A Scoping Review of the Community Health Worker Model Used for Food Systems Interventions Within the United States

Abstract

Objective To document and analyze the food systems interventions delivered by community health workers (CHW) serving as educators within the United States (U.S.) Data Source Ten databases (ie, Agricola, CAB Abstracts, CINAHL, ERIC, Proquest Social Science and Education, Proquest Theses and Dissertations, PubMed, Scopus, SocIndex, Web of Science) and gray-literature repositories were searched for publications between 2005-2020. Study Inclusion and Exclusion Criteria English-language and U.S. studies included with CHW as educators or facilitators for food systems interventions. Food systems defined as processes of production, processing, distribution, marketing, access, preparation, consumption, and disposal of food products. Studies excluded for clinical settings; non-adult CHWs; CHWs with medical or public health credentials; and programming guides, reviews, and commentaries. Data Extraction Variables included CHW and intervention description, priority population, food system processes, and targeted and unexpected outcomes. Data Synthesis Data were analyzed by the lead investigator and described narratively. Results Of 43 records, CHWs educated for consumption (n = 38), preparation (n = 33), and food access (n = 22) to improve health of priority populations. Community health workers educated for the highest number of food system processes in garden-based interventions. Programs reached many underserved racial and socioeconomic populations. Conclusions The CHW model has been used to educate in interventions for all food systems processes and reached many diverse underserved audiences. Future work must explore garden-based food systems education and CHWs as community change agents.