Evaluating a 30-Hour Training Program for Community Health Workers on 4Ms Implementation in FQHCs Using the Kirkpatrick Model

TL;DR

A 30-hour training program for community health workers improved their knowledge and likelihood of using geriatric care strategies, with some clinics adapting new documentation practices.

Contribution

The study evaluates a training program for community health workers using the Kirkpatrick model, showing organizational adaptation in geriatric care implementation.

Findings

Participants showed improved knowledge and content retention after the training.

83% of participants intended to apply the training in their practice.

Organizational changes included adding an intake form in the EHR for 4Ms documentation.

Abstract

Objective: To evaluate a 30 h educational program delivered to community health care workers (CHWs) involved in geriatric care within a primary care clinic, measure increase in knowledge, likelihood of using the education, and baseline results of geriatric screenings for patients 65 and older conducted by CHWs in their clinics. Methods: Design, Setting and Participants: This is an evaluation with a two-center, pre–post design study of a 30 h in-person educational program. The program used the Kirkpatrick model to evaluate the educational program. The study used quantitative and qualitative data collection with surveys measuring knowledge, feedback, content, and demographics of the participants and chart reviews to measure clinical implementation of 4Ms discussion. Qualitative data collection included a focus group and open-ended questions in the survey. Thematic analysis from focus groups explored the feedback from the educational program. Results: Twelve community health care workers (average age 40, 90% female) from two federally qualified health centers (FQHC) participated in the 30 h training program. Perceived knowledge improved after the completion of the training. Final exam scores after the training were also significant, indicating an improvement in content retention. Overall, 98% of participants described the training as “Excellent” and 96% rated excellent for the speakers who provided the training. Additionally, 83% suggested they would apply the training in their practice. Approximately 40% of chart reviews indicated the completion of the 4Ms (What Matters, Mentation, Medication, and Mobility) discussion with patients. Thematic analysis yielded two new practice dimensions: care provision and clinical documentation. The training resulted in organizational adaptation with the development of an intake form in the Electronic Health Record (EHR) to document the 4Ms. Conclusion: Results indicate improvement in all dimensions of the training with an emphasis on level 4, indicating wider organization adaptation of 4Ms discussion.

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