercising regularly, and limiting alcohol eliminates the chance of breast cancer. While this can lower the risk, it doesn’t eliminate it.

On the other end, some misinformation states mammograms cause breast cancer rather than detect it.

6. Provide Guidance About Lowering Risk

Many breast cancer risk factors come down to lifestyle, including how much a person smokes, eats poorly, and gets physical activity. CHWs can provide clients the information and support they need to make these challenging lifestyle changes.

They can often provide more than basic education. They can help clients and patients really understand what a healthy lifestyle is, how to implement a doctor’s advice, and find the motivation to continue on a positive path.

The longer a CHW program is established in any given community, the more successful it becomes. The success of any CHW program depends upon the support of the community, along with continuous resource provision and training. Regular training is the most effective strategy in increasing the productivity of the program in the community. Breast cancer screening can be integrated into regular primary healthcare visits performed by CHWs.

The Top CHW Conferences of 2020

Every year more people become community health workers across the United States, and every year there are more conferences to support them. Conferences, workshops, annual meetings, and symposiums are excellent opportunities to brush up on your skills, learn new skills, and hear from the experts and thinkers in the community and public health industry. They’re also great for meeting and networking with peers in the community health community if you want to start your CHW training program.

Last year we researched and gathered a list of the top CHW conferences, and we’ve done it again. Here’s this year’s list, ordered by date. Pull out your calendar, scroll through this list, and find some that sound exciting. We’ve arranged these events by date and state. This will be updated regularly, so check back often.

Contact us if you would like to add a CHW conference to this list. To be considered, please send us a message containing all details including the conference name, dates of the event, location, and a link to the event’s website.

Top CHW Conferences of 2020

  1. CHW Employer Event – “CHWs and Sustainability in RI” (North Providence, RI)
  2. Western Forum for Migrant and Community Health (Sacramento, CA)
  3. Northwest Rural Health Conference (Spokane, WA)
  4. CCHF (Christian Community Health Fellowship) Conference 2021 (Cincinnati, OH)
  5. Indiana CHW/CRS Annual Conference (Plainfield, IN)
  6. The Academy of Oncology Nurse & Patient Navigators (AONN+) (Baltimore, MD)
  7. MNCHWA Conference (Plymouth, MN)
  8. Annual Rural Health Conference (Online)
  9. Kansas Community Health Worker (CHW) Symposium (Online)
  10. ACHI 2020 National Conference (Cleveland, OH)
  11. South Carolina Community Health Worker Annual Conference (Columbia, SC)
  12. Florida Community Health Worker Coalition Summit (Orlando, FL)
  13. Visión y Compromiso’s 18th Annual Conference (Los Angeles, CA)
  14. Community Health Institute & EXPO (San Diego, CA)
  15. APHA’s Annual Meeting (Online)
  16. TGCCPA Annual Conference (Houston, TX)

CHW Employer Event – “CHWs and Sustainability in RI”

Date: January 31, 2020
Location: North Providence, RI
Cost: Free

This event brings together employers, insurers, and other healthcare/social services stakeholders in Rhode Island to discuss progress and plans for making the Community Health Worker workforce more sustainable in our state.

  • Learn lessons from a Massachusetts health sector innovator on forging collaboration among Medicaid, state DOH, Accountable Care Organizations (AOs) and Community Partners
  • Understand better what your CHWs and Peer Recovery Specialists do by getting a special training on supporting employees recovering from substance use disorder
  • Enjoy lunch with partners doing the same work
  • Discuss ways the Community Health Worker Association of RI can best help you to secure CHWs with the appropriate and most current training and to supervise them effectively

Western Forum for Migrant and Community Health

Date: February 19-21, 2020
Location: Sacramento, CA
Cost: $150-$350

The Western Forum is a regionally celebrated and nationally recognized conference known for innovative content, expert speakers, and a diverse audience from various disciplines. We look forward to hosting another engaging and vibrant conference. We hope to see you at our annual conference.

Northwest Rural Health Conference

Date: TBD
Location: Spokane, WA
Cost: N/A

Conference goals are: Highlight rural health public policy issues, – Identify changes in the delivery of and access to rural health care, – Identify ways that data & technology are improving health in rural communities, – Examine issues that impact rural hospitals and – Collaborate with peers on innovative models for rural health care delivery.

Who should attend? – Rural hospital leadership and Board of Directors – Rural clinic administrators & staff – Quality managers ~ Risk Managers – Public health officers – State and local leaders – Policy makers – EMS staff – Home health staff

CCHF (Christian Community Health Fellowship) Conference 2021

Date: March 25-27, 2021
Location: Cincinnati, OH
Cost: $95-$325

Hundreds of practitioners and students from all over the United States gather annually at the CCHF conference to share knowledge, skills, and experiences, and spend time worshipping and seeking God. If you’re serious about domestic medical missions, this conference is a must. Scholarships are available for medical students and residents.

Indiana CHW/CRS Annual Conference

Date: April 21, 2020
Location: Plainfield, IN
Cost: Webinars available online

The Indiana CHW/CRS Annual Conference is an opportunity for Community Health Workers and Certified Recovery Specialists to connect and network with other helping professionals and learn knowledge and skills beneficial to the important work that they do.

To make sure Community Health Workers and Certified Recovery Specialists across the state still received relevant education that can help them be more effective in their communities, Mental Health America of Northeast Indiana, in partnership with the Indiana Division of Mental Health and Addiction, converted all conference sessions into webinars.

Recordings from most of these webinars can be accessed below.
CHW/CRS Annual Conference

The Academy of Oncology Nurse & Patient Navigators (AONN+)

Date: November 4-8, 2020
Location: Baltimore, MD
Cost: $115-$165

Oncology navigators and care providers gather to advance the development, implementation, utilization, and metrics of multidisciplinary oncology navigation. It is designed to address the questions of navigators, social workers, physicians, and administrators in regard to cancer care, and offer practical solutions from experts and peers in implementing effective programs and measuring their outcomes.

