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C3 Council Findings: Roles & Competencies

The C3 recommendations include a total of ten roles and eleven skills, as listed below.  You can download a complete checklist, including sub-roles and sub-skills, on the resources page.​ We note that roles and skills are not intended to match each other; multiple skills may support several roles.​ The National C3 Council team did not re-evaluate CHW qualities. Instead, the affirmed and endorsed existing knowledge about CHW qualities, with “connection to the community served” being the most critical quality. A word cloud of endorsed qualities is found at the bottom of this page.

CHW Core Roles

  • Cultural Mediation Among Individuals, Communities, and Health & Social Service Systems
     

  • Care Coordination, Case Management, and System Navigation
     

  • Advocating for Individuals and Communities
     

  • Providing Direct Services
     

  • Conducting Outreach

  • Providing Culturally Appropriate Health Education and Information
     

  • Providing Coaching and Social Support
     

  • Building Individual and Community Capacity
     

  • Implementing Individual and Community Assessments
     

  • Participating in Evaluation and Research

CHW Core Skills

  • Communication Skills

​

  • Interpersonal & Relationship-Building Skills
     

  • Service Coordination & Navigation Skills
     

  • Capacity Building Skills
     

  • Advocacy Skills
     

  • Building Individual and Community Capacity

  • Individual & Community Assessment 
     

  • Outreach Skills
     

  • Professional Skills and Conduct
     

  • Evaluation and Research Skills
     

  • ​Knowledge Base

Roles

Core Roles and Sub-Roles

1

Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems

Sub-Roles:

1. Educating individuals and communities about how to use health and social service systems (including understanding how systems operate) 2. Building health literacy and cross-cultural communication 3. Educating systems about community perspectives and cultural norms (including supporting implementation of Culturally and Linguistically Appropriate Services [CLAS] standards.

2

Providing Culturally Appropriate Health Education and Information

Sub-Roles:

1. Conducting health promotion and disease prevention education in a manner that matches linguistic and cultural needs of participants or community 2. Providing necessary information to understand and prevent diseases and to help people manage health conditions (including chronic disease)

3

Care Coordination, Case Management, and System Navigation

Sub-Roles:

1. Participating in care coordination and/or case management 2. Making referrals and providing follow-up 3. Facilitating transportation to services and helping address barriers to services 4. Documenting and tracking individual and population level data 5. Informing people and systems about community assets and challenges

4

Providing Coaching and Social Support

Sub-Roles:

1. Providing individual support and coaching 2. Motivating and encouraging people to obtain care and other services 3. Supporting self-management of disease prevention and management of health conditions (including chronic disease) 4. Planning and/or leading support groups

5

Advocating for Individuals and Communities

Sub-Roles:

1. Advocating for the needs and perspectives of communities 2. Connecting to resources and advocating for basic needs (e.g. food and housing) 3. Conducting policy advocacy

6

Building Individual and Community Capacity

Sub-Roles:

1. Building individual capacity 2. Building community capacity 3. Training and building individual capacity with peers and among CHW groups

7

Providing Direct Services

Sub-Roles:

1. Providing basic screening tests (e.g. height, weight, blood pressure 2. Providing basic services (e.g. first aid, diabetic foot checks) 3. Meeting basic needs (e.g., direct provision of food and other resources)

8

Implementing Individual and Community Assessments

Sub-Roles:

1. Participating in design, implementation, and interpretation of individual-level assessments (e.g. home environmental assessment) 2. Participating in design, implementation, and interpretation of community-level assessments (e.g. windshield survey of community assets and challenges, community asset mapping)

9

Conducting
Outreach

Sub-Roles:

1. Case-finding/recruitment of individuals, families, and community groups to services and systems 2. Follow-up on health and social service encounters with individuals, families, and community groups 3. Home visiting to provide education, assessment, and social support 4. Presenting at local agencies and community events

10

Participating in Evaluation and Research

Sub-Roles:

1. Providing basic screening tests (e.g. height, weight, blood pressure 2. Providing basic services (e.g. first aid, diabetic foot checks) 3. Meeting basic needs (e.g., direct provision of food and other resources)

Skills

Core Skills and Sub-Skills

1

Communication Skills

Sub-Skills:

