Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carton Streets, Buffalo, NY, 14263, USA.
Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA.
J Cancer Educ. 2021 Dec;36(6):1277-1284. doi: 10.1007/s13187-020-01764-8.
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.
肥胖是癌症预防、控制和生存的一个关键可改变的风险因素。政府机构建议采用综合减肥干预措施（如糖尿病预防计划[DPP]）来治疗肥胖。然而，它们高昂的实施成本限制了其普及范围，特别是在服务不足的非裔美国人（AA）社区。社区卫生工作者（CHW）或可信赖的社区成员可以帮助增加服务不足地区获得肥胖干预措施的机会，这些地区面临着服务提供者短缺的问题。CHW 主导的干预措施已经增加了体重的减轻。然而，面对面的 CHW 培训成本高昂，并且通常需要大量的旅行才能实施。基于网络的培训已成为增加覆盖范围和降低成本的常见方式。然而，在线 CHW 培训在 AAs 中实施 DPP 的可行性尚不清楚。本研究评估了在线 CHW 培训在 AAs 中实施 DPP 的可行性。将在线培训与已建立有效性的面对面 DPP 培训进行了比较。在基线和 6 周时评估 CHW 的有效性和满意度。招募了 19 名参与者（面对面组 n=10；在线组 n=9）。在培训后，所有参与者在知识测试中得分均高于 80%，这是实施干预措施所需的分数。所有参与者报告了高水平的培训满意度（在线参与者中有 88.9%，面对面参与者中有 90%对培训的评价至少为 1-7 分制的 6 分）和完成干预任务的舒适度（在线参与者中有 78%，面对面参与者中有 60%对培训的评价至少为 1-7 分制的 6 分）。两组结果无显著差异。为 AA 信仰社区量身定制的在线 CHW 培训在实施 DPP 方面与基于证据的面对面 CHW 培训具有相当的效果和满意度。需要进一步研究不同 CHW 培训模式的成本效益，以减少肥胖。
