Department of Psychology, University of Texas Permian Basin, Odessa, Texas.
Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, New Mexico.
Am J Prev Med. 2021 Mar;60(3):e159-e167. doi: 10.1016/j.amepre.2020.09.019. Epub 2020 Dec 25.
Cancer is the second leading cause of death in the U.S. Utilizing family health history in cancer prevention holds promise in lessening the burden of cancer. Nevertheless, family health history is underutilized in public health and preventive medicine. Community health workers, also known as lay health educators, are ideal candidates to offer basic cancer family history-based education and services to the general public. The authors developed the first cancer family history-based genomics training program in cancer prevention tailored for community health workers. This paper details the development and pilot testing findings of the training. Specifically, a multidisciplinary research team of geneticists, genetic counselors, health educators, community health workers, and community health worker instructors developed a 7-module, 6-hour, bilingual (English and Spanish) cancer family history-based training focusing on cancer family history-based risk assessment, lifestyle recommendations, and genetic evaluation and testing. The curriculum was based on an integrated theoretical framework, the National Comprehensive Cancer Network guidelines, the community health worker core competencies, and the 4MAT instructional model. The Texas Department of State Health Services approved and certified the curriculum with 2 delivery formats: in-person/face-to-face workshops and online training. A total of 34 community health workers completed the pilot training in person (n=17) and online (n=17) in 2018 and 2019. Participating community health workers' knowledge, attitudes, self-efficacy, and intention in delivering basic cancer family history-based genomics education and services significantly increased on the immediate post-test measures compared with their pretest data. Positive ratings and feedback were also reported by the community health workers. Findings from this pilot study suggest that wider training is warranted for educating more community health workers in the U.S.
癌症是美国的第二大死亡原因。利用家族健康史进行癌症预防有望减轻癌症负担。然而，家族健康史在公共卫生和预防医学中的应用不足。社区卫生工作者，也被称为初级卫生教育工作者，是向公众提供基本癌症家族史为基础的教育和服务的理想人选。作者为社区卫生工作者量身定制了首个基于癌症家族史的预防癌症基因组学培训计划。本文详细介绍了培训的开发和试点测试结果。具体来说，一个由遗传学家、遗传咨询师、健康教育者、社区卫生工作者和社区卫生工作者指导员组成的多学科研究团队开发了一个 7 模块、6 小时、双语（英语和西班牙语）的基于癌症家族史的培训，重点是基于癌症家族史的风险评估、生活方式建议以及遗传评估和测试。该课程基于综合理论框架、国家综合癌症网络指南、社区卫生工作者核心能力和 4MAT 教学模式。德克萨斯州卫生服务部批准并认证了该课程，有两种交付格式：面对面研讨会和在线培训。共有 34 名社区卫生工作者于 2018 年和 2019 年分别以面对面（n=17）和在线（n=17）的方式完成了试点培训。与他们的预测试数据相比，参加试点培训的社区卫生工作者在立即进行的后测中在知识、态度、自我效能感和提供基本的基于癌症家族史的基因组学教育和服务的意愿方面显著提高。社区卫生工作者还报告了积极的评价和反馈。这项试点研究的结果表明，有必要为美国更多的社区卫生工作者提供更广泛的培训。
