Abstract
Community health advisor-led interventions are associated with improved health promotion behaviors, such as cancer screening, but the process of training community health advisors is rarely described and evaluated. We trained 91 Filipino Americans from 19 organizations to conduct small-group sessions with members of their organizations to promote colorectal cancer screening. Community health advisors completed brief pre- and post-training surveys that included knowledge of colorectal cancer screening guidelines (four items), perceived self-efficacy of performing specific tasks (15-item scale, Cronbach’s alpha > 0.90) and satisfaction with the training itself (five items). Community health advisors had high levels of knowledge and self-efficacy at pre-training, but levels increased significantly immediately after the 6-h training (percent of knowledge items answered correctly: 63–94 %; self-efficacy: 8.2–8.9 on a 10 point scale, both p < 0.001). Correlates of self-efficacy at pre- and post-test were high educational attainment, health care background, high level of participation in the organization, being perceived by others as a leader, and frequent participation in research activities in the past. Consistent evaluation measuring similar constructs across studies may help to standardize the quality of the training, and may improve the implementation of community health advisor-led programs.
Similar content being viewed by others
References
Woodruff, S. I., Candelaria, J. I., & Elder, J. P. (2010). Recruitment, training outcomes, retention, and performance of community health advisors in two tobacco control interventions for Latinos. Journal of Community Health, 35(2), 124–134.
Wells, K. J., Luque, J. S., Miladinovic, B., Vargas, N., Asvat, Y., Roetzheim, R. G., et al. (2011). Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiology, Biomarkers & Prevention, 20(8), 1580–1598.
Earp, J. A., Eng, E., O’Malley, M. S., Altpeter, M., Rauscher, G., Mayne, L., et al. (2002). Increasing use of mammography among older, rural African American women: results from a community trial. American Journal of Public Health, 92(4), 646–654.
Johnson, R. E., Green, B. L., Anderson-Lewis, C., & Wynn, T. A. (2005). Community health advisors as research partners: an evaluation of the training and activities. Family & Community Health, 28(1), 41–50.
Navarro, A. M., Senn, K. L., McNicholas, L. J., Kaplan, R. M., Roppe, B., & Campo, M. C. (1998). Por La Vida model intervention enhances use of cancer screening tests among Latinas. American Journal of Preventive Medicine, 15(1), 32–41.
Yu, M. Y., Song, L., Seetoo, A., Cai, C., Smith, G., & Oakley, D. (2007). Culturally competent training program: a key to training lay health advisors for promoting breast cancer screening. Health Education & Behavior, 34(6), 928–941.
Han, H. R., Lee, H., Kim, M. T., & Kim, K. B. (2008). Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women. Health Education Research. 2008 May 7.
Curbow, B., Bowie, J., Garza, M. A., McDonnell, K., Scott, L. B., Coyne, C. A., et al. (2004). Community-based cancer screening programs in older populations: Making progress but can we do better? Preventive Medicine, 38(6), 676–693.
Rabin, B. A., Nehl, E., Elliott, T., Deshpande, A. D., Brownson, R. C., & Glanz, K. (2010). Individual and setting level predictors of the implementation of a skin cancer prevention program: A multilevel analysis. Implementation Science, 5, 40.
Shelton, R. C., Thompson, H. S., Jandorf, L., Varela, A., Oliveri, B., Villagra, C., et al. (2011). Training experiences of lay and professional patient navigators for colorectal cancer screening. Journal of Cancer Education, 26(2), 277–284.
O’Brien, M. J., Squires, A. P., Bixby, R. A., & Larson, S. C. (2009). Role development of community health workers: An examination of selection and training processes in the intervention literature. American Journal of Preventive Medicine, 37(6 Suppl 1), S262–S269.
Han, H. R., Kim, K. B., & Kim, M. T. (2007). Evaluation of the training of Korean community health workers for chronic disease management. Health Education Research, 22(4), 513–521.
