Community health worker encounter forms: a tool to guide and document patient visits and worker performance

UMMS Affiliation

Meyers Primary Care Institute; Department of Family Medicine and Community Health

Publication Date


Document Type



Community Health Centers; Community Health Workers; Humans; Massachusetts; Professional-Patient Relations; *Records as Topic; Self Care


Community Health and Preventive Medicine


OBJECTIVES: We explored the benefits of using community health worker (CHW) encounter forms to collect data on patient interactions and assessed the effectiveness of these forms in guiding and directing interactions.

METHODS: A 1-page standardized encounter form was developed to document topics discussed during visits with diabetes patients. A portion of the form was designed to be used as a script to guide the interaction and assist patients in setting appropriate self-management goals. Data were also collected via CHW work logs and interviews with CHWs and their supervisors to validate findings.

RESULTS: Data were collected for 1198 interactions with 540 patients at 6 community health centers. Self-management goals were set during 62% of encounters. With respect to the most recent self-management goal set, patients who had set a challenging goal were more likely to be in the action stage of change than in other stages. Work logs revealed that CHWs engaged in a number of activities not involving direct patient interactions and thus not captured on encounter forms.

CONCLUSIONS: Evaluating and monitoring CHWs' daily activities has been challenging. Encounter forms have great potential for documenting the work of CHWs with patients.

DOI of Published Version



Am J Public Health. 2012 Jul;102(7):e70-5. doi: 10.2105/AJPH.2011.300416. Link to article on publisher's site

Journal/Book/Conference Title

American journal of public health

Related Resources

Link to Article in PubMed

PubMed ID