The Launch of Massachusetts Community Health Worker Certification: Findings From the Massachusetts Community Health Worker Workforce Surveys.

IF 3 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Reports Pub Date : 2024-11-01 Epub Date: 2024-05-28 DOI:10.1177/00333549241253419

Victoria M Nielsen, W W Sanouri Ursprung, Glory Song, Gail Hirsch, Theresa Mason, Claire Santarelli, Erica Guimaraes, Erica Marshall, Caitlin G Allen, Pei-Pei Lei, Diane Brown, Bittie Behl-Chadha

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Abstract

Objectives: The launch of state certification for community health workers (CHWs) in Massachusetts in 2018 aimed to promote and champion this critical workforce. However, concerns exist about unintentional adverse effects of certification. Given this, we conducted 2 cross-sectional surveys to evaluate this certification policy.

Methods: We conducted surveys of CHW employers and CHWs in 3 sample frames: community health centers and federally qualified health centers, acute-care hospitals, and community-based organizations. We administered the surveys in 2016 (before certification launch) and 2021 (after certification launch) to answer the following questions: Was certification associated with positive outcomes among CHWs after its launch? Did harmful shifts occur among the CHW workforce and employers after certification launch? Was certification associated with disparities among CHWs after its launch?

Results: Certification was associated with higher pay among certified (vs noncertified) CHWs, better perceptions of CHWs among certified (vs noncertified) CHWs, and better integration of certified (vs noncertified) CHWs into care teams. We found no adverse shifts in CHW workforce by sociodemographic variables or in CHW employer characteristics (most notably CHW employer hiring requirements) after certification launch. After certification launch, certified and uncertified CHWs had similar demographic and educational characteristics. However, certified CHWs more often worked in large, clinical organizations while uncertified CHWs most often worked in medium-sized community-based organizations.

Conclusions: Our evaluation of Massachusetts CHW certification suggests that CHW certification was not associated with workforce disparities and was associated with positive outcomes. Our study fills a notable gap in the research literature and can guide CHW research agendas, certification efforts in Massachusetts and other states, and program efforts to champion this critical, grassroots workforce.

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马萨诸塞州社区健康工作者认证启动：马萨诸塞州社区健康工作者劳动力调查的结果。

目标：2018 年，马萨诸塞州启动了社区卫生工作人员（CHWs）的州级认证，旨在促进和支持这一重要的劳动力队伍。然而，人们对认证的无意不利影响存在担忧。有鉴于此，我们开展了两项横断面调查，以评估这项认证政策：我们对社区保健工作者雇主和社区保健工作者进行了 3 个样本框架的调查：社区保健中心和联邦合格保健中心、急症护理医院和社区组织。我们在 2016 年（认证启动前）和 2021 年（认证启动后）进行了调查，以回答以下问题：认证启动后，CHW 是否取得了积极成果？认证启动后，社区保健工作者队伍和雇主是否发生了有害转变？认证启动后，保健工作者之间是否存在差异？认证与获得认证（与未获得认证）的 CHW 工资更高、获得认证（与未获得认证）的 CHW 对 CHW 的看法更好以及获得认证（与未获得认证）的 CHW 更好地融入护理团队有关。我们发现，在认证启动后，根据社会人口变量或 CHW 雇主特征（最明显的是 CHW 雇主雇佣要求），CHW 劳动力没有发生不利变化。认证启动后，获得认证和未获得认证的 CHW 具有相似的人口和教育特征。然而，获得认证的社区保健工作者更多地在大型临床机构工作，而未获得认证的社区保健工作者则更多地在中型社区机构工作：我们对马萨诸塞州 CHW 认证的评估表明，CHW 认证与劳动力差异无关，而且与积极的结果相关。我们的研究填补了研究文献中的一个显著空白，可以为 CHW 研究议程、马萨诸塞州和其他州的认证工作以及支持这一重要的基层劳动力的计划工作提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health Reports 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.00

自引率

6.10%

发文量

164

审稿时长

6-12 weeks

期刊介绍： Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.