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The Outcome Evaluation of a CHW Cancer Prevention Intervention: Testing Individual and Multilevel Predictors Among Hispanics Living Along the Texas-Mexico Border

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Abstract

This paper evaluates the effectiveness of community health workers/promotores (CHWs) in promoting cancer preventive behaviors in the 2011–2013 Education to Promote Improved Cancer Outcomes (ÉPICO) project. The ÉPICO project utilized CHWs to disseminate cancer education to predominately Spanish-speaking Hispanics living in colonias in the Lower Rio Grande Valley of Texas. The CHWs received training to become Texas-certified CHW instructors and specialized training in message tailoring, and they delivered more than 5000 units of resident education on cancer prevention/detection, treatment, and survivorship for breast, cervical, and colorectal cancer. Using panel data to examine overtime changes in cancer knowledge among Lower Rio Grande Valley residents, the evaluation found significant changes from baseline to both times 1 and 2. Additional individual-level analysis indicated that the increase in resident cancer knowledge was predicted by residents’ perceptions of CHW credibility and intention to change their lifestyles. Multilevel analysis also showed that the increase in cancer prevention knowledge among residents was predicted by attributes of the CHWs who taught them. In particular, CHWs with higher education levels had the most impact on residents’ increased knowledge over time. Unexpectedly, CHWs with more years of experience were less effective teachers than their early-career counterparts.

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References

  1. Rosenthal EL, Wiggins N, Ingram M, Mayfield-Johnson S, De Zapien JG (2011) Community health workers then and now: an overview of national studies aimed at defining the field. J Ambul Care Manage 34(3):247–59, Available from: http://www.hubmed.org/display.cgi?uids=21673523

    Article  PubMed  Google Scholar 

  2. Balcazar HG, de Heer H, Rosenthal L, et al. A promotores de salud intervention to reduce cardiovascular disease risk in a high-risk Hispanic border population, 2005-2008. Prev Chronic Dis 2010; 7(2). Available from: http://www.hubmed.org/display.cgi?uids=20158973.

  3. Brownstein JN, Andrews T, Wall H, Mukhtar Q (2015) Addressing chronic disease through community health workers: a policy and systems-level approach. Centers for Disease Control Division for Heart Disease and Stroke Prevention, Atlanta, http://www.cdc.gov/dhdsp/docs/chw_brief.pdf

    Google Scholar 

  4. Brownstein JN, Hirsch GR, Rosenthal EL, Rush CH (2011) Community health workers “101” for primary care providers and other stakeholders in health care systems. J Ambul Care Manage 34(3):210–20

    Article  PubMed  Google Scholar 

  5. Swider SM (2002) Outcome effectiveness of community health workers: an integrative literature review. Public Health Nurs 19(1):11–20

    Article  PubMed  Google Scholar 

  6. Ingram M, Reinschmidt KM, Schachter KA et al (2012) Establishing a professional profile of community health workers: results from a national study of roles, activities and training. J Community Health 37(2):529–37

    Article  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention. Policy evidence assessment report: community health worker policy components. 2014.

  8. McLeroy KR, Bibeau D, Steckler A, Glanz K (1988) An ecological perspective on health promotion programs. Health Educ Q 15(4):351–77, Available from: http://www.hubmed.org/display.cgi?uids=3068205

    Article  CAS  PubMed  Google Scholar 

  9. Scarinci IC, Garcia FA, Kobetz E et al (2010) Cervical cancer prevention. Cancer 116(11):2531–42

    PubMed  PubMed Central  Google Scholar 

  10. Ward E, Jemal A, Cokkinides V et al (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 54(2):78–93

    Article  PubMed  Google Scholar 

  11. Diaz JA, Roberts MB, Goldman RE, Weitzen S, Eaton CB (2008) Effect of language on colorectal cancer screening among Latinos and non-Latinos. Cancer Epidemiol Biomarkers Prev 17(8):2169–73

    Article  PubMed  PubMed Central  Google Scholar 

  12. Watts L, Joseph N, Velazquez A et al (2009) Understanding barriers to cervical cancer screening among Hispanic women. Obstet Gynecol 201(2):1–8, Available from: http://www.hubmed.org/display.cgi?uids=19646571

    Google Scholar 

  13. Brewer NT, Tzeng JP, Lillie SE, Edwards AS, Peppercorn JM, Rimer BK (2009) Health literacy and cancer risk perception: Implications for genomic risk communication. Med Decis Mak 29(2):157–66, Available from: http://www.hubmed.org/display.cgi?uids=19050227

    Article  Google Scholar 

  14. Lalani N (2011) The impact of socioeconomic status on the breast cancer journey. J Cancer Educ 26(1):200–1

    Article  PubMed  Google Scholar 

  15. Puschel K, Thompson B, Coronado GD, Lopez LC, Kimball AM (2001) Factors related to cancer screening in Hispanics: a comparison of the perceptions of Hispanic community members, health care providers, and representatives of organizations that serve Hispanics. Health Educ Behav 28(5):573–90, Available from: http://www.hubmed.org/display.cgi?uids=11575687

    Article  CAS  PubMed  Google Scholar 

  16. Navarro AM, Senn KL, McNicholas LJ, Kaplan RM, Roppé B, Campo MC (1998) Por la vida model intervention enhances use of cancer screening tests among Latinas. Am J Prev Med 15(1):32–41

    Article  CAS  PubMed  Google Scholar 

  17. Ramos IN, May M, Ramos KS (2001) Environmental health training of promotoras in colonias along the Texas-Mexico border. Am J Public Health 91(4):568–70, Available from: http://www.hubmed.org/display.cgi?uids=11291367

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Kreuter MW, Sugg-Skinner C, Holt CL et al (2005) Cultural tailoring for mammography and fruit and vegetable intake among low-income African-American women in urban public health centers. Prev Med 41(1):53–62

    Article  PubMed  Google Scholar 

  19. Valente TW, Saba WP (2001) Campaign exposure and interpersonal communication as factors in contraceptive use in Bolivia. J Health Commun 6(4):303–22, Available from: http://www.hubmed.org/display.cgi?uids=11783665

    Article  CAS  PubMed  Google Scholar 

  20. Texas Department of State Health Services, Cancer Epidemiology and Surveillance Branch. Texas cancer registry 2015. Available from: http://www.dshs.state.tx.us/tcr/default.shtm.

  21. Daniel J (2002) O’Keefe. Persuasion, Theory and research. Sage

    Google Scholar 

  22. Wiehe SE, Garrison MM, Christakis DA, Ebel BE, Rivara FP (2005) A systematic review of school-based smoking prevention trials with long-term follow-up. J Adolesc Health 36(3):162–9

    Article  PubMed  Google Scholar 

  23. Merriam SB, Leahy B (2005) Learning transfer: a review of the research in adult education and training. PAACE J Lifelong Learn 14(1):1–24

    Google Scholar 

  24. Hurd TC, Muti P, Erwin DO, Womack S (2003) An evaluation of the integration of non-traditional learning tools into a community based breast and cervical cancer education program: the witness project of buffalo. BMC Cancer 3:18

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hurdle DE (2001) Social support: a critical factor in women’s health and health promotion. Health Soc Work 26(2):72–9

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Katharine Nimmons.

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Nimmons, K., Beaudoin, C.E. & St. John, J.A. The Outcome Evaluation of a CHW Cancer Prevention Intervention: Testing Individual and Multilevel Predictors Among Hispanics Living Along the Texas-Mexico Border. J Canc Educ 32, 183–189 (2017). https://doi.org/10.1007/s13187-015-0930-0

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  • DOI: https://doi.org/10.1007/s13187-015-0930-0

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