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o History in the U.S.o 1950s: saw the first volunteer and paid CHW programso Started in Native Nations in the west and in migrant farm workercamps in the southwesto Indian Health Service (1960s) community health representatives(CHRs)o 1960s and 1970s growth of community health centers(CHCs) with outreach staff.o 1970s referred to as “lay health advisors” (no longer called “lay”workers for the most part nationally today)o 1980s the Federal “Healthy Start” Program and RuralHealth Outreach Grants (HRSA) employed CHWso 1980s motivated by the AIDS epidemic…investments incommunity health outreach programs (founded 1987 the AIDSCoalition to Unleash Power (ACTUP)