Strengthening Community Health Worker and <i>Promotora</i> Workforce Capacity

Importance: Community health workers and promotores (CHW/Ps) are a crucial workforce supporting health promotion, resource navigation, and dissemination of evidence-based health information across diverse communities. Objective: To describe the process and best practices for codesigning and coimplementing innovative, scalable, and culturally relevant capacity-building trainings for CHW/Ps. Design, Setting, and Participants: This mixed-methods study employed a quantitative and qualitative approach and an implementation process involving a collaborative approach that integrated feedback from CHW/Ps, community partners, and advisory board members to select relevant workshop topics. Trainings were attended by CHW/Ps from 243 zip codes across California between September 2023 and March 2024. Exposure: CHW/P participation in culturally and linguistically relevant training workshops delivered monthly over videoconference. Workshops fostered engagement through interactive formats, multilingual resources, and accessible online platforms. Main Outcomes and Measures: Using data from a California-wide partnership, mixed methods (preworkshop and postworkshop sureys analyzed with paired sample t tests, qualitative data analyzed with thematic analysis, ripple effects mapping sessions, and listening sessions with attendees) were used to assess the feasibility, acceptability, and effectiveness of the CHW/P trainings. Results: A total of 505 CHW/Ps (469 female [93%]; mean [SD] age, 47.1 [10.5] years; 430 Hispanic or Latino [85%] 413 Spanish-speaking [82%]) participated. Preworkshop and postworkshop surveys (244 attendees) indicated significant improvements in self-reported knowledge, skills, and confidence (t test values ranging from -8.01 to -3.99). Additionally, qualitative data highlighted the workshops' cultural relevance and the desire for more resources and extended engagement opportunities. Conclusions and Relevance: The findings of this study indicate that this CHW/Ps workforce training model and infrastructure can support the dissemination of trusted public health information during public health emergencies and beyond. Using this model, teams can adapt the content to their specific needs, and the resulting network of trained CHW/Ps can be mobilized to rapidly disseminate evidence-based information across medically underserved and other communities of interest.