2020 MNCHWA Conference

Date: Canceled
Location: Plymouth, MN
Cost: N/A

The Annual Minnesota Community Health Worker Alliance Statewide Conference brings together community health workers, supervisors, educators, providers, payers, policy makers and many others from across the state for a day of learning, exchange, networking and charting action on next-stage work.

Annual Rural Health Conference

Date: Jun 16-19, 2020 and on demand
Location: Online
Cost: $368-$735

NRHA’s Annual Rural Health Conference is the nation’s largest rural health conference, created for anyone with an interest in rural health care, including rural health practitioners, hospital administrators, clinic directors and lay health workers, social workers, state and federal health employees, academics, community members and more.

NRHA’s 43rd Annual Rural Health Conference, the nation’s largest gathering of rural health professionals, is the Association’s first virtual, online-only event occurring live June 16-19. The entire event will be available on-demand afterward.

Kansas Community Health Worker (CHW) Symposium

Date: June 11, 2020
Location: Wichita, KS
Cost: Free

Provide a venue where all stakeholders can better understand the progress and barriers associated with CHWs specific to Kansas. Offer an opportunity for networking among the CHWs and their organizations across the state. Focus on designing CHW infrastructure and systems rather than skill building. The long-term goal of the CHW Symposium is to help reduce health disparities and increase access to care through CHWs in Kansas.

ACHI 2020 National Conference

Date: Canceled
Location: Cleveland, OH
Cost: N/A

The Association for Community Health Improvement’s National Conference convenes over 700 population and community health professionals to learn from experts and exchange the latest tools, approaches and ideas from the field. Attendees will have the opportunity to participate in interactive workshops, site visits, breakout and plenary sessions.

In light of the latest COVID-19 developments and CDC recommendations, the American Hospital Association has canceled the ACHI National Conference scheduled for June 15-17 in Cleveland, as well as all affiliated events. Please see: ACHI 2020 National Conference

South Carolina Community Health Worker Annual Conference

Date: Fri, August 14, 2020 – 9:00 AM – 4:00 PM EDT
Location: The River Center, 5605 Bush River Road, Columbia, SC Cost: $25-$45

This conference will provide Community Health Workers with a day of learning and networking. Although this conference is designed for CHWs, it is also a conference for supervisors, stakeholders, and policy makers to come and learn about the CHW’s scope of practice.

Florida Community Health Worker Coalition Summit

Date: September 10-11, 2020
Location: Orlando, FL
Cost: N/A

Florida Community Health Worker Coalition is a statewide partnership dedicated to the support and promotion of the CHW profession through collaboration, training, advocacy and leadership development. The Summit is for CHWs/promotores de salud, outreach workers, allies, employers, insurers, clinical staff, academic centers, community organizations, state and local leaders from across the state. We hope to see you at our annual conference! For more information, please contact us at 850-888-2495 or via email at flchwcoalition@gmail.com.

Visión y Compromiso’s 18th Annual Conference

Date: October 1-3, 2020
Location: Los Angeles, CA Cost: N/A

The goal of the conference is to create a space where experiences and ideas can be exchanged among promotores and other participants that foster the learning of new skills, knowledge and advocacy for our communities. The annual conference for promotores and community health workers is organized by Visión y Compromiso in collaboration with a planning committee that is comprised of promotores and other leaders in the community and organizations.

2020 Community Health Institute & EXPO

Date: Canceled
Location: San Diego, CA
Cost: N/A

The NACHC Community Health Institute (CHI) and EXPO is the largest annual gathering of health center clinicians, executives, consumer board members, along with State/Regional Primary Care Associations and Health Center Controlled Networks. The conference August 30-September 1, 2020 is scheduled to kick off in San Diego, CA, at a time when health centers are charting a new course in a rapidly changing health environment and being called upon to assume a larger role in the nation’s health care system.

APHA’s Annual Meeting

Date: Oct. 24-28, 2020
Location: Online
Cost: N/A

Violence and the threat of violence limit the ability of individuals, families and communities to have healthy, whole lives. Yet research and practice have demonstrated violence is not inevitable and can be prevented. Public health must work with other sectors to prevent violence in all of its forms and across the lifespan. Using a public health approach, we can address the structures and root causes that contribute to this burden and work to change these underlying conditions in homes, schools and communities. We must continue to implement prevention efforts that help provide the opportunity for all to live their lives to their greatest potential.

As the COVID-19 pandemic changes how we connect, live and learn, we continue to plan for a streamlined in-person meeting Oct. 24 – 28 in San Francisco, with a virtual component to enable our attendees, presenters and exhibitors to participate and connect with the largest audience possible. This hybrid meeting will feature the scientific sessions, presentations and networking so essential to the public health workforce. Safety is our key concern, and planning decisions are being guided by science-based recommendations from health officials.

Registration and housing will open on July 1.

TGCCPA Annual Conference

Date: 2020
Location: Houston, TX
Cost: N/A

The Texas Gulf Coast CHW/Promotors Association (TGCCPA) is a nonprofit association with a mission to meet the needs of the diverse CHW workforce throughout the Texas gulf coast by improving communication, providing access to resources, and improving job opportunities. The TGCCPA has established chapters of the association to accommodate CHWs in various metropolitan areas. Who Should Attend: Community Health Workers / Promotores de Salud; CHW Instructors; Prospective CHW Employers; Community-based organization representatives. CEUs: Combination of DSHS-certified and non-certified CHW and CHW-I CEUs.

The 14th Annual CHW Conference of Houston, TX will be coming up in 2020.

Originally published Jan. 14, 2020; updated June 23, 2020.

Survive Distance Learning Talance


CHWTraining Opens New Course on Breast Cancer Screening for 2020

Enrollment is now underway for the latest in a series of cutting-edge courses designed to address the urgent need for managing chronic illnesses in communities

WOBURN, Mass. June 12, 2020 — CHWTraining is adding a new, community-focused breast cancer screening course to its 2020 portfolio. The cutting-edge online course, created by cancer prevention experts at the national and state level, is one of several that fill the industry’s skills gap by providing training in key areas such as breast cancer screening, cancer prevention, women’s health, communication skills, outreach and more.

