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Resources / Advancing California’s Community Health Worker & Promotor Workforce in Medi-Cal / Section 4. Training and Support
Knowledge Center

Challenges and Ingredients for Success

Published October 1, 2021

3 minute read

Health Workforce
  • Advancing California’s Community Health Worker & Promotor Workforce in Medi-Cal
    • Section 1. Introduction
      • Background on CHW/Ps in California
      • Advancing CHW/P Integration in Medi-Cal
      • Making the Case for CHW/P Integration
    • Section 2. Program and Partnership Development
      • Implementation Approaches
      • Challenges and Ingredients for Success
      • Resources and Tools
    • Section 3. Roles and Recruitment
      • Implementation Approaches
      • Challenges and Ingredients for Success
      • Resources and Tools
    • Section 4. Training and Support
      • Implementation Approaches
      • Challenges and Ingredients for Success
      • Resources and Tools
    • Section 5. Data Collection and Program Measurement
      • Implementation Approaches
      • Challenges and Ingredients for Success
      • Resources and Tools

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    Challenges related to training CHW/Ps, CHW/P supervisors, and interdisciplinary teams — such as not having enough time, resources, and organizational commitment — are not dissimilar to general barriers related to training in the health care field and beyond. This section explores the unique barriers and potential solutions related to structuring effective CHW/P training programs.

    For additional detail, access “Common Challenges and Ingredients for Success” (PDF) in the “Training and Supporting CHW/Ps” section of the Resource Guide.

    • Establishing CHW/P training programs. MCPs may have a short timeline in standing up new CHW/P interventions, as well as limited expertise in developing and facilitating trainings for CHW/Ps. As organizations plan out their training schedule, they may want to consider sequencing the training to include a core training before CHW/Ps begin to work in the field to lay the groundwork for integration, followed by ongoing training that takes place while on the job. Partnering with established training organizations can support MCPs in addressing this barrier, as can an early focus on strengthening community relationships to dynamically inform program design and training.
    • Addressing training costs. MCPs must view training as an investment — both up front and continuously — to adequately set up CHW/P programs for success. This workforce has been historically underfunded, and MCPs should recognize the value of comprehensive training to support their goals. MCPs looking to understand the value proposition in the context of ECM and ILOS as well as other programs may be interested in exploring research showing the positive return on investment from CHW/P interventions, as detailed in Exhibit 4 of the Resource Guide (PDF).
    • Making training accessible for CHW/Ps. CHW/P training needs to be accessible for individuals with diverse backgrounds and lived experience, and MCPs and their contracted partners should ensure that CHW/Ps from all socioeconomic backgrounds can participate in training. Measures of accessibility include cost of participation per person, training frequency, training location and time of day offered, and languages in which the training is available. Paying CHW/Ps to participate in training and using web-based trainings (both synchronous and asynchronous) will help support access to training.
    • Mitigating staff turnover. When a CHW/P leaves a position, it may be empty for weeks or months until filled and support to the community is resumed. Ensuring that the right CHW/Ps are hired for programmatic and organizational fit can reduce turnover. CHW/P feedback, particularly about workflows and the work environment, should be regularly invited and gathered so there can be continuous quality improvement. Additionally, organizations can facilitate greater peer support to newly hired CHW/Ps by hiring them in pairs or groups. Robust professional development opportunities and ongoing training will also foster workforce retention.

    Authors & Contributors

    Center for Health Care Strategies

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