Non-Randomized Pre-Post Testing to Evaluate Knowledge of Community Health Workers on Chronic Diseases After...

Community Health Worker (CHW) training started to be conducted mostly virtually during the 2020 COVID-19 pandemic when there was increased need for CHWs and a restriction on in-person gathering. Synchronous virtual training has become the norm for initial training with a need for continuous training to further improve capabilities found in the literature. In this paper we explore conducting online continuing education on chronic diseases asynchronously for CHWs.

CHWs in Maryland were sent information on availability of online training for chronic diseases through the network of Area Health Education Centers (AHEC) in the state. It was a convenient sample. Pre-post testing was used to evaluate a CHW online training module for 3 chronic diseases delivered asynchronously. The training used slides developed for virtual synchronous training which had been delivered earlier, and the online training opened to CHWs in Maryland from March 31st to June 20th 2025. The trainees were given a pre-test before each module and a post-training test.

The pre-test score average were 78.8%, 80%, and 82% for the hypertension, cholesterol, and diabetes modules respectively and the post-test score average was 89.9%. The post-training average test score was statistically significantly higher than the pre-test scores for each of the modules. Each of the training module pre-test scores were not statistically significantly different from each other.

Virtual training of CHWs is becoming the norm, starting during the COVID-19 pandemic to train CHWs under the pervading no contact limitations in place, without analysis for whether such mode of delivery improved knowledge and skills. Studies have started to indicate that virtual training adequately improves knowledge of CHWs, and in this study we delivered an asynchronous continuing education training on chronic diseases that CHWs in the field could take on their own time. We found improved post-training knowledge on chronic diseases. Having access to online asynchronous learning means CHWs can continue to have further training that they can take at their own pace to improve their ability to serve their clients effectively, without having to travel out of their communities for such training.