“Breast cancer screenings can save lives, and CHWTraining is leading the way toward mobilizing women to get annual mammograms,” says Monique Cuvelier, Executive Director of CHWTraining Subscriptions. “Women face many barriers to accessing clinical screenings, and community-focused health teams are vital to educating and supporting women to overcome those hurdles.”

CHWTraining’s education and training cater to community-facing teams by addressing chronic conditions including the following, among others:

Breast Cancer Screening: communicate to clients the importance of screening, who should be screened, and what to expect.

Breast Cancer Genetics: understand how and why breast cancer happens and how to support women through a diagnosis.

Cervical Cancer: evaluate the major barriers to cervical cancer screening, plus how and when to encourage boys, girls, and women to be screened and vaccinated for HPV.

Diabetes: develop an understanding of the types of diabetes and how to manage them, including motivating clients to change lifestyle habits.

Asthma: discover how to reduce triggers during home visits and understand and follow asthma action plans.

COPD: acquire the skills needed to help clients through this group of lung conditions including chronic bronchitis and pulmonary emphysema.

Registration for all 2020 training bundles is now open. For more information about enrollment, visit our Learning Tracks page (https://chwtraining.org/learning-tracks/).

About CHWTraining subscriptions

CHWTraining training and certifications are available to healthcare teams seeking to quickly expand non-clinical skillsets as community health needs evolve. CHWTraining provides healthcare professionals around the country with the best practices, guidelines, and practical advice through education programs designed especially for them. In addition to industry-focused online programs, CHWTraining offers teams the opportunity to attend customized programs tailored specifically for their companies. For more information, please visit: chwtraining.org/contact

Photo by Andrea Piacquadio from Pexels

Where To Find Public Health Funding in 2020

Individuals and small businesses have recently received financial assistance in the form of stimulus packages. However, many public health are chronically underfunded.

[Related: 5 Ways To Save Your Budget with a Sustainable CHW Training Program]

State public health departments—always scraping for more in their budgets—and other programs funded by grants or the CDC are experiencing huge staffing cuts and declining spending.

This is at odds with the fact that public health initiatives can reduce overall healthcare spending while improving outcomes. This includes those programs employing community health workers/promotores (CHWs/Ps) and other community-focused health workers can help improve outcomes. But their programs are often the first to go.

Finding funding isn’t always straightforward, so it can pay to think crooked. We worked with program leaders from states around the US to uncover and brainstorm creative possibilities for funding. Here they are, grouped into categories.

National Funding Resources for Healthcare Agencies

  • Various Funding Categories
  • General Funding Sources
  • COVID-19 Grants and Funding
  • Private Donors
  • Unexpected Departments and Sectors
  • Partners
  • Strategy Ideas
  • Mixing Funding Streams

Various Funding Categories

Before starting on any grant-seeking expedition, it pays to understand the terminology around different kinds of funding and what it means. Spend some time with a glossary. This could help you structure projects that fit in areas you might not have considered. For example:

  • seed funding
  • place-based funding
  • capacity-building
  • supporting the non-profit sector

General Funding Sources

National Network of Libraries of Medicine

The National Network of Libraries of Medicine (NNLM) is a collaboration of members with the shared goal of advancing medicine and improving public health by giving health professionals access to biomedical information and improving individuals’ access to information to enable them to make informed decisions about their health. It’s comprised of academic health sciences libraries, hospital, pharmaceutical and other special biomedical libraries, public libraries, information centers, and community-based organizations.

NNLM offers funding for projects that improve access to health information, increase engagement with research and data, expand professional knowledge, and support outreach that promotes awareness and use of NLM resources in local communities. It includes many funding opportunities you might not think of, such as grants for holding training in libraries.

Candid Newsletters

Candid, a merger of the Foundation Center and GuideStar, publishes a handful of helpful newsletters focused on fundraising, boards, best practices, and more. The Candid Newsletters include the Funding Watches are monthly newsletters that summarize news in subject-based philanthropy, links to resources, funding opportunities for individuals and organizations, and job listings. There are also a selection of regional newsletters and the useful RFP Bulletin.

Council on Foundations

The Council on Foundations is a philanthropic network and nonprofit leadership association of grantmaking foundations and corporations. You can use the Council on Foundations website to scan through members to find out who is giving grants. The membership directory is for members only, but the website is still full of references and keywords that can help in a search.

Grantmakers in Health 

Grantmakers in Health is a networking group for funders that reveals trends and directions in grant making. The site provides announcements of grant funding, such as “The Well Being Trust, a national foundation dedicated to advancing the mental, social, and spiritual health of the nation, recently announced new grant funding for twenty-six initiatives as part of their California Mental Health and Wellness Initiative.”

COVID-19 Grants and Funding

The coronavirus is creating some funding opportunities meant to offset the disruption caused by the virus. According to an article by Moss Adams, “Large sums have been designated for health care industry purposes. The federal agencies will award the funds directly to health care providers as well as to states or state agencies, which will then pass the funds to hospitals and provider recipients.”

Some funding opportunities include FEMA public assistance awards,

Community Health Center (FQHC) Grants, telehealth grants, and a helpful grant Distance Learning and Telemedicine Grants from the Department of Agriculture Utilities Programs useful for any organization trying out online training for the first time.

Private Donors

Many agencies make a habit of looking at the general funding sources listed above. But they ignore many private sources of funding that are less well publicized. Some examples are:

Unexpected Departments and Sectors

Think outside of public health for funding other than or connected to health, like science, transportation, or other areas dedicated to social determinate of health. Note to examine your buzzwords, neutralize them, and learn the buzzwords in other sectors.

