Community health worker recruitment from within the target neighborhood: A framework for success

Community Health Workers (CHWs) enhance quality of life, improve adherence to clinical directives, and promote health. How do we recruit the most appropriate trainees to serve a particular community? Our community driven initiative, located within three disenfranchised urban housing “projects” and comprised of 3,000 citizens, required that all newly recruited CHW trainees reside exclusively in that community. A Community Advisory Board, working in collaboration with a local medical and nursing school, shaped the process. The collaboration allowed the community's needs to be identified from within, and CHWs to be recruited directly by neighborhood leaders. Recruited CHWs were subsequently trained by local and regional healthcare providers. The CHWs are presently employed and we are now evaluating their impact on improving health and reducing the burden of disease over the long-term. Connecting this small, community-based, locally controlled unit with a larger medical and health system nearby, assured availability of expertise when needed. It is now providing a partnership framework for conducting participatory research, supervision and upward mobility for the newly trained cadre of CHWs. We summarize this CHW recruitment model's practical considerations, strategies, and key elements for successful replication elsewhere. We present a relevant framework and successful strategies for involvement of the local community illustrating the following elements of this recruitment process: 1) Health problem list development by the community to be served, 2) Development of a CHW job description, and 3) Community development of a list of character traits required of new CHW recruits.