Social Work and Community Health Worker Partnership in Healthcare Settings: A Systematized Literature Review

Overview: This presentation reveals findings and implications from a systematized literature review capturing the nature of the partnership between social workers and community health workers in the United States. Roles and scopes of practice, settings of the collaborative practice, and targeted outcomes and efficacy of their interprofessional collaboration interventions are reviewed.Proposal text:

Background: The human right to health must be enjoyed without discrimination on the grounds of race/ethnicity or socioeconomic status. A large body of research has indicated that social determinants of health (SDH), such as education, income, and neighborhood, account for the majority of patient health outcomes (Braveman et al., 2009; Brown et al., 2016). Addressing health inequity in the U.S. has been at the forefront of public health social work.
Hospitals and health plans have begun piloting numerous interventions to address SDH with social workers (SWs) and community health workers (CHWs). SWs are trained in system navigation and behavioral health interventions, while CHWs are uniquely trained in culturally appropriate health education and advocacy. However, few studies have outlined the specific roles that SWs and CHWs play in collaborative interventions and best practices for partnership. Further, there is a dearth of literature regarding SW and CHW’s collaborative effectiveness. Therefore, the objective of this review was to identify (a) the nature of the partnership between CHWs and SWs; (b) the healthcare settings where the partnership exists; (c) impacts on patient outcomes.

Methods: The systematized search of the literature was conducted in December 2020 using the following six databases: CIANHL, Health Source, PsychINFO, SocINDEX, Web of Science, PubMed. The inclusion criteria were 1) US-based; 2) published between 2000-2020; 3) peer-review journal articles; 4) SW & CHW partnership; 5) examining health or mental health outcomes. The exclusion criteria were 1) interventions that did not include SW or CHW; 2) duplicate reporting of the same project; 3) mental health training and credentials not defined/included.

Results: Search results identified 281 articles, and 15 were included in the final analysis. SW/CHW partnerships included direct practice collaboration (n=8); providing supervision (n=5); or social workers as a referral source (n=2). Settings that utilized SW/CHW partnerships included outpatient clinics (n=10); community organizations (n=4) or hospital (n=1). CHW and SW interventions were focused on disease prevention (n= 8), chronic care (n= 4) and mental health (n=3). Health outcomes were the most common (n= 13) and included disease-specific outcomes such as vaccination rates, blood glucose level or BMI, disease-specific self-efficacy and utilization rates such as hospital readmissions. All studies reported at least one significant improvement of a health outcome due to the intervention. Mental health outcomes were less common (n= 6) and included depressive symptoms or the number of referrals to social or mental health services. Only two studies reported a significant improvement in mental health outcomes. SDH outcomes were the least common (n=3) and included social support, socioeconomic stress, the number of people screened for SDH. All three of these studies reported descriptive data and did not assess the intervention’s efficacy of addressing SDH.

Conclusions: Partnership that includes both SWs and CHWs may increase access to preventive care, mental health, and behavioral health services and address current health inequities. More research is needed to delineate the roles and scopes of practice for SW and CHW, as well as evaluate the efficacy of SW and CHW partnership to achieve health equity.