Some ideas:

  • Department of Transportation and Highway Safety, which wants to use CHWs to promote the use of car seats.
  • Reproductive Health provides funding to boost maternal health programs.
  • Partnering with doula organizations for post-partum maternal health, for what is a doula but a CHW?
  • Departments of Housing, e.g., Healthy Homes, Housing Trust Fund
  • CitizenScience, which works largely in technology and environments but also population health (Smoke Sense is a project that aims to understand the extent to which exposure to wild land fire smoke affects health and productivity, as well as inform health risk communication strategies that protect public health during smoke days; SONYC is a smart cities initiative focused on developing a cyber-physical system (CPS) for the monitoring, analysis and mitigation of urban noise pollution; GoViral is a free and real-time online Cold & Flu surveillance system administered by researchers at New York University. Participants will get a Do-It-Yourself flu saliva collection system that they can keep and use at home if they are feeling sick.)
  • Keep looking for federal, but also state and community funding sources.


Partners can help share the load and also open up possibilities for new grants. Some examples:

  • Indian Health grant for diabetes
  • Good Health and Wellness (Indian) – careful of duplicating efforts
  • CHRs
  • EMS (guiding CHWs to getting certified in CPR and First Aid)
  • Gaming Commissions often need to spend their money on communities

Strategy Idea: Mixing Funding Streams

Lastly, think about strategy when looking for funding. Remember that funding seeds funding. Funders look at successful programs that have already received money as potential sources for additional funding. They want their investment to succeed.

Sometimes you can increase funding if you tell one funder that you’ve received funding from another. They can provide a matching grant for the same cause.

Disclaimer: This article is a basic resource and is not comprehensive. We’ll continue to update it to add more information as funding opportunities become available or change.

Photo by bongkarn thanyakij from Pexels

Quiz: Is Your Community-Based Team Burned Out?

For most of us, a job with more independence; enough time to support staff, clients, and patients; and less stress would be ideal. But having this kind of flexibility when so many people need help is challenging. In fact, when stressors stack up, it’s easy for community health workers and promotores (CHWs/Ps) to reach a breaking point.

[Register now for Supporting Mental Wellness in CHW Teams]

Stress on the Job

Stress is a natural response to challenging situations. Low levels of stress are not damaging or a serious threat. In fact, a little stress can be a helpful motivator.

CHWs/Ps, healthcare workers, and in fact workers in most industries regularly face countless stressors. These can pile on top of daily stressors (divorce, sickness, financial difficulties) and anxiety-inducing world events … like pandemics.

But what happens when stress leads to exhaustion, a bleak view of your work and organization, and the loss of drive and interest in daily tasks? Burnout.

Burnout in Healthcare Providers

Burnout is when someone has reached a breaking point, they’ve lost control of the stress, struggle to keep up with work, and feel growing frustration. The World Health Organization recognized workplace burnout as a real condition in 2019.

Burnout on the job happens when someone runs out of physical, emotional, mental, and spiritual energy. It happens when they’re dealing with emotionally demanding situations for a long time. People report feeling burned out when they feel tired, frustrated, and like they’re not meeting their personal or professional goals. Burnout can happen especially when CHWs/Ps are feeling stressed.

CHWs/Ps develop strong bonds with clients and report that they feel fulfilled by their jobs. However, CHWs/Ps are often called on to respond to mental health crises but may not have the training to handle these challenging situations.

Many CHWs/Ps and their teams are often overworked, which contributes to growing frustration. Taking on so many responsibilities ups their risk of depression, anxiety, burnout, and compassion fatigue.

Another common source of frustration and discouragement is when a relationship they build with a client ends. The emotional roller coaster that comes with getting involved in the lives of their community — the people in their care — makes it easy to get attached and struggle with feelings like guilt, sadness, and even anger.

When your CHWs/Ps’ mental wellness is at risk, so are their clients. And so is your program.

If you work in a close team, you might be able to easily tell if someone is feeling undue stress. In our behavioral health course, we flag these as some of the items to look for if you suspect someone needs help.

Signs of Burnout

  • Sleeping too much or not enough
  • Sudden weight loss or gain
  • Avoiding people and activities
  • Smoking or drinking more, or using drugs
  • Mood swings
  • Apathy and calling in sick to work

In general, you can consider any big changes in everyday life patterns and habits a red flag among your team unless there’s a clear cause for them.

Whether you feel overwhelmed by tasks, trying to balance work and home, or just looking for ways to make your job better, here’s a quiz

you can take—or give to your CHW/P staff—to help determine if you should address burnout.

Quiz: Is Your Community-Based Team Burned Out or Stressed?

Ask your team members to select the answers that best apply to them.

1. Lately have you felt exhausted and frustrated at work?

2. Have you worried that your work is making you feel cynical?

3. Have you often felt down, depressed, or hopeless?

4. Have you felt overwhelmed or like you can’t finish all your tasks?

5. Have you felt anxious, depressed, or irritable?

6. Has your physical health declined, or have you been ill more frequently?

7. Do you believe that your work is not important or appreciated?

8. Do you find yourself simply wanting to escape by reading fiction, watching TV, playing video games, using substances?

Are You Dealing with Burnout?

If responses are mostly As, that could be full-fledged burnout. Even a single yes answer can indicate signs of burnout.

As a leader, you can create healthy work conditions, build a toolbox for your team to manage stress properly, and spot red flags that may point to hidden issues before your CHWs/Ps hit a breaking point. Help your staff to recover from burnout. A healthy, motivated staff makes all the difference in performance, job happiness, and overall wellbeing for your team and the people in your care.

Photo by energepic.com from Pexels

The Coronavirus Is Changing the Community Health Workforce. The Shifts May Be Here to Stay

Being a community health worker or promotora (CHW/P) now isn’t the same as it was in January. And the job might never be the same again. Public health departments, health plans, agencies, vocational high schools—all manner of health care systems in the United States are rethinking what it means to hire, train, and integrate CHW/Ps and other frontline health workers because of the coronavirus.

Since COVID-19 swept across the U.S., the many agencies and individuals are rethinking much of their CHW/P workforce: how new CHW/Ps are trained as they enter the job, what kinds of skills new and experienced workers need in a new health landscape, and even how they work as part of multidisciplinary healthcare teams.

[Ready for your next learning adventure? Start with CHWTraining’s Learning Tracks]

While some of the job changes are born out of necessity, some are simply a better way of working and connecting to clients and patients.

