Skip to main content

Advertisement

SpringerLink
Log in

Assessing the Feasibility of an Online Training Designed to Enable Community Health Workers to Deliver a Comprehensive, Evidence-Based Weight Loss Intervention for Rural African Americans of Faith

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Obesity is a critical modifiable risk factor in cancer prevention, control, and survivorship. Comprehensive weight loss interventions (e.g., Diabetes Prevention Program (DPP)) have been recommended by governmental agencies to treat obesity. However, their high implementation costs limit their reach, especially in underserved African American (AA) communities. Community health workers (CHWs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. CHW-led interventions have increased weight loss. However, in-person CHW training can be costly to deliver and often requires extensive travel to implement. Web-based trainings have become common to increase reach at reduced cost. However, the feasibility of an online CHW training to deliver the DPP in AAs is unknown. The feasibility of an online CHW training to deliver the DPP adapted for AAs was assessed. The online training was compared to an in-person DPP training with established effectiveness. CHW effectiveness and satisfaction were assessed at baseline and 6 weeks. Nineteen participants (in-person n = 10; online n = 9) were recruited. At post-training, all scored higher than the 80% on a knowledge test required to deliver the intervention. All participants reported high levels of training satisfaction (88.9% of online participants and 90% of in-person participants rated the training as at least 6 on a 1–7 scale) and comfort to complete intervention tasks (78% of online participants and 60% of in-person participants scored at least 6 on a 1–7 scale). There were no significant differences in outcomes by arm. An online CHW training to deliver the DPP adapted for AAs faith communities produced comparable effectiveness and satisfaction to an evidence-based in-person CHW training. Further research is needed to assess the cost-effectiveness of different CHW training modalities to reduce obesity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kyrgiou M, Kalliala I, Markozannes G et al (2017) Adiposity and cancer at major anatomical sites: umbrella review of the literature. Bmj. 356:j477

    Article  Google Scholar 

  2. Iyengar NM, Hudis CA, Dannenberg AJ (2015) Obesity and cancer: local and systemic mechanisms. Annu Rev Med 66:297–309

    Article  CAS  Google Scholar 

  3. Goodwin PJ, Stambolic V (2015) Impact of the obesity epidemic on cancer. Annu Rev Med 66:281–296

    Article  CAS  Google Scholar 

  4. Zylke JW, Bauchner H (2016) The unrelenting challenge of obesity. Jama. 315(21):2277–2278

    Article  CAS  Google Scholar 

  5. Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB (2015) Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Curr Obes Rep 4(3):363–370

    Article  Google Scholar 

  6. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL (2016) Trends in obesity among adults in the United States, 2005 to 2014. Jama. 315(21):2284–2291

    Article  CAS  Google Scholar 

  7. Hales CM, Fryar CD, Carroll MD, Freedman DS, Aoki Y, Ogden CL (2018) Differences in obesity prevalence by demographic characteristics and urbanization level among adults in the United States, 2013-2016. Jama. 319(23):2419–2429

    Article  Google Scholar 

  8. Lundeen EA, Park S, Pan L, O’Toole T, Matthews K, Blanck HM (2018) Obesity prevalence among adults living in metropolitan and nonmetropolitan counties — United States, 2016. MMWR Morb Mortal Wkly Rep 67:653–658

    Article  Google Scholar 

  9. Service USDoAER. Rural poverty and well-being: geography of poverty. 2013-2014

  10. Harris RP, Worthen D (2003) African Americans in rural America. Challenges for rural America in the twenty-first century. 32–42

  11. Panel TOSaACoCAHATFoPGBoasrftTOE (2014) Executive summary: Guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. Obesity (Silver Spring) 22(Suppl 2):S5–S39

  12. Leblanc ES, O'Connor E, Whitlock EP, Patnode CD, Kapka T (2011) Effectiveness of primary care-relevant treatments for obesity in adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 155(7):434–447

