Original ArticlesComparative Case Analysis of the Role of Community Health Workers in Rural and Low-Income Populations of West Virginia and the United StatesSchleiff, Meike J. DrPH, MSPH; Peters, David H. DrPH, MD; Surkan, Pamela J. ScDAuthor Information Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Correspondence: Meike J. Schleiff, DrPH, MSPH, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Rm E8638, Baltimore, MD 21205 ([email protected]). This article is the product of M.S.'s doctoral dissertation research, which received support for fieldwork from the West Virginia School of Osteopathic Medicine's Center for Rural and Community Health. All authors confirm that there are no conflicts of interest. Journal of Ambulatory Care Management: July/September 2020 - Volume 43 - Issue 3 - p 205-220 doi: 10.1097/JAC.0000000000000335 Buy Metrics Abstract The rural United States, including West Virginia, has decades of experience engaging communities and utilizing community health workers (CHWs). This study aims to inform policy and planning by comparing how 2 county-level CHW programs engage with communities. The analysis is based on in-depth interviews with 19 community representatives and 20 health workers and archival documents and published literature reviews. Results highlight the local contextual determinants for community engagement with CHW programs. Making CHW policies inclusive and adaptable to local realities will enable more community benefits. Making the value of CHW programs for communities explicit should guide resource allocation and policies. © 2020 Wolters Kluwer Health, Inc. All rights reserved.