Here’s a closer look at three key ways in which the CHW/P job has changed and will probably stay.

In-Person Training Will Move Online

Virtual training is necessary because it’s not safe for many learners, trainers, and staff to safety travel to on-site locations. As time goes on, and as more health experts and communities warn that opening the country too soon could result in suffering and death, and critically for CHW/Ps, the ability to support underserved communities when they need it most.

The Washington State Department of Health usually offers in-person training across the state four times per year as part of its hybrid CHW training program. This year, however, just as the program was ready to offer its spring session, the state went on lock-down orders.

Washington is one of many organizations that say some or all training for CHW/Ps through the summer and fall is being provided online. Vocational high schools that train CHWs and other medical tech workers are also moving to an online format. We at CHWTraining have an entire team dedicated to creating a wide variety of courses and certifications to educate health workers no matter where they are so they can grow their careers.

CHW/Ps Will Use Telehealth

Telehealth, or telemedicine, is another domain that wasn’t part of many CHW/P tasks until recently. This is good news, because telehealth is a proven strategy to engage and support clients, especially those in rural communities. Now, most people are remote, and the same strategy of communicating with clients for long-distance health care and education works.

Exactly how CHW/Ps will use telehealth to connect with their clients is still evolving.

“Telehealth policy changes occurring within the COVID-19 environment have been rapidly developing on almost a daily basis,” according to Center for Connected Health Policy.

Some of the common ways telehealth is used, according to the Center, include:

  • Video conferencing in a live, two-way interaction between a patient and a provider
  • Store-and-forward technologies to transmit medical information, such as digital images, documents, and pre-recorded videos
  • Remote Patient Monitoring (RPM) to send personal health and medical data collection from a patient in one location to a provider in a different location
  • Mobile Health (mHealth) to support clinical and public health services and education on mobile devices such as phones and tablets
  • eConsult for providers to consult with specialists via live video conferencing or store-and-forward.

Skill Areas Will Evolve

Health education, outreach, referrals, and understanding health disparities are all important skills that CHW/Ps provide on a daily basis. Those are more important than ever in a pandemic. Prevention is essential to protecting the lives of people in low-income communities without adequate access to healthcare.

CHW/Ps, for example, can organize hand hygiene stations for homeless and migrant areas. They can use telehealth (see above) to check in with high-risk community members. They can keep people out of overused emergency rooms by teaching skills like understanding how to read and follow an asthma care plan.

Many CHW/P jobs include tasks no one ever imagined a few months ago – sometimes in ways they wouldn’t have thought of. The term “contact tracing” is something associated with CHWs during the Ebola crisis in Africa or cholera in Haiti, but wasn’t really practiced in the United States. CHW/Ps are working within their communities to map cases before it spreads.

Providing social support and behavioral health support are going to be even more important than before.

CHW/Ps Will Be More Integrated

Many healthcare systems that have considered using CHW/Ps, or use them but aren’t sure how they connect with the larger system, will need to change. These organizations’ workforces will need to understand the role of a CHW/P and how it differs from a social worker, case manager, or nurse. When disasters—health and otherwise—effect a community, it’s helpful to have a community-based workforce to minimize its impact.

“Right now there’s a focus on coordinating services for high-risk individuals to meet their health and social needs and help them remain at home safely to reduce their risk of contracting COVID-19,” Melanie Bella, chief of new business and policy at Cityblock Health and current chair of the Medicaid and CHIP Payment and Access Commission (MACPAC) said in an interview with Center for Health Care Strategies.

“States may want to consider re-focusing efforts on making system changes that increase coordination and alignment,” she advised.

Now more than ever before healthcare systems need to invest in CHW/Ps. They’re essential during pandemics and not.


Most Important Tobacco Cessation Skills for a CHW Training Plan

Tobacco kills and doesn’t have to. That’s why most health agencies already include dedicated tobacco or vaping cessation programs. They don’t, however, always include community health workers (CHWs) or other health promoters as part of that equation.

Need for CHWs on Tobacco Cessation

CHWs are proven through multiple studies to provide significant impact on health promotion and disease prevention, including tobacco and vaping cessation. They excel at prevention strategies, and tobacco use is the leading cause of preventable mortality in this country. And CHW initiatives can excel where clinic-based programs fail: CHWs know their communities and can reach more underserved and hard-to-reach smokers, such as LGBTQ+ communities.

“Tobacco use is twice as high for LGBTQ+ high school students than for heterosexual students,” says Mandi Pratt-Chapman, director of the GW Cancer Institute, on Twitter. 

Tobacco programs across the world that use CHWs have demonstrated promising quit rates. A study from the CDC shows community-based interventions included are cost-effective. Another study shows that people working with CHWs were about three times more likely to quit when compared with a control group.

Thankfully, guiding people to stop smoking or vaping is an accessible skill. CHWs who have the right kind of training and supervision can work within a community to provide culturally relevant motivational strategies, social support, and bridge gaps in healthcare.

[Read more: Online Training Beginner’s Guide for Program Managers]

Any tobacco and vaping cessation program should include not only clinicians, clinical staff, and also community-based health workers with the knowledge and skills they need to promote tobacco cessation.

Where To Start with Tobacco Cessation Training Programs for CHWs

Before designing your tobacco cessation program, assess your needs. You could start with a skills gap analysis. This analysis, or assessment, is an important first step in creating any online training initiative. Establishing what stakeholders need from a program, and what your trainees need to learn, will help you create a program that has a greater chance of success.

But too many people either skip the step of creating a needs assessment, or they make mistakes. If a training needs assessment is messy, it could set the tone for your entire program, and could leave unsatisfied health workers or wasted funds.

To do your own skills gap analysis, list the essential skills in a CHW tobacco training program (some suggestions are below), check off the areas where you already excel, and note areas where you need extra support. Then, rank each CHW based on these criteria to find out who needs to learn which skill.

Sample Gap Analysis Template





















Don’t forget to include your CHWs and healthcare team. Ask what they’d like to learn more about, and involve them in designing a tobacco cessation training program that dovetails with additional training opportunities. Any training and development program works best when the people you’re training are involved.

