How is academic medicine engaging with community health workers in the United States?: a systematic review

OBJECTIVE: CHWs are a key workforce to address health disparities and offer expertise in community engagement, health promotion, and system navigation. Academic Medical Institutions (AMIs) play a critical role in supporting CHW workforce development and training, yet a systematic review of how AMIs engage with CHWs has not been conducted. METHODS: Literature was systematically searched in November 2022 and February 2024 from the following databases: PubMed, Web of Science, CINAHL, SocINDEX, and PsychInfo. Forward and backward citation searches in February 2025 identified an additional 64 articles. We reviewed 347 full-text articles, and 136 were included in the final sample. RESULTS: CHW/AMI engagement was delineated by three, non-mutually exclusive categories: 1) intervention implementation/evaluation (n = 104); 2) workforce development (n = 32), and 3) community-based participatory research (CBPR) (n = 23). Intervention implementation and evaluation studies measured the effectiveness of CHWs in a variety of healthcare settings. Among intervention studies that assessed efficacy, 52 (79%) found that CHWs significantly improved at least one health outcome. In workforce development, AMIs developed specialized training for CHWs or incorporated CHWs into training for medical students and residents. In CBPR studies, CHWs contributed to recruitment, community engagement, needs assessment, data collection, and community expertise. However, CHWs were rarely included in the interpretation or dissemination of findings, or as authors. CONCLUSIONS: CHWs contribute to AMI’s tripartite mission and preventive medicine efforts including addressing health disparities, improving patient outcomes and educating future doctors. Developing sustainable CHW career paths with equitable payment structures is essential to move from engagement to partnership.