    Article  Google Scholar 

  13. Yeary KH, Moore P, Gauss CH, Cornell C, Prewitt TE, Turner J (2020) The WORD: Outcome results of a randomized weight loss maintenance trial in rural African Americans of faith. Obesity 28(3):510–520

  14. Samuel-Hodge CD, Johnson CM, Braxton DF, Lackey M (2014) Effectiveness of Diabetes Prevention Program translations among African Americans. Obes Rev 15(Suppl 4):107–124

    Article  Google Scholar 

  15. Wing RR (2010) Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med 170(17):1566–1575

    CAS  PubMed  Google Scholar 

  16. Wing RR, Crane MM, Thomas JG, Kumar R, Weinberg B (2010) Improving weight loss outcomes of community interventions by incorporating behavioral strategies. Am J Public Health 100(12):2513–2519

    Article  Google Scholar 

  17. Cometto G, Ford N, Pfaffman-Zambruni J, Akl EA, Lehmann U, McPake B, Ballard M, Kok M, Najafizada M, Olaniran A, Ajuebor O, Perry HB, Scott K, Albers B, Shlonsky A, Taylor D (2018) Health policy and system support to optimise community health worker programmes: an abridged WHO guideline. Lancet Glob Health 6(12):e1397–e1404

    Article  Google Scholar 

  18. Kim K, Choi JS, Choi E, Nieman CL, Joo JH, Lin FR, Gitlin LN, Han HR (2016) Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: a systematic review. Am J Public Health 106(4):e3–e28

    Article  Google Scholar 

  19. Ayala GX, Vaz L, Earp JA, Elder JP, Cherrington A (2010) Outcome effectiveness of the lay health advisor model among Latinos in the United States: an examination by role. Health Educ Res 25(5):815–840

    Article  Google Scholar 

  20. (WHO) WHO (2018) WHO guideline on health policy and system support to optimize community health worker programmes. World Health Organization, Geneva

    Google Scholar 

  21. Winters N, Langer L, Geniets A (2018) Scoping review assessing the evidence used to support the adoption of mobile health (mHealth) technologies for the education and training of community health workers (CHWs) in low-income and middle-income countries. BMJ Open 8(7):e019827

    Article  Google Scholar 

  22. Yeary KHK, Cornell CE, Turner J et al (2011) Feasibility test of an evidence-based weight loss intervention translated for a faith-based, rural, African American population. Prev Chronic Dis 8(6):1–12

    Google Scholar 

  23. O'Brien MJ, Squires AP, Bixby RA, Larson SC (2009) Role development of community health workers: an examination of selection and training processes in the intervention literature. Am J Prev Med 37(6 Suppl 1):S262–S269

    Article  Google Scholar 

  24. Muramoto ML, Hall JR, Nichter M, Nichter M, Aickin M, Connolly T, Matthews E, Campbell JZ, Lando HA (2014) Activating lay health influencers to promote tobacco cessation. Am J Health Behav 38(3):392–403

    Article  Google Scholar 

  25. Abdel-All M, Putica B, Praveen D, Abimbola S, Joshi R (2017) Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review. BMJ Open 7(11):e015529

    Article  Google Scholar 

  26. Yeary KH, Cornell CE, Prewitt E, Bursac Z, Tilford JM, Turner J, Eddings K, Love S, Whittington E, Harris K (2015) The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach. Contemp Clin Trials 40:63–73

    Article  Google Scholar 

  27. McCloskey AH, Woolwich J, Holahan D Reforming the Health Care System: State Profiles 1995, vol 1995. American Association of Retired Persons, Washington, DC, pp 20–104

  28. Pamuk E, Maduc D, Heck H, Reuben C, Lochner K (1998) Socioeconomic status and health chartbook. Health, United States. National Center for Health Statistics, Hyattsville, MD

    Google Scholar 

  29. Winters S, Magalhaes L, Kinsella EA (2015) Interprofessional collaboration in mental health crisis response systems: a scoping review. Disabil Rehabil 37(23):2212–2224

