School of Medicine and Health Sciences, The George Washington University, Washington, USA.
Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Glob Health Action. 2021 Jan 1;14(1):1883336. doi: 10.1080/16549716.2021.1883336.
: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area.
: 创新干预措施对于应对全球乳腺癌负担的不断增加至关重要,尤其是在弱势群体中。鉴于社区卫生工作者(CHW)在解决传染病和非传染性疾病方面的成功经验,本范围界定综述将研究 CHW 在乳腺癌筛查计划中的作用和影响。本文还旨在确定这些计划的有效性和可行性,特别关注中低收入国家(LMICs)和高收入国家(HICs)中 CHW 领导的干预措施之间的差异。: 使用从 1978 年到 2019 年的六个数据库进行了范围界定综述。为“社区卫生工作者”和“乳腺癌筛查”建立了全面的定义和搜索词,并根据世界银行对中低收入国家的定义提取了研究。使用多个独立审查员对筛查和数据提取进行了方案设计。使用卡方检验进行独立性检验,以分析 HICs 和 LMICs 中主题的发生率。: 在筛选出的 1551 篇论文中,根据纳入和排除标准,有 33 篇论文被纳入。研究地点包括美国(n=27)、孟加拉国(n=1)、秘鲁(n=1)、马拉维(n=2)、卢旺达(n=1)和南非(n=1)。确定了 CHW 在乳腺癌筛查中的三个主要角色:教育(n=30)、直接协助或进行乳腺癌筛查(n=7)和导航服务(n=6)。在这些角色中,CHW 提高了乳腺癌筛查率(n=23)和整体社区成员知识水平(n=21)。有两项研究对 CHW 主导的干预措施进行了成本分析。: 本综述扩展了我们对 CHW 有效性的理解,将其应用于乳腺癌筛查。它说明了 CHW 参与筛查计划如何在 LMICs 和 HICs 中产生重大影响,并强调了 CHW 在教育、直接进行筛查和导航服务方面的三个角色,这些角色成为政府和非政府组织在这一领域设计有效计划的有用支柱。