Community health worker certification as a pathway to workforce development and career advancement: a qualitative study.

Abstract

Background: Community Health Workers (CHWs) play a vital role in bridging between healthcare systems and underserved communities. Although CHW certification has expanded across the United States, limited research has examined whether certification supports long-term career advancement and workforce development for CHWs themselves. This study examined how certified CHWs perceive the role of certification in shaping career trajectories and long-term workforce retention, with implications for CHW program design and public health workforce policy. A qualitative study using semi-structured interviews was conducted with 30 certified CHWs recruited from a database maintained by the Central Maryland Area Health Education Center (AHEC). Interviews were conducted virtually via Zoom and analyzed using Braun and Clarke's six-step reflexive thematic analysis framework. Five themes were identified: (1) CHW certification as a pathway to workforce development and career advancement; (2) CHW work as a calling rooted in service and advocacy; (3) CHWs as bridges between healthcare systems and communities; (4) barriers to certification and workforce integration; and (5) long-term commitment to public health and community impact. CHW certification serves a function beyond credentialing; it is a workforce development tool that supports career mobility, professional identity, and long-term engagement in public health. Addressing persistent barriers, including low wages, limited opportunities for advancement, and scope-of-practice confusion, is essential to sustaining a robust CHW workforce.