Community health workers (CHWs) are a growing workforce with demonstrated effectiveness in improving health care access and outcomes for diverse populations. While CHW certification programs exist, due to their broad coverage of many topics, addressing social determinants of health (SDoH) is often overlooked. Using a mixed-methods community-based participatory research design, we co-designed and implemented a 20-hour training curriculum focused on SDoH and resource navigation.

Four community engagement studios (n=60 CHWs) were conducted across the Bay Area to obtain feedback on the content, relevance, and logistics of curriculum implementation. After iterative revisions, we implemented the curriculum with Cohort 1 (N=15, 100% Latino, 87% women, 100% in Santa Clara County). Pre-and post-surveys assessed effectiveness and acceptability. Quantitative data were analyzed using paired-sample t-tests. Qualitative data (open-ended responses) were analyzed using thematic analysis.

Significant increases in SDoH knowledge were noted, with overall knowledge increasing by 48% (P<.001). Participants increased their ability to explain the impact of SDoH on families and communities by 42% (P<.001) and confidence in their role addressing SDoH by 25% (P=0.001). Familiarity with SDoH screening tools increased 45% (P<.001) and use of referral models (e.g., closed-loop and no-wrong-door) increased 40% (P=0.006). Despite increased knowledge of available resources, CHWs expressed real-world challenges addressing clients’ needs, including cumbersome referral processes delaying access. Additional positive outcomes include network building and expansion (100% endorsement).

Findings highlight the need for culturally and linguistically relevant trainings that deepen and complement existing certifications for the CHW workforce. Our mixed-methods evaluation revealed CHWs are highly receptive to curricula designed with their input and focused on topics directly impacting their communities.