Abstract B090: Exploring the roles of CHWs in improving uptake of family health history assessment among patients and providers: Implications for cancer risk reduction and prevention among minority populations
Authors: Allen Caitlin G. , McKinney Lawrence , Bethea Brittaney , Escoffery Cam , McCray Gail , McBride Colleen , Akintobi Tabia 
Published: August 2020

The collection of family health history (FHH) is integral to the implementation of population screening that could identify those at high cancer risk who could benefit most from life-saving interventions. Although most individuals believe FHH is important to their health, few actually collect or know their FHH. Recent findings have identified a reduced likelihood of FHH collection among minority populations who may already be at an increased risk for familial cancers such as kidney, cervical, prostate, ovarian, and triple-negative breast cancer. The community health worker (CHW) workforce is especially well positioned to address these challenges in FHH collection, as they are trusted members of their community and well recognized for their work in creating community-clinical linkages. Engaging CHWs in promoting FHH collection could help improve cancer risk assessment utilization among minority populations. We conducted 30 semistructured interviews with CHWs in Georgia to understand their current roles and opportunities to expand their roles to include the gathering and sharing FHH information. Interview questions were guided by the Consolidated Framework for Implementation Research and also included current engagement in FHH collection, beliefs and understanding of FHH collection, and perceived training needs to complete an FHH record using an FHH collection tool. All interviews were double coded in MAXQDA using a codebook developed, adapted, and agreed upon by the research team. Findings demonstrate that most CHWs believe that there is value in collecting FHH and that they are well suited to gather basic FHH information, but the majority had no experience collecting FHH, either formally as part of their jobs or from their own family members. Some concerns raised about this role include the potential for community members to be resistant to providing the information, CHWs' lack of medical knowledge required to address questions from clients about genetics, and the potential complexity of information needed to complete FHH tools. CHWs also provided recommendations for reducing the burden of FHH collection such as tutorials about how to gather accurate and complete information. They also suggested providing resources to clients that focus on the importance of knowing FHH and how it can be used to improve health and become knowledgeable about cancer risk-reduction resources and prevention strategies. Understanding opportunities for CHWs to extend their role in this way could help improve health care delivery and access by enhancing patient-provider communication about FHH in order to tailor recommendations, prevention, and treatment of diseases. Results from this study may inform efforts to strengthen the utility of existing FHH collection tools and accompanying materials to promote the uptake of FHH assessment among patients and providers.

Citation Format: Caitlin G. Allen, Lawrence McKinney, Brittaney Bethea, Cam Escoffery, Gail McCray, Colleen McBride, Tabia Akintobi. Exploring the roles of CHWs in improving uptake of family health history assessment among patients and providers: Implications for cancer risk reduction and prevention among minority populations [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B090.