User Journey Mapping in Community Health Work: A Case Study From Philly CEAL.

Community health workers (CHWs) serve as bridges between clinical care and community-based social support, yet they are often excluded from the design of the health interventions they implement. User Journey Mapping (UJM) is a tool that can enhance health behavior interventions and their implementation. As part of formative planning for the Philadelphia Community Engagement Alliance (Philly CEAL), we employed UJM methods to engage CHWs as co-designers in the implementation of an adapted chronic disease self-management intervention to promote heart health while addressing social needs. We conducted semi-structured interviews (n = 8) with seven CHWs and one supervisor from Philadelphia's Office of Community Empowerment and Opportunity. During the interviews, participants co-created visual workflow maps documenting daily tasks, emotional experiences, pain points, and opportunities. Individual maps were synthesized into comprehensive team maps and validated through follow-up sessions with the CHW team. Analysis revealed a four-part CHW process: community-based responsibilities, individual case management, in-office duties, and supervisory functions. Themes were identified related to the specialized skills and strengths associated with the CHW role, systemic challenges related to service workflows, and persistent emotional and psychological role-related stressors. UJM methods used in this formative work generated actionable insights for intervention refinement while positioning CHWs as expert co-designers rather than solely as the implementers of the intervention. The findings underscore the importance of integrating frontline expertise early in intervention planning to ensure programs are operationally efficient, emotionally attuned, and contextually grounded. We propose a set of methodological recommendations for embedding UJM within future public health planning, implementation, and evaluation efforts.