Nursing ETDs


Mark Siemon

Publication Date



A number of states have adopted certification programs for community health workers (CHWs) to increase oversight, allow for direct funding, and improve recognition of CHWs as members of the health care team. More states are considering CHW certification programs to increase the use of CHWs by health care organizations with the hopes of improving health outcomes and decreasing health disparities. There has been little research into the impact of state CHW certification on the adoption and dissemination of CHWs into the existing health care system. This study examined the impact of state CHW certification on the perceptions of team climate among registered nurses (RNs) who work with CHWs in states with and without CHW certification programs. Team climate is defined as the perceptions of team members on how they work together, share a single vision, are open to new ideas, and if they feel safe and supported by other team members. This study recruited RNs using an online purposeful sampling method to compare the perceptions of team climate using the Team Climate Inventory (TCI) short-form. The study found no significant differences in the overall mean TCI score or TCI subscale scores between RNs who work in states with CHW certification programs (n = 81) and those who work in states without CHW certification programs (n = 115). There was a significant difference in one survey question on the RNs views of whether state certification of CHW improved the ability of their health care team to deliver quality care. Further analysis of the results using multiple regression found few significant predictors of overall TCI and TCI subscale scores among the independent variables used in the regression models. Registered nurses are the largest part of the professional health care workforce, and their ability to collaborate and work with CHWs is critical to the integration of CHWs into existing health care organizations. More research on the impact of state certification of CHW and the factors that influence the adoption of innovative health care delivery methods is needed to meet the national goal of eliminating health disparities and improving health in minority and underserved populations.

Degree Name


Level of Degree


Department Name

College of Nursing

First Committee Member (Chair)

Lobo, Marie

Second Committee Member

Parker, Tassy

Third Committee Member

Cohen, Sally


Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at the University of New Mexico.


Community Health Workers, Team Climate, Registered Nurses



Document Type