Am J Public Health. 2026 Sep;116(S4):S285-S294. doi: 10.2105/AJPH.2026.308734.
ABSTRACT
Objectives. To examine characteristics of CHWs engaged in a nationwide program in the United States and the extent to which they were culturally congruent with program participants. Methods. In 2024, CHWs participating in a nationwide federal program completed a cross-sectional census survey (n = 689). Results. High CHW-centered congruence and varying levels of community-centered congruence were observed across racial/ethnic and other communities of identity. Among CHWs who self-identified with specific communities, proportions also serving those communities ranged from 86.4% to 100%; among communities defined in other ways, congruence ranged from 76.5% to 96.7%. Congruence was higher in community-based settings than in clinical or public health settings. Conclusions. As one of few studies examining CHW congruence in a large-scale national program, our findings demonstrate that substantial cultural congruence was achieved across diverse communities. Public Health Implications. Findings demonstrate that (1) CHWs are embedded within communities most affected by structural inequities, optimally positioned to address health disparities and (2) even in federally funded, multisite CHW programs, cultural congruence can be achieved at scale. (Am J Public Health. 2026;116(S4):S285-S294. https://doi.org/10.2105/AJPH.2026.308734).
PMID:42647797 | DOI:10.2105/AJPH.2026.308734
