Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA.
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA.
Health Educ Res. 2023 Jul 25;38(4):350-361. doi: 10.1093/her/cyad011.
Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what characteristics make for an effective CHA. We examined the relationship between CHA personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial. Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N = 375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops, and efficacy as workshop participants' cancer knowledge scores at the 12-month follow-up, controlling for baseline scores. CHA personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (P = 0.03) and a significant, positive association with male workshop participants' prostate cancer knowledge scores at 12 months (estimated beta coefficient = 0.49, P < 0.01) after adjusting for confounders. Findings suggest that CHAs with family history of cancer may be particularly suitable for cancer peer education, although further research is needed to confirm this and identify other factors conducive to CHA success.
社区卫生顾问（CHAs）在促进医疗服务不足社区的健康方面发挥着关键作用，包括解决癌症差异问题。需要扩大研究范围，了解哪些特征能造就一名有效的 CHA。我们考察了 CHA 个人和家族的癌症病史与癌症控制干预试验中的实施和效果结果之间的关系。28 名经过培训的 CHA 为 14 家教堂的 375 名参与者实施了一系列三次癌症教育小组研讨会。实施情况通过参与者参加教育研讨会的情况来衡量，而效果则通过 12 个月随访时的癌症知识评分来衡量，同时控制了基线分数。CHA 个人的癌症病史与实施情况或知识结果均无显著相关性。然而，与没有家族癌症病史的 CHA 相比，有家族癌症病史的 CHA 参加者参加研讨会的比例显著更高（P=0.03），并且在调整混杂因素后，与男性参与者的前列腺癌知识得分在 12 个月时呈显著正相关（估计的β系数=0.49，P<0.01）。这些发现表明，有家族癌症病史的 CHA 可能特别适合进行癌症同伴教育，尽管需要进一步研究来证实这一点，并确定其他有利于 CHA 成功的因素。