Then, you’ll be ready to decide what portions of your training program you want internal, and which you can outsource to a program like CHWTraining. An outside education consultant can supplement your team by helping you build a training plan and conduct these analyses. A cloud learning subscription can make your training much more successful by being accessible 24/7 and allowing CHWs to train remotely.

Tobacco Cessation Training Guide

When you’ve defined which training areas you can address internally and which you’d like to outsource, then you can put together a program. Here are some of the skills CHWTraining recommends as part of a tobacco cessation and vaping program.

  1. Tobacco Cessation
  2. Vaping
  3. Motivational Interviewing
  4. Communication Skills
  5. Outreach Skills
  6. Cardiovascular Disease
  7. Providing Social Support

1. Tobacco Cessation

An overall course on tobacco cessation will show your team what motivates people to use tobacco or vape and what resources are available to help them stop. An ability to make smart recommendations that help people live a healthier life relies on understanding factors that can help or hinder cessation attempts, as well as several strategies that tobacco users can employ to work towards their cessation goals. (Check out 10 Free Apps for Tobacco Cessation.)

2. Vaping

New information appears regularly on severe lung disease associated with using vaping devices and e-cigarette products. Vaping should be a focus of any tobacco control program, especially among youth.

This is a bigger program than you might think, and vaping leads to smoking. The Washington State Department of Social and Health Services posted on LinkedIn, “One in five 10th graders in Washington uses vapor products or e-cigarettes … each year in Washington, approximately 1,800 youth start smoking & will continue smoking into adulthood.”

Training on vaping should include what the products are and how they are used, effects on brain and lung development, addiction, pathways to tobacco use, and understanding how tobacco and vape marketing intentionally target low-income communities.

3. Motivational Interviewing

Motivational interviewing (MI) is a technique used to help people discover their own reasons for positive change in a non-confrontational way. It was originally developed as a way to help people quit smoking, and while MI techniques can be used for helping people make any kind of behavioral change, it’s still an essential skill for stopping smoking.

4. Communication Skills

Frontline healthcare workers need to be able to understand the language used on a daily basis to provide education and motivation for quitting tobacco or vaping. Using good communication techniques helps them relate health information better, limit misunderstandings, and build trust. Include a course that provides foundational communication techniques to facilitate better communication between health care providers and community members, and it will be useful in many different settings.

5. Outreach Skills

Any tobacco cessation program should be built on solid outreach and engagement skills so that community members know what resources are available to them.

An outreach skills and engagement course should provide a path that goes through identifying a target audience, determining their needs, and spreading the word about smoking cessation services or programs that will benefit them.

6. Cardiovascular Disease

Smoking takes a toll on the heart, so CHWs should understand how in a training about cardiovascular disease. A good course on CVD should cover how the cardiovascular system functions, what happens during a heart attack and stroke, as well as how smoking can lead to worse outcomes. Skills in this course should also include management and prevention strategies that will include using cigarettes and e-cigarettes and well as other negative influences.

7. Providing Social Support

Learning to navigate social situations and building a support system is critical for dealing with a quit attempt and motivating patients for change.

A providing social support course will provide positive stress management and coping skills, ways to strengthen social support networks, and interpersonal and relationship-building skills.

Related: Chronic illness education and training for teams

Health photo created by freepik – www.freepik.com

Asthma Awareness Best Practices

Allergy season is a tough time for everyone—especially people with asthma.

Helping community members manage asthma is more important now than ever before. Supporting patients with asthma and their caregivers can keep people out of the emergency room (ER) and also help keep their lungs healthy in case of a complication, such as COVID-19.

Asthma affects approximately 20 million people in the United States. According to the American Lung Association, asthma is one of the main reasons that students miss school due to illness. Making a few changes can significantly change those statistics.

Frontline health workers can have a much higher success rate helping their clients follow asthma action plans, understand their medication, and avoid (or minimize) an attack in the future by following a few best practices. It can be as easy as sharing a few key pieces of knowledge—even if you don’t have a dedicated asthma care team.

Click here to read more about chronic illness training.

Changes that work for people with asthma or their caregivers don’t have to be about major lifestyle overhauls. They can be as simple as a few steps and a little careful planning. It comes down to showing clients how to recognize asthma symptoms, identify and use asthma medications, and reduce asthma triggers in the home.

It’s also helpful to remember that asthma education isn’t a one-and-done activity. Community health workers, promotores, and other health educators should take the time to build relationships so they can communicate best practices to their clients over time.

To that end, read on for essential asthma awareness best practices that apply to any healthcare agency, especially now in allergy season.

5 Asthma Awareness Best Practices

  1. Prepare for COVID-19
  2. Push for asthma training for CHWs
  3. Understand the asthma action plan
  4. Remove shoes at the door
  5. Ventilate the house

1. Prepare for COVID-19

Asthma is one of the underlying health conditions that can increase people’s risk for serious case of COVID-19, the disease caused by the coronavirus. This doesn’t mean they’re more likely to get an infection, but they are more likely to have worse outcomes if they become sick with COVID-19.

Also, hospitals are a bad place to be right now. People with lung conditions are more frequently admitted to hospitals because of their illnesses.

The best thing frontline health workers can do is help people stay home, keep a safe distance from others, and avoid getting sick in the first place. They should stay connected with their healthcare providers about any symptom changes. And, of course, follow the asthma action plan.

2. Push for Asthma Training for CHWs

Many healthcare agencies and systems don’t realize CHWs can be an important source in home-based asthma care, which can directly and significantly help the agency. Without the right training, CHWs won’t be able to help. So push for training in courses like CHWTraining’s Improving Asthma Outcomes or other courses.

It’s even better if these training programs are part of standard CHW requirements. Minnesota, for example, requires a field-based program that can involve an asthma care team. Washington state also recommends asthma continuing education for graduates of its community health worker training program.