1. Ability to use language confidently  2. Ability to use language in ways that engage and motivate  3. Ability to communicate using plain and clear language  4. Ability to communicate with empathy  5. Ability to listen actively  6. Ability to prepare written communication, including electronic communication  7. Ability to document work  8. Ability to communicate with the community served

2

Interpersonal & Relationship-Building Skills

Sub-Skills:

1. Ability to provide coaching and social support  2. Ability to conduct self-management coaching  3. Ability to use interviewing techniques (e.g. motivational interviewing)  4. Ability to work as a team member  5. Ability to manage conflict  6. Ability to practice cultural humility

3

Service Coordination & Navigation Skills

Sub-Skills:

1. Ability to coordinate care (including identifying and accessing resources and overcoming barriers)  2. Ability to make appropriate referrals  3. Ability to facilitate development of an individual and/or group action plan and goal attainment  4. Ability to coordinate CHW activities with clinical and other community services  5. Ability to follow-up and track care and referral outcomes

4

Capacity Building Skills

Sub-Skills:

1. Ability to help others identify goals and develop to their fullest potential  2. Ability to work in ways that increase individual and community empowerment  3. Ability to network, build community connections, and build coalitions  4. Ability to teach self-advocacy skills  5. Ability to conduct community organizing

5

Advocacy Skills

Sub-Skills:

1. Ability to contribute to policy development  2. Ability to advocate for policy change  3. Ability to speak up for individuals and communities

6

Building Individual and Community Capacity

Sub-Skills:

1. Ability to use empowering and learner-centered teaching strategies  2. Ability to use a range of appropriate and effective educational techniques  3. Ability to facilitate group discussions and decision-making  4. Ability to plan and conduct classes and presentations for a variety of groups  5. Ability to seek out appropriate information and respond to questions about pertinent topics  6. Ability to find and share requested information  7. Ability to collaborate with other educators  8. Ability to collect and use information from and with community members

7

Individual & Community Assessment 

Sub-Skills:

1. Ability to participate in individual assessment through observation and active inquiry  2. Ability to participate in community assessment through observation and active inquiry

8

Outreach Skills

Sub-Skills:

1. Ability to conduct case-finding, recruitment, and follow-up  2. Ability to prepare and disseminate materials  3. Ability to build and maintain a resource inventory

9

Professional Skills and Conduct

Sub-Skills:

1. Ability to set goals and follow a work plan  2. Ability to balance priorities and manage time  3. Ability to apply critical thinking techniques and problem solving  4. Ability to use pertinent technology  5. Ability to pursue continuing education and lifelong learning opportunities  6. Ability to maximize personal safety while working in community and/or clinical settings  7. Ability to observe ethical and legal standards (e.g. CHW Code of Ethics, Americans with Disabilities Act [ADA], Health Insurance Portability and Accountability Act [HIPAA])  8. Ability to identify situations calling for mandatory reporting and carry out mandatory reporting requirements  9. Ability to participate in professional development of peer CHWs and in networking among CHW groups 10. Ability to set boundaries and practice self-care

10

Evaluation and Research Skills

Sub-Skills:

1. Providing basic screening tests (e.g. height, weight, blood pressure 2. Providing basic services (e.g. first aid, diabetic foot checks) 3. Meeting basic needs (e.g., direct provision of food and other resources)

11

Knowledge Base

Sub-Skills:

1. Knowledge about social determinants of health and related disparities  2. Knowledge about pertinent health issues  3. Knowledge about healthy lifestyles and self-care  4. Knowledge about mental/behavioral health issues and their connection to physical health  5. Knowledge about health behavior theories  6. Knowledge of basic public health principles  7. Knowledge about the community served  8. Knowledge about United States health and social service systems

CHW Core Qualities

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If citing the roles and competencies alone or the C3 Council overall and its website, please use the following citation:


Rosenthal EL, Menking P, St. John J, Fox D, Holderby-Fox LR, Redondo F, Hirsch G, Lee L, Brownstein JN, Allen C, Haywood C, Ortiz Miller J, Ibarra J, Cole M, Huxley L, Palmer C, Masoud S, Uriarte J, Rush CH.  The National Council on CHW Core Consensus (C3) Standards Reports and Website. Texas Tech University Health Sciences Center El Paso. 2014-2024. https://www.C3Council.org/ 

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