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Best Practices for Integrating Community Health Workers Into Care Teams and Organizations: Lessons From the Front
Ada M Wilkinson-Lee1, Dana R Hunter1, Caroline R Evans1
1Ada M. Wilkinson-Lee is with the Department of Mexican American Studies, The University of Arizona, Tucson. Dana R. Hunter and Mary-Ellen Brown are with the Steve Hicks School of Social Work at The University of Texas at Austin. Kate C. Stalker is with the University at Buffalo, School of Social Work, Buffalo, NY. Caroline R. Evans is with the University of North Carolina at Chapel Hill. Mettea Pezza is with the University of Nevada‒Las Vegas. Heidi Pottinger was with Arizona State University, School of Social Work, Global Center for Applied Health Research, Phoenix. Pennie Jewell is with the Community Health Worker Center for Research and Evaluation, Boston, MA. Chidinma A. Ibe is with Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract:
This qualitative case study examined community health worker (CHW) integration within the CHW for COVID Response and Resilient Communities (CCR) program across 7 CCR recipient sites in the United States. The study questions addressed how CHWs are integrated into health organizations and care teams and facilitators and barriers to the integration of CHWs. From July to August 2023, we conducted 25 interviews with CHWs (n = 11) and program staff or partners (n = 14). Guided by the Consolidated Framework for Implementation Research (CFIR), we analyzed data thematically to identify the impact of facilitators and barriers on CHW integration. Nine themes emerged: organizational structure, relational connections-leadership understanding and valuing the CHW role, CHW qualities and qualifications, strategies for promoting CHW sustainability, challenges and solutions among partner collaborations, creating supportive integration environments, communication across partner organizations, CHW participation in decision-making, and outcomes of integration based on the CFIR model. The findings illustrate a continuum of implementation approaches used to integrate CHWs into organizations and care teams, highlighting how intentional integration practices can strengthen an organization's public health response capacity. (Am J Public Health. 2026;116(S4):S365-S373. https://doi.org/10.2105/AJPH.2026.308685).
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