Empowering the Community Health Worker Role in the Stroke Continuum of Care: Development of the Florida Stroke...

Community health workers (CHWs) help patients navigate community resources and support healthier lifestyles. Although stroke transitions of care require navigating complex clinical services and behavioral changes, there is no established formal training for CHWs in stroke care across Florida. We describe the impact of a comprehensive stroke training course designed and tailored for community health workers.

We developed a CHW stroke care curriculum with input from the Florida CHW Coalition, vascular neurologists, epidemiologists, and Florida Stroke Registry stakeholders. The course, featuring a 12-credit continuing medical education curriculum, was a hybrid of live and recorded lectures, modules, and community engagement exercises. Free registrations were promoted via the Florida CHW Coalition advertisements, Florida Stroke Registry Web site and listserv, and stakeholder meetings.

Three separate cohorts accomplished the course. Across 3 years (2022-2024), a total of 75 participants (54 of whom completed the course) were included in this analysis. The median age was 44 years (interquartile range 35-54), with 74% of participants aged 54 years or younger. The racial/ethnic distribution was 33% Hispanic, 30% White, and 26% Black. The majority were female (n = 50, 93%). The mean pretraining score was 72% (standard deviation 15.2%), which increased to 91% (standard deviation 6.2%) posttraining. Due to the nonnormal distribution of score differences, we used the Wilcoxon signed-rank test (S) which confirmed a statistically significant improvement in scores post training (S = 735.5, p < 0.001) indicating higher post-training scores and reduced variability, indicating both effectiveness and consistency of learning gains.

The formal training of CHWs to recognize stroke risk factors, promote self-management, and support stroke care equipped CHWs with the essential skills and knowledge to confidently foster meaningful partnerships with the community aimed at improving stroke outcomes.