Working in asthma treatment goes deeper than just knowing what asthma is and how to control it. It should be part of a comprehensive training program. Other supplemental skills should include:

3. Understand the Asthma Action Plan

Healthcare providers give people with asthma an asthma action, or management, plan to control the disease. The goal is to prevent or reduce flareups and limit trips to the ER. Not everyone understands their plan, which is where CHWs can help.

They can help interpret the instructions on the plan and make sure it’s in a place that can be accessed when it needs to be during an emergency. CHWs can also help patients and their caregivers understand proper inhaler technique and connect to the right professional if needed.

4. Remove Shoes at the Door

CHWs are effective where their clients live, which is where most people deal with asthma each day. They can help as soon as they arrive at the door with this simple technique: take your shoes off.

One of the easiest ways to reduce triggers and allergens in a client’s home is to ask everyone to remove their shoes before they go inside. It’s so simple and costs nothing—just take them off before going inside. It’s also a good way to make a pair of shoes last longer.

When someone walks around outside, their shoes collect dirt, molds, fungi, pesticides, and anything else on the ground.

The coronavirus can travel on shoes too, although scientists are unsure if the droplets were still infectious. A study from the CDC shows the virus can survive on shoe soles.

5. Ventilate the House

Indoor air quality has a big impact on how well someone can manage their asthma. An efficient ventilation system with clean air filters helps, but it can be expensive. People who live in apartments might not have control over the ventilation system either.

An easy and free solution is to keep air from outside coming in. The best way to ventilate the house is to go to every window, and open it. When every window has been opened, start over and close each one. That gives the house enough time to ventilate without letting in too many allergens.

To learn more about educating clients about asthma, contact us to sign up for Improving Asthma Outcomes.

Survive Distance Learning Talance

Oral Health Training Initiatives in Every State

It’s well documented that oral health is connected to the whole body. So, it makes sense for CHWs and health promoters to understand why oral health is important and what to look out for when visiting clients. Many agencies recognize the need to include oral health in CHW training.

Some states, such as Oregon and Minnesota, require CHWs to take training in oral health.

To help your program meet any requirements or support initiatives—and improve oral and overall health outcomes in clients and patients—we did a deep dive into each state to see what they offer in terms of oral health training, requirements, and resources for CHWs.

Do you know of anything we left out? Let us know, and we’ll add it to this list.

Oral Health CHW Training Initiatives by State


The Alaska Community Health Aide Program (CHAP)/Dental Health Aide Program (DHAP) complements Alaska’s tribal health care system to ensure access to primary health services in remote frontier communities serving Alaska Natives.


Arizona has a state Oral Health Action Plan that includes a strategy to “engage other health professionals (physician assistants, nurse practitioners, community health workers (CHWs), to help consumers navigate the healthcare system.”


The Arkansas Department of Health includes a STAR.Health initiative that use CHWs to promote health in maternal-child health, oral health, and chronic disease management.


The California Oral Health Plan includes a strategy to “Provide technical assistance and training to support the inclusion of oral health goals in promotora/community health worker (CHW) programs and home visitation programs.”


Colorado doesn’t specifically recommend oral health training by CHWs but it does expand the role of dental hygienists to include some traditional CHW skills, “Colorado allows licensed independent dental hygienists to provide preventive care and refer for restorative treatment.” The state does include standards and requirements for health navigators—sometimes called oral health patient navigators–on “Recognizing and reporting abnormal signs and symptoms of common conditions including mental and oral health.”


Connecticut is showing some signs of requiring oral health training for CHWs by integrating oral health with medical health.


Delaware is committed to training CHWs in oral health by training with a presentation called “An Inside Look into the Connection Between Oral Health and Overall Wellness,” from the Division of Public Health at Delaware Health and Social Services. It also has an “Oral Health 101” presentation. “We also encourage the Smiles for Life educational resources,” says Gabrielle Hilliard, the public health treatment program administrator at the Delaware Department of Health and Social Services’ Division of Public Health.


The Florida Senate issued language addressing “critical shortages of providers” in oral health care, among others, and is encouraging CHWs to plug that gap. The Florida Oral Health Alliance works with the Florida Community Health Worker Coalition to work toward its oral health plan.


Georgia was one of 13 states working on state guidelines for instituting best practices for oral health access.


Hawaii was one of 13 states working on state guidelines for instituting best practices for oral health access.


The Idaho Oral Health Network carves out space for CHWs to help with oral health. Idaho also was one of 13 states working on state guidelines for instituting best practices for oral health access.


Illinois was one of 13 states working on state guidelines for instituting best practices for oral health access. Its action plan includes, “Increase oral health services (diagnostic, preventive, and restorative) to Medicaid and SCHIP children, birth through 13, by 14 percent.” It received a HRSA grant to build up an oral health workforce.


The CHW Workgroup includes an initiative for “diagnosis-related patient education towards self-managing physical, mental, or oral health in conjunction with a health care team.”


Iowa was one of 13 states working on state guidelines for instituting best practices for oral health access.


Kansas does not yet have established CHW requirements but does have many areas of specialty, including oral health as well as diabetes, asthma, and others, according to Oral Health Kansas. Kathy Hunt, Dental Program Director, says “Next steps are to offer supplemental specialty courses (on-line and face to face) after graduation that will best match job placement,” including CHWs who will work in oral health.


We were unable to find details on CHWs and oral health in Kentucky.


We were unable to find details on CHWs and oral health in Louisiana.


We were unable to find details on CHWs and oral health in Maine.


“Maryland had just begun its process to accredit CHW Certification Training Programs and has not yet issued any accreditations,” says Kimberly Hiner, deputy director of the Office of Population Health Improvement at the Maryland Department of Health.

“Maryland’s CHW certification process is built on our CHW core competencies.  While oral health is not explicitly listed as a core competency, training programs may have it incorporated into their comprehensive curricula. We should have more information within the next six to twelve months.”


Oral health is offered as a special health topic to be potentially taken for the CHW requirement course, and/or offered as a potential course for the CHW Certification Renewal.


Michigan was one of 13 states working on state guidelines for instituting best practices for oral health access.


