Documenting Unpublished Employer Data

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A group of men around a conference table looking at charts.A number of benefits may derive from persuading employers and payers to release previously unpublished data on employment of CHWs.

  • Employers lack incentive to publish
    • Data may be proprietary
    • Studies may not meet highest research standards
  • Real-world data reflect diverse CHW activity
  • Some employers and payers will share data with their peers
  • Data can be compelling to policymakers and other stakeholders
  • Little strategic planning or coordination behind the research being done

[SPEAKER]

A number of benefits may derive from persuading employers and payers such as managed care organizations to release previously unpublished data on employment of CHWs. Unlike academic researchers, employers and payers may have little incentive to publish their data. It takes a lot of work, and the CHW occupation is not universally recognized. The corporate culture of many organizations does not reward scholarly publishing to the extent it does in the academic world.

Many decision makers, including public officials, tend to rely on common standards for evidence: To be valid, findings must come from a scientifically designed study, preferably a randomized controlled trial, and must be presented in a peer-reviewed journal. Many evaluation studies and internal employer reports do not meet these standards, often because they are the result of regular internal operations and are not subject to experimental comparisons. Data also may reveal proprietary aspects of company operations. On the positive side, the data collected from ongoing services and established organizations often reflect the reality of the wide range of activities performed by CHWs.

However, some employers and payers may be willing to share data with their peers in a collegial atmosphere, and this exchange can help to build momentum in reaching common conclusions about the effectiveness of CHWs. If employers and payers themselves present results to policymakers and other stakeholders, the effect can be very different from that of testimony by academic researchers or even CHWs. A key to getting attention for systems change is for stakeholders such as employers to communicate that employing CHWs advances their organizational self-interest.

In closing, please note that research on CHWs has varied greatly in terms of quality and topics. No global strategy is in place for the systematic assembly of evidence about this workforce. Researchers and funders of research have tended to pursue specific topics in which they have an interest, and no unifying strategy or research agenda guides the selection of future studies.

To address this situation, an invitational conference was held in Dallas in 2007. The goal was to draft an initial research agenda for the CHW field. The conference produced a prioritized list of research questions that needed to be addressed and recommended some common principles for future research studies involving CHW interventions. Participants expressed interest in creating a standard set of research metrics and an online clearinghouse for published and unpublished research documents. A summary of the proceedings of that conference can be downloaded from the address shown on the Resources page.