College of Nursing, University of Kentucky, 751 Rose St. 531 College of Nursing Building, Lexington, KY, 40536-0232, USA.
College of Medicine, Cancer Biostatistics within the Division of Medical Oncology, University of Kentucky, Lexington, KY, USA.
J Community Health. 2021 Feb;46(1):165-173. doi: 10.1007/s10900-020-00864-2.
National lung cancer screening with low dose computed tomography (LDCT) uptake is suboptimal. One factor contributing to slow uptake is lack of awareness. Trained Community Health Workers (CHWs) may be effective in increasing lung cancer screening awareness among disparate populations, however little is known about the processes necessary to scale an intervention for implementation by CHWs in a new area. We examined implementation processes with the RE-AIM framework and pilot tested a CHW-delivered lung cancer education intervention based on the Health Belief Model. We measured pre-post participant knowledge, attitudes and beliefs regarding cancer screening, lung cancer stigma, and intent to obtain LDCT screening. We used community-engaged strategies to collaborate with a local health system, to identify CHWs. CHWs were trained to recruit participants and deliver the one-session lung cancer education intervention. Seven CHWs and eight community sites participated. Participants (n = 77) were female (53%) primarily low income (62.9%); tobacco use was high (36.9%). Post intervention changes in lung cancer screening knowledge (p = < .0001), attitudes regarding lung cancer screening benefit (p = .034) and lung cancer stigma. (p = .024) We learned important lessons that will be useful in subsequent scaling. Collaborating with a local health system is a promising method to disseminate a lung cancer screening education intervention.
国家肺癌筛查采用低剂量计算机断层扫描(LDCT)的普及率不高。导致普及率低的一个因素是缺乏意识。经过培训的社区卫生工作者(CHW)可能在提高不同人群的肺癌筛查意识方面非常有效,但是,对于 CHW 在新地区实施干预措施所需的过程知之甚少。我们使用 RE-AIM 框架检查了实施过程,并根据健康信念模型对 CHW 提供的肺癌教育干预措施进行了试点测试。我们测量了参与者对癌症筛查、肺癌污名化以及获取 LDCT 筛查的意图的知识、态度和信念。我们使用社区参与策略与当地卫生系统合作,以确定 CHW。CHW 接受了招募参与者和提供单次肺癌教育干预的培训。七名 CHW 和八个社区参与。参与者(n=77)为女性(53%),主要为低收入人群(62.9%);烟草使用率高(36.9%)。干预后,肺癌筛查知识(p= < .0001)、肺癌筛查获益的态度(p= .034)和肺癌污名化的态度(p= .024)都发生了变化。我们学到了一些重要的经验教训,这些经验教训将在随后的扩展中非常有用。与当地卫生系统合作是传播肺癌筛查教育干预的一种有前途的方法。