Minnesota initiated an expansion of its oral health workforce because more than half of its counties are considered Dental Health Professional Shortage Areas. Minnesota’s 2013-2018 Oral Health Plan details strategies to expand the oral health workforce to reduce these disparities, including using CHWs.


Some CHWs in Mississippi have completed oral health training, according to Tameka Walls, director of the Mississippi Delta Health Collaborative at the Mississippi State Department of Health.


CHWs in Missouri do not currently receive training regarding oral health, but “we are considering options to encourage this training,” says Karen Dent, Director of the Oral Health Network of Missouri at the Missouri Primary Care Association.


Montana encourages training in oral health for CHWs but has no posted requirements.


The state Health Worker training program does not offer training in oral health, but the state has used CHWs in the past and has placed some individuals in the training program.


CHWs who are not certified or who have the first level of certification in Nevada, need the basic state-approved course. “There’s 20 additional hours of required ‘general training,’ which is not prescribed and CHWs can certainly submit trainings that were on oral health,” says Kayla Valy, project manager for the Nevada Community Health Worker Association. “Oral health trainings are likely to be approved for the ‘general’ category but not specifically called out anywhere.”

The Nevada Certification Board has information for people who would like details on the requirements and process of becoming a certified CHW.

New Hampshire

New Hampshire encourages training in oral health for CHWs but has no posted requirements. The Oral Health Program at the New Hampshire Department of Health and Human Services has some information about oral health initiatives.

New Jersey

New Jersey has no posted requirements and did not respond to our survey, but the Children’s Oral Health page at the State of New Jersey Department of Health lists some educational resources.

New Mexico

New Mexico was one of 13 states working on state guidelines for instituting best practices for oral health access.

New York

“Will test a model that uses family-level, peer-counseled, and technology-assisted behavioral risk reduction strategies, aims to divert children with early- and advanced-stage early childhood caries (ECC) from high-cost surgical dental rehabilitation (DR) to low-cost non-surgical disease management (NSDM). Together, parents and community health workers (CHWs) will use MySmileBuddy (MSB), a mobile tablet-based health technology, to plan, implement, and monitor positive oral health behaviors, including dietary control and use of fluorides, which arrest ECC’s progression.”

Oral health for CHWs as part of Maternal and Infant Community Health Collaborative.

North Carolina

North Carolina supports community dental health coordinators. “CDHCs are dental assistants or dental hygienists with the combined skills of a community health worker, dental auxiliary, and care coordinator who are recruited from the vulnerable community they will serve,” according to a newsletter from the NC Department of Health and Human Services.

North Dakota

North Dakota is working on a Community Health Dental Coordinator program supported by the state Dental Association, the ADA, and other partners. “There are a few in North Dakota who have taken the training, and are working in the state (though community health workers/Community health dental coordinators do not yet provide care that can be reimbursed – this is a conversation that is being had with state Medicaid),” says Shawnda Schroeder, the oral health expert at the University of North Dakota School of Medicine and Health Sciences’ Center for Rural Health. “The state has just begun to have conversations around dental community health workers and there is consensus among oral health providers and stakeholders that this model could work in North Dakota.”


Oregon’s Traditional Health Worker (THW) program requires applicants to complete between 1.5 and 3 hours oral health training.


The state pledged to “develop programs that promote and support oral health careers” to meet a gap in promoting oral health education in its Pennsylvania Oral Health Plan 2017-2020 (PDF). This includes “comprehensive plan to improve the number of oral health professionals graduating and remaining in Pennsylvania.”

Rhode Island

Rhode Island has requirements for becoming a certified CHW, and while CHWs aren’t required to complete oral health training, they are required to include a “portfolio”: a collection of personal and professional activities and achievements in categories that can include oral health. The state’s Oral Health Program is a “mini-residency” that increases career opportunities for oral health professionals and access to the marginalized communities.

South Carolina

Oral health is a specialty track that the South Carolina Community Health Worker Association would like to provide to CHWs. It is an area that trainers in the state are looking to include in the future.

South Dakota

Delta Dental of South Dakota, which covers over thirty‐thousand isolated, low‐income, and underserved Medicaid beneficiaries and other American Indians on reservations throughout South Dakota, received an award to improve oral health and health care for American Indian mothers, their young children, and American Indian people with diabetes.”


The Tennessee Department of Health made October 2019 Child Health Month and published a toolkit full of resources for health workers (available here as a cached resource).


Certified CHWs in Texas should be trained in oral health principles as part of the core competency Knowledge Base on Specific Health Issues. It includes the objective, “Find information on specific health topics and issues across all ages [lifespan focus], including healthy lifestyles, maternal and child health, heart disease & stroke, diabetes, cancer, oral health and behavioral health.”


The Utah Department of Health’s Office of Health Disparities publishes many resources for community-focused workers and program coordinators, including “Seal Your Smile: A Step Toward Combatting Oral Health Disparities in Utah,” “Cross-Cultural Education and Training: Oral Health Education Institutions in Utah,” and “Addressing Oral Health Disparities in Urban Settings: A Strategic Approach to Advance Access to Oral Health Care.”


Vermont offers a few initiatives focused on improving oral health (PDF), especially in rural areas. A major achievement is “Access to oral health care was a top priority identified in our current CHNA. In response a multi-agency Rural Oral Health Access initiative was launched to provide oral health screening and dental hygiene services to children in elementary schools throughout our HSA and to link these children to a dental home.”


Virginia’s action plan includes increasing utilization of dental services. Virginia Health Catalyst has resources surrounding its initiatives for CHWs.


The Washington State Department of Health has many resources and trainings for community health workers focused on oral and dental health. The Community Health Worker Training project includes a course available to Washington participants on oral health, available in English and Spanish.


The Wisconsin Oral Health Coalition released “Roadmap to Improving Oral Health 2020-2025” to reduce the prevalence of oral disease and reduce disparities in oral health status among populations but doesn’t contain specific information about CHWs.

No information was available for Alabama, Delaware, Ohio, Oklahoma, West Virginia, or Wyoming.