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Community health workers (CHWs) are trusted frontline public health workers who often function as liaisons or intermediaries between health and social services and the community. Their activities can include outreach, community education, informal counseling, social support, advocacy and — increasingly — research.

More CHWs are serving as active members of research teams at UB. At the forefront of this partnership is UB’s Clinical and Translational Science Institute (CTSI), which has long prioritized the knowledge and skill sets of CHWs.

Renee Cadzow, assistant professor, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, and CTSI recruitment and special population co-director, has been involved with local CHWs since 2012. She has supported the Community Health Worker Network of Buffalo as a training facilitator and an evaluator, and has served as a board member and co-chair. Cadzow says having “the presence of somebody who really links and bridges to community” on a research team can have a measurable impact on whether a study is successful.

“Any research that addresses social determinants of health can benefit from having one or more community health workers on the team,” she says. “You maximize the chance of your research question being relevant, your research methods being appropriate and well received, and your ability to then — if you are doing human subjects research — recruit and retain participants.”

CHWs have existed in the United States for more than 70 years. Cadzow explains that CHWs have been working in nonprofit as well as health care sectors to address social determinants of health through outreach and home visitation. During COVID-19, this became particularly important and highlighted their role in community health and well-being.

As the roles of CHWs evolved, so did their involvement with and impact on research. Evidence showed they were having a clear impact on health outcomes.

“Until recently, many people have been unaware of CHWs and their impact,” Cadzow says. “So, there was a new understanding within health care of their role in addressing social determinants of health, and that also goes hand in hand with health care's increased focus on these issues.”

Collaborating with community health workers is key to the CTSI’s goal of advancing research discoveries to improve health for all. In her role, Cadzow has been at the forefront of connecting the university community — investigators, research staff, administrators — with CHWs.

“We have implemented trainings and programs that help different populations understand the role of addressing social needs, while also encouraging partnership with community health workers toward research so that investigators understand the needs of community,” she says. “This community-based perspective should be driving the research questions that we ask and the ways that we seek answers to those questions in partnership.”

Jessica Bauer Walker is executive director of CoNECT (Community Network for Engagement, Connection and Transformation), a network of frontline workers, community organizers and advocates in the areas of health care, public health, housing, education, environment, food access and social services. She serves the same role with the Community Health Worker Network of Buffalo and is a CHW herself. Bauer Walker is a member of the CTSI board, comprised of leading academic, health care and research institutions, and key community partners in the Buffalo region.

Bauer Walker says early involvement in a project makes a difference. “CHWs are often asked to deliver an intervention or gather information from directly impacted communities without having been involved in the project design,” she says. “This opportunity of CHW/researcher teams working in full partnership leverages the best aspects of academic rigor, as well as community and cultural responsiveness, to make research and evaluation more robust and impactful.” 

Cadzow hopes to see continued growth in intentionally driven community-partnered research. Those efforts, she says, take time and effort, but the results are tremendous. One way to get started is to connect with the CHW Allies and Â鶹´«Ã½ Group, which meets every other month and discusses ways to connect researchers with community members.

“Finding somebody to mentor or provide guidance can make a researcher feel more comfortable reaching out,” says Cadzow. “Another researcher may be able to provide that bridge to organizations or individuals they have worked with in the past.” Email Cadzow for more information on the group.

Bauer Walker believes it’s also important for researchers to go into the community and engage with people on a personal basis.

“Spend time building trust and relationships in community. Do a lot of listening,” she advises. “Value CHW and community knowledge, skills and experience, and make sure that you are bringing value as a researcher and not perpetuating extractive and harmful dynamics that have led to mistrust of academia and researchers.”

Once one or more CHWs are engaged on a team, Cadzow stresses that researchers must understand and value that they might be the only voice in the room that speaks up for the community. Trained in advocacy and understanding dynamics of power and privilege, they are not afraid to use their voice, even if they are the only non-PhD or non-MD in the room.

Katie C. Stalker, associate professor and director of field education, School of Social Work, was part of the national evaluation team for the CDC’s Community Health Workers for COVID Response and Resilient Communities (CCR) initiative. It involved CHWs to support the response to COVID and engage with the community. “Community health workers were able to steer the direction of the national evaluation,” she says.

Based on her experience, Stalker calls CHWs “invaluable” and highly recommends that community-engaged researchers involve CHWs as members of their research teams.

“CHWs’ lived experience and training make them experts in engaging communities, understanding community opportunities and challenges, and developing solutions,” she explains.

Cadzow points out that CHWs may have some formal education, or they may not. “As researchers, we need to value that kind of knowledge and recognize it as valuable. It is time to broaden our perspectives,” she says.

Teresa Quattrin, UB Distinguished Professor, Department of Pediatrics, and associate dean for research integration, Jacobs School, and CTSI Recruitment and Special Populations Core co-director, says the ability of community health workers to represent the interest of their constituencies cannot be underestimated. “They make us researchers much more aware of what matters to community members. This is an essential step to ensure that any research is conducted in partnership with and directed by the will of the community. It also paves the way to co-creation of projects that answer questions relevant to the community.”

Laurene Tumiel-Berhalter, director of community translational research in the Department of Family Medicine, Jacobs School, and CTSI Community Engagement Core director, says the CTSI is developing training for researchers to enhance their ability to engage successfully with CHWs to conduct research that is more relevant to community priorities. “Collaborating with community health workers on a research team is founded on the principles of community engagement and will function differently than the traditional research coordinator model,” she adds.

To learn more about working with community health workers, Cadzow recommends getting in touch with Buffalo Translational Consortium member institution . She suggests exploring national organizations such as the , the  and the . In addition, researchers are encouraged to make a service request to the CTSI’s  and/or  cores.

“Our research will have a greater impact if we can engage our communities,” says Timothy F. Murphy, SUNY Distinguished Professor and CTSI director. “CHWs are trained to participate in and guide the research, including what questions we should be investigating and asking.

“Advancing the role of these individuals helps us ensure that we have meaningful, bidirectional community partnerships.”