Framework, design, and baseline data of a collective impact initiative to strengthen the Community Health Worker workforce ecosystem in Texas.

Abstract

Background: The Health Equity Collective (HEC), a multi-sector systems-level collective impact coalition in the Greater Houston region, partnered with the City of Houston Health Department (HHD) to launch a 2-year effort to implement a comprehensive approach towards strengthening the regional Community Health Workers (CHW) workforce infrastructure as a pathway to advancing health equity. Our paper presents the logic model, methods, and baseline qualitative and quantitative data from this initiative.

Methods: In the fall of 2022, the Health Equity Collective brought together a Network of CHW-employing or training organizations in the Greater Houston region. This Network was the working group of CHW employer/training organizations tasked with developing the shared agenda for collaborative action toward strengthening the regional CHW workforce. As part of the baseline needs assessment qualitative interviews were conducted to understand the role and add-value of CHWs in advancing health equity. A landscape scan survey was administered to assess CHW employer organization's funding and sustainability mechanisms for their CHWs job stability, CHW focus areas, organizational health equity priorities, etc. A journey mapping exercise was also conducted to capture CHWs lived experiences in their own voices.

Results: The qualitative interviews outlined three themes that describe the role, barriers, and needs of CHWs. Landscape scan survey responses were obtained from 21 out of 29 organizations in the CHW Network. Responses provided insight into CHW employer organizational funding and sustainability mechanisms for CHWs job stability, CHW focus areas, etc. The journey mapping exercise outlines the various paths that brought the participants to pursue a CHW career path and their journey through CHW training and work.

Conclusion: In summary, our paper outlines the collective impact approach and baseline data guiding efforts to strengthen the regional CHW workforce. Strategies and priorities were developed based on CHW voices and engaging stakeholders across organizations employing and training CHWs.