Abstract A30: The role of community health workers in disseminating colorectal cancer guidelines in Asian Americans
Authors: Kim Karen , Quinn Michael , Chandrasekar Edwin , Lam Helen 
Published: March 2017

Background Community health workers (CHWs) are lay people from within the communities where they work, who share common characteristics with their members, such as ethnicity, culture, and language. They are frontline health workers who often serve socially and linguistically isolated populations. As trusted members of their communities, they provide critical links between community and systems of care. CHWs can empower community members with enhanced health knowledge, help navigating health systems, and access to care. This study examined the central role of CHWs in disseminating colorectal cancer screening guidelines in seven Asian immigrant communities (Cambodian, Chinese, Filipino, Korean, Lao, South Asian, and Vietnamese) in Chicago.

Method The parent project was designed to use a community-centered dissemination model to promote the adoption of colorectal cancer (CRC) screening guidelines in seven Asian communities. In this study, we used social marketing campaign and CHWs as part of the intervention to disseminate CRC screening guidelines. Although social marketing campaigns can create public awareness, they rarely shape attitudes and bring behavior change. To take community members from awareness to commitment and then action, we used CHWs as influencers. All ten CHWs recruited in this study were bicultural and bilingual health professionals. In addition, all CHWs had at least a bachelor's degree, had worked in the community for more than a year and well understood the social norms of the community. All CHWs were required to attend a 6-hour training course on CRC screening, motivational interviewing techniques, and the application of Stage of Change Theory. A CHW guidebook, which listed rationales and components of the intervention, was given to the CHWs. The roles and responsibilities of the CHW (outreaching, educating, navigating and collecting data) were also clearly stated in the guidebook. All CHEs were committed 20 hours/week for the project during the 12-week intervention period. Both quantitative and qualitative data were collected during and after the CHW intervention through weekly activity logs, site visits notes, and focus groups with implementation CHWs at the end of the project.

Results Our ten CHWs placed 320 posters (in English or native language) to promote CRC screening in different venues, such as restaurants, churches, temples, and grocery stores, that were frequented by local community members. They also sent out 4,665 CRC postcards to clients on their mail lists. Besides one-on-one counselling session, CHW also conducted 32 CRC information sessions (&gt; 5 people). Across the seven communities, over 2,400 community residents were reached through one-on-one education or small group information sessions over the 12-week intervention period. Most of the CHWs used familiar places to do their outreach, such as in-house programs (e.g. senior services or immigrant programs) or other places that they have implemented programs before. They also used other opportunities, such when they were shopping at the community store or in a bible study, as well as family and friend gatherings, to disseminate CRC screening guidelines. Although not all people they encountered wanted to be screened, they felt that they at least got them thinking about CRC and had impact on them. For personal experience, most CHWs stated that the project increased their knowledge of CRC and they also felt valued.

Discussion Participation of CHWs in this demonstration project was invaluable. Each CHW brought critical knowledge of their community, its language, values, norms, and health beliefs. CHWs are uniquely positioned to deliver culturally ad linguistically tailored intervention and can serve as a source of peer support and social influence.

Citation Format: Karen Kim, Michael Quinn, Edwin Chandrasekar, Helen Lam. The role of community health workers in disseminating colorectal cancer guidelines in Asian Americans. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A30.