This project aims to develop and evaluate the role of Community Health Workers (CHWs) in primary health care in Australia.  It includes a range of projects and activities including a systematic review of the literature on CHWs’ role in enhancing preventive care in the community and an evaluation of the Xtend program which involves CHWs in following patients up post discharge to prevent readmission.  It is intended to extend this with work with trials to evaluate their effectiveness in the prevention of hospitalisation especially for people with multiple long-term conditions and/or who live alone and of their role in general practice in preventive care for vulnerable population groups.

Chief Investigators

Mark Harris

Project Coordinators

Ben Harris-Roxas, Elizabeth Harris, Catherine Spooner


Julie Finch (SLHD), Fran Baum (Flinders University), Sabuj Kanti Mistry

Project Rationale

The American Public Health Association defines a CHW as a “frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery”(40). There is increasing evidence of the effectiveness of CHWs in assisting patients to navigate their care and the complexities of referral and follow-up. CHW follow-up improved access to primary care while controlling recurrent readmissions in a high-risk population and they have been demonstrated to improve medication adherence post-discharge. CHWs have an important role in reducing health inequities by improving access to care for vulnerable and disadvantaged population groups especially indigenous and CALD populations. A 2018 systematic review found that, while navigators were first established to assist with access to cancer screening or care by marginalised populations, they are now expanding into diabetes prevention and self-management, smoking cessation, disease education, and addressing social and financial barriers to care. 

Project Aim/s

To develop and evaluate the role of Community Health Workers (CHWs) in primary health care in Australia especially in improving access to preventive and pro-active care and appropriate use of hospital care.  

Project Design and Method

Activities includes:

  1. Systematic review of the literature on the role of CHW in improving preventive care in primary health care - see attached Protocol for the Systematic Review
  2. Evaluation of the Xtend program in Sydney Local health District.  This involves CHWs in following patients up post discharge to prevent readmission.
  3. Workshops and seminars with visiting academics on the role of CHW in health care: Community Health Workers workshop, Lay Navigators workshop, Healthcare Access Seminar and Healthcare Access Forum
  4. Mapping existing community health worker and peer worker roles in Sydney and South Eastern Sydney Local Health Districts
  5. Pilot project involving placement of community health navigators in general practice 

We are planning trials to evaluate:

  • The effectiveness of CHW interventions to prevent hospitalisation for patients with multiple long-term conditions or who live alone.
  • The role of CHW in primary health care to enhance navigation of vulnerable patients to preventive care.


Key Partners

Sydney LHD (Initially)

Project lead centre
Project stream
Health System Integration and Primary Health Care Development