Stroke-Focused Competency Assessment Tools for Community Health Workers in the United States: A Scoping Review
Creators: name: Mallaiah, Janhavi
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Social and Behavioral Sciences
subject: Community Health Workers
subject: Competency Assessments
subject: Stroke Prevention

description: The purpose of the review was to: i) provide a summary of competency assessment methods used in cardiovascular disease (CVD) and stroke-focused CHW training programs in the United States; and ii) identify existing validated assessment tools for knowledge and skills in stroke and cardiovascular risk factors used in CHW training programs. Specifically, this review aimed to synthesize the types of assessment tools used to measure CHW competencies in the seven MRFs for stroke, to explore if such assessment tools were validated, to describe the psychometric properties of the instrumentation, and results on performance outcomes. To our knowledge, this is the first review to synthesize stroke-focused assessment methods to measure CHW competencies. Based on our findings, we propose that there is an urgent need for development of a comprehensive and valid assessment instrument in stroke prevention to assess CHW performance to optimize their credibility and as a first-step to their integration into healthcare systems. Research Question(s): • What competency assessment tools are available for CVD and stroke-focused training programs for community health workers in the United States? • What is known from the existing literature about training programs for community health workers in stroke prevention? Objectives: • What competency assessment tools (knowledge, skills &amp; self-efficacy) are available? • How are CHWs assessed for competencies post-training? • What evaluation methods are available? PCC Framework: • Population: Community Health Workers • Concept: Cardiovascular disease and Stroke • Context: Training Program Databases: 1- PUBMED 2- CINAHL 3- Cochrane 4- Web of Science 5- EMBASE 6- PsychInfo Inclusion Criteria • Papers published in English • Papers with primary participants as community health workers (CHWs) [Community health workers provide health education, referral and follow up, case management, and basic preventive health care and home visiting services to specific communities. They provide support and assistance to individuals and families in navigating the health and social services system] (ISCO, 2008) • CHWs from the United States • Papers focused on CHW training in stroke prevention: the simple 7 (diabetes, hypertension, high blood cholesterol, cigarette smoking, obesity, physical activity, nutrition); and stroke preparedness (calling 911) (AHA, 2021) • Papers focused on CHW training methods and/or evaluation • Papers with one of the simple 7 plus another topic (e.g. mental health) • Papers explicitly stating that the objectives or aims of the study were to evaluate competencies of CHWs who were trained in stroke or CVD prevention • Papers from all available years until January 2021. Exclusion Criteria • Published in other language than English • Papers not related to US • The primary focus of paper was on training healthcare professionals other than CHWs (for example, doctors, nurses, medical students, allied healthcare professionals such as personal support workers, home care workers, home health aides, long-term care workers) • Papers not mainly focused on stroke risk factors, and prevention (other than simple 7- i.e. depression, infectious diseases etc.) (Sanchez 2018) • The paper was not an original, full-text, research study. For example, commentaries, letters, opinion pieces, study protocols, training needs assessments and conference proceedings with only an abstract available. • Papers with studies led by CHWs, but doesn’t mention how CHWs were trained Search Terms The search was conducted using various keywords and subject headings to systematically capture all articles relevant in the review. All database searches included articles that resulted from the following search terms: (smoking OR physical activity OR exercise OR diabetes OR hypertension OR high blood pressure OR nutrition OR diet OR cholesterol OR obesity) AND (community health worker OR community health advisors OR lay health advocates OR promotoras OR outreach educators OR community health representatives OR peer health educators) AND (program*) OR (training*) AND (assessment OR competency OR test OR knowledge).