    Article  Google Scholar 

  30. Babenko-Mould Y, Andrusyszyn MA, Goldenberg D (2004) Effects of computer-based clinical conferencing on nursing students' self-efficacy. J Nurs Educ 43(4):149–155

    Article  Google Scholar 

  31. P. L. Create Awesome Videos & Presentations. 2012–2018

  32. Van Nuland SE, Eagleson R, Rogers KA (2017) Educational software usability: artifact or design? Anat Sci Educ 10(2):190–199

    Article  Google Scholar 

  33. Khorrami-Arani O (2001) Researching computer self-efficacy. Int Educ J 2(4):17–25

    Google Scholar 

  34. Chu A, Huber J, Mastel-Smith B, Cesario S (2009) “Partnering with seniors for better health”: computer use and Internet health information retrieval among older adults in a low socioeconomic community. J Med Libr Assoc 97(1):12–20

    Article  Google Scholar 

  35. Hill J, Peer N, Oldenburg B, Kengne AP (2017) Roles, responsibilities and characteristics of lay community health workers involved in diabetes prevention programmes: a systematic review. PLoS One 12(12):e0189069

    Article  Google Scholar 

  36. Cueva K, Revels L, Cueva M, Lanier AP, Dignan M, Viswanath K, Fung TT, Geller AC (2018) Culturally-relevant online cancer education modules empower Alaska's community health aides/practitioners to disseminate cancer information and reduce cancer risk. J Cancer Educ 33(5):1102–1109

    Article  Google Scholar 

  37. Gayed A, LaMontagne AD, Milner A et al (2018) A new online mental health training program for workplace managers: pre-post pilot study assessing feasibility, usability, and possible effectiveness. JMIR Ment Health 5(3):e10517

    Article  Google Scholar 

  38. https://www.cdc.gov/diabetes/prevention/lifestyleprogram/2017. PCRfCr

  39. CfDCa P. Registry of recognized organizations. In. https://nccd.cdc.gov/DDT_DPRP/Registry.aspx2017

  40. Health ADo. Personal communication. In: https://www.healthy.arkansas.gov/; 2019

  41. Tate DF, Wing RR, Winett RA (2001) Using Internet technology to deliver a behavioral weight loss program. Jama. 285(9):1172–1177

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors also thank Jerome Turner, M.Div. and the Faith Task Force for their invaluable work and feedback.

Funding

The study was funded by the University of Arkansas for Medical Sciences and University of Tennessee Health Science Center CORNET Awards in Cancer.

Author information

Authors and Affiliations

  1. Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carton Streets, Buffalo, NY, 14263, USA

    Karen Hye-cheon Kim Yeary

  2. Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA

    Songthip Ounpraseuth

  3. Department of Surgery, Washington University School of Medicine in St. Louis, 660 Euclid Avenue, St. Louis, MO, 63110, USA

    Fei Wan

  4. Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Suite 636, Atlanta, GA, 30322, USA

    Ilana Graetz

  5. Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA

    Pebbles Fagan, Anna Huff-Davis, Kemmian Johnson & Ellen Hutchins

  6. The Gehr Center for Health Systems Science & Innovation, Keck School of Medicine of USC, 2020 Zonal Ave., Los Angeles, CA, 90033, USA

    Cameron Kaplan

Authors
  1. Karen Hye-cheon Kim Yeary
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Songthip Ounpraseuth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fei Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ilana Graetz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pebbles Fagan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anna Huff-Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cameron Kaplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kemmian Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ellen Hutchins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen Hye-cheon Kim Yeary.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yeary, K.Hc.K., Ounpraseuth, S., Wan, F. et al. Assessing the Feasibility of an Online Training Designed to Enable Community Health Workers to Deliver a Comprehensive, Evidence-Based Weight Loss Intervention for Rural African Americans of Faith. J Canc Educ 36, 1277–1284 (2021). https://doi.org/10.1007/s13187-020-01764-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-020-01764-8

Keywords

Search

Navigation