Pathways to Cancer Prevention and Screening: Developing a Training to Educate the Community Health Worker Workforce

Diagnoses of cancer at later stages contribute to racial/ethnic disparities in cancer survival, with African Americans/Blacks and sometimes Hispanics experiencing poorer 5-year survival rates for breast, cervical, colorectal, lung, and prostate cancers. Interventions that promote early detection and cancer prevention are critically needed to reduce racial/ethnic disparities in cancer survival. The purpose of this study was to develop the Pathways to Cancer Prevention and Screening training program to educate community health workers (CHWs) on cancer prevention and screening guidelines; and cancer screening referrals for breast, cervical, colorectal, lung, and prostate cancers. We examined pre- and post-training changes among CHWs in (a) cancer prevention and knowledge overall and by sub-category: cancer knowledge, screening, and preventive lifestyles; (b) cancer fear and fatalism; and (c) comfort discussing screening guidelines. In an urban area using a quasi-experimental design, we recruited 47 CHWs, with 44 who completed pre- and post-assessments. Statistically significant changes that suggest improvement in mean cancer knowledge prevention scores overall and by sub-categories: cancer knowledge, cancer screening, and preventive lifestyles. Improvements in cancer fear and fatalism were marginally significant, and comfort in discussing cancer screening guidelines significantly improved from pre- to post-assessment. Pathways to Cancer Prevention and Screening is a feasible way to improve knowledge of cancers, and screening guidelines for breast, cervical, prostate, lung, and colorectal cancers. Investing in CHW workforce development can improve the quality of one-on-one education to clients with increased risk for five of the most prevalent forms of cancer.