Another limitation of our study was that the CHNs completed the surveys and tests anonymously, preventing pairing of pre- and posttest scores or the ability to adjust for lecture attendance. This was, however, done to encourage full participation and to remove concerns about job performance, which we feel aided in more candid survey responses. Furthermore, our dataset of surveys and tests was small, as it was designed as a pilot program evaluation, limiting our ability to calculate further correlation or data beyond central tendency. We do not know from our small pilot study whether the knowledge gain by the CHNs translated into better work performance and for what duration of time the knowledge gain persisted. This will be another important area of future exploration.