Evaluating the Training of Chinese-Speaking Community Health Workers to Implement a Small-Group Intervention Promoting Mammography

  • Jiayan Gu
  • Annette E. Maxwell
  • Grace X. Ma
  • Xiaokun Qian
  • Yin Tan
  • Hsing-Chuan Hsieh
  • Shin-Ping Tu
  • Judy Huei-yu Wang


This study evaluated the training of Chinese American Community Health Workers (CHWs) to implement a small-group mammography video and discussion program as part of a randomized controlled trial that had the goal to increase adherence to mammography screening guidelines among Chinese American women. A total of 26 Chinese American CHWs in the metropolitan Washington DC area, Southern California, and New York City participated in a 4-h training workshop and completed surveys before and after the workshop to assess their knowledge regarding mammography screening guidelines and human subjects protection rules. The results showed significantly increased knowledge of mammography screening guidelines and human subjects protection rules (both p < 0.01) after the training. CHWs were also trained to lead a discussion of the video, including screening benefits and misconceptions. Forty-three audio recordings of discussions led by 13 active CHWs were transcribed and qualitatively analyzed to assess implementation fidelity. Ten out of 13 active CHWs fully addressed about 3 of the 5 benefit items, and 11 out of 13 CHWs fully addressed more than 5 of the 9 misconception items. Chinese CHWs can be trained to implement research-based intervention programs. However, a one-time training resulted in moderate adherence to the discussion protocol. Ongoing or repeat trainings throughout the intervention period may be needed to enhance implementation fidelity.


Community health workers Small-group intervention Chinese Americans Breast cancer screening Implementation fidelity 



We sincerely thank all leaders and staff from participating community organizations.

Funding Information

Research reported in this study was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA142941.

Compliance with Ethical Standards


The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


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Copyright information

© American Association for Cancer Education 2018

Authors and Affiliations

  1. 1.Department of Oncology, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer CenterGeorgetown University Medical CenterWashington D.C.USA
  2. 2.Fielding School of Public Health and Jonsson Comprehensive Cancer CenterUniversity of California Los AngelesLos AngelesUSA
  3. 3.Lewis Katz School of MedicineTemple UniversityPhiladelphiaUSA
  4. 4.Center for Asian Health, Lewis Katz School of MedicineTemple UniversityPhiladelphiaUSA
  5. 5.Division of General Internal Medicine, Geriatrics, and BioethicsUniversity of California DavisSacramentoUSA

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