AMPATH Cervical Cancer Program, P.O. Box 4606, Eldoret, Kenya.
School of Public Health, Moi University, P.O. Box 4606, Eldoret, Kenya.
J Cancer Educ. 2022 Apr;37(2):466-473. doi: 10.1007/s13187-020-01839-6.
The cancer disease burden is higher in the low- and middle-income countries like Kenya where uptake of screening services is low. Community health volunteers (CHVs) have been shown to be effective in improving uptake of health services and could also be used in cervical cancer screening. However, they still have inadequate knowledge hindering effective public education. The aim of this study is to determine the effect of focused training of the CHVs on their knowledge on cervical cancer and screening uptake among women of reproductive age. This was a quasi-experimental study in rural sub-counties of Nyando and Nyakach. Nyando was the intervention arm with 186 CHVs and Nyakach the control with 239 CHVs. Participants' knowledge on cervical cancer was assessed using a self-administered questionnaire. CHVs in the intervention arm were trained about cervical cancer and screening. Knowledge was re-assessed following a 6-month public education period. The focused training improved the CHVs' knowledge on cervical cancer to 60.9% compared to 13.4% in the control arm (p = 0.004) at the end-line. The knowledge was dependent on the level of education (χ = 34.41, p = 0.045), religion (χ = 25.85, p = 0.007), and occupation (χ = 95.04, p < 0.0001). Screening uptake was significantly associated with knowledge of risk factors (p = 0.019) and sign and symptoms (p = 0.017). Screening uptake improved in the intervention arm while declined in the control arm. The training significantly improved the CHVs' knowledge on cervical cancer and uptake of screening services in the intervention area, Kisumu County, Kenya, and should be continuous.
癌症疾病负担在肯尼亚等中低收入国家更高，这些国家的筛查服务利用率较低。社区卫生志愿者（CHV）已被证明能有效提高卫生服务的利用率，也可用于宫颈癌筛查。然而，他们的知识仍然不足，阻碍了有效的公众教育。本研究旨在确定集中培训 CHV 对其关于宫颈癌和生殖年龄妇女筛查接受度的知识的影响。这是在 Nyando 和 Nyakach 农村县进行的一项准实验研究。Nyando 是干预组，有 186 名 CHV，Nyakach 是对照组，有 239 名 CHV。参与者对宫颈癌的知识通过自我管理问卷进行评估。干预组的 CHV 接受了关于宫颈癌和筛查的培训。在为期 6 个月的公众教育期后，重新评估知识。与对照组（13.4%）相比，集中培训使 CHV 对宫颈癌的知识提高到 60.9%（p=0.004）。知识水平取决于教育程度（χ²=34.41，p=0.045）、宗教信仰（χ²=25.85，p=0.007）和职业（χ²=95.04，p<0.0001）。筛查利用率与危险因素（p=0.019）和症状（p=0.017）的知识显著相关。筛查利用率在干预组显著增加，而对照组则下降。培训显著提高了 CHV 在肯尼亚基苏木县的宫颈癌知识和筛查服务的利用率，应持续进行。
