A community health worker’s close ties to a community are part of what makes them successful, but it can also be a source of stress. CHWs consistently request training in how to set boundaries with clients. Establishing professional boundaries can be an important component of preventing burnout and protecting the well-being of CHWs and clients alike. Many CHWs have previously worked in volunteer positions where blurred boundaries such as meal sharing, paying for transportation, and sharing personal stories were commonplace.

Our research indicates continued conversations among management, CHWs, and other stakeholders about the importance of boundaries can prevent boundary setting from becoming a draining experience for the CHW (e.g., from not being able to provide further assistance within the program context). Having more experienced CHWs share their stories can be a powerful motivator while providing positive examples. Other solutions that help CHWs successfully set boundaries include implementing clear organizational policies, such as prohibiting client transportation in personal vehicles, or prohibiting CHWs from serving as official interpreters.

Particularly for broad-based programs with many components, it can be difficult to keep processes and workflows consistent across time. One way to address this issue is to check in with CHWs once or twice a year about the workflow and process. An important part of the continued education and training should be focused on process improvement. For example, if most CHWs express difficulty with certain questions or checklists, it is likely that the questions and checklists need to be refined. Creating an atmosphere where CHWs feel supported — rather than admonished — is crucial for retention and program quality.