Rodriguez, V. M., Conway, T. L., Woodruff, S. I., & Edwards, C. C. (2003). Pilot test of an assessment instrument for Latina community health advisors conducting an ETS intervention. Journal of Immigrant Health, 5(3), 129–137.
Maxwell, A. E., Bastani, R., Danao, L. L., Antonio, C., Garcia, G. M., & Crespi, C. M. (2010). Results of a community-based randomized trial to increase colorectal cancer screening among Filipino Americans. American Journal of Public Health, 100(11), 2228–2234.
Maxwell, A. E., Crespi, C. M., Danao, L. L., Antonio, C., Garcia, G. M., & Bastani, R. (2011). Alternative approaches to assessing intervention effectiveness in randomized trials: Application in a colorectal cancer screening study. Cancer Causes and Control, 22(9), 1233–1241.
Terpstra, J., Coleman, K. J., Simon, G., & Nebeker, C. (2011). The role of community health workers (CHWs) in health promotion research: Ethical challenges and practical solutions. Health Promotion Practice, 12(1), 86–93.
Jackson, E. J., & Parks, C. P. (1997). Recruitment and training issues from selected lay health advisor programs among African Americans: A 20-year perspective. Health Education Behaviour, 24(4), 418–431.
Balcazar, H., Rosenthal, E. L., Brownstein, J. N., Rush, C. H., Matos, S., & Hernandez, L. (2011). Community health workers can be a public health force for change in the United States: Three actions for a new paradigm. American Journal of Public Health, 101(12), 2199–2203.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.
Maxwell, A. E., & Crespi, C. M. (2009). Trends in colorectal cancer screening utilization among ethnic groups in California: Are we closing the gap? Cancer Epidemiology, Biomarkers & Prevention, 18(3), 752–759.
Maxwell, A. E., Bastani, R., Crespi, C. M., Danao, L. L., & Cayetano, R. T. (2011). Behavioral mediators of colorectal cancer screening in a randomized controlled intervention trial. Preventive Medicine, 52(2), 167–173.
Maxwell, A. E., Crespi, C. M., Antonio, C. M., & Lu, P. (2010). Explaining disparities in colorectal cancer screening among five Asian ethnic groups: A population-based study in California. BMC Cancer, 10, 214.
Sung, J. F., Blumenthal, D. S., Coates, R. J., Williams, J. E., Alema-Mensah, E., & Liff, J. M. (1997). Effect of a cancer screening intervention conducted by lay health workers among inner-city women. American Journal of Preventive Medicine, 13(1), 51–57.
Zhu, K., Hunter, S., Bernard, L. J., Payne-Wilks, K., Roland, C. L., Elam, L. C., et al. (2002). An intervention study on screening for breast cancer among single African-American women aged 65 and older. Preventive Medicine, 34(5), 536–545.
Fernandez, M. E., Gonzales, A., Tortolero-Luna, G., Partida, S., & Bartholomew, L. K. (2005). Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: Cultivando La Salud. Health Promotion Practice, 6(4), 394–404.
Navarro, A. M., Raman, R., McNicholas, L. J., & Loza, O. (2007). Diffusion of cancer education information through a Latino community health advisor program. Preventive Medicine, 45(2–3), 135–138.
Hatcher, J., & Schoenberg, N. E. (2007). Human subjects protection training for community workers: An example from “Faith Moves Mountains”. Progress in Community Health Partnerships, 1(3), 257–265.
Acknowledgments
This work was supported by Grant RSGT-04-210-05-CPPB from the American Cancer Society. CMC was also supported by NIH/NCI grant P30 CA16042. We would like to thank the members of the Filipino American community who participated in this study.
Conflict of interest
The authors declare that there are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Maxwell, A.E., Danao, L.L., Cayetano, R.T. et al. Evaluating the Training of Filipino American Community Health Advisors to Disseminate Colorectal Cancer Screening. J Community Health 37, 1218–1225 (2012). https://doi.org/10.1007/s10900-012-9557-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-012-9557-9