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社区卫生工作者培训以提高癌症基因组学能力的结果。

Results from the Delivery of a Community Health Worker Training to Advance Competencies in Cancer Genomics.

机构信息

Medical University of South Carolina, Charleston, South Carolina, USA.

出版信息

Public Health Genomics. 2024;27(1):83-95. doi: 10.1159/000539595. Epub 2024 May 31.

Abstract

INTRODUCTION

Less than half of eligible Black women are assessed for genetic risk and only 28% engage in recommended hereditary breast and ovarian cancer (HBOC) risk-reducing interventions. CHWs are trusted individuals that work as a liaison between health systems and the community to improve access to services and support cancer prevention efforts, though they are an overlooked resource to support genetic risk assessment. To address the need and training gaps for CHWs, we developed and assessed an online training program to build CHW's competencies in cancer genomics and use of health information technologies to navigate high-risk individuals to appropriate genetic services.

METHODS

The curriculum and 10 training modules were developed through engaging a panel of experts in a three-round Delphi process. Recruitment focused on CHWs who worked in clinical settings or groups providing outreach or health services to Black women. We assessed: changes in knowledge and attitudes about HBOC and genomics, as well as the perceptions about the quality and implementation of the training.

RESULTS

Forty-six individuals expressed interest in the training after recruitment. Thirty eight individuals were eligible for the training and 26 completed the course. We found improvements in knowledge and genomics competencies immediately post-course, but the majority of these improvements were not sustained at 3-month follow-up. The training was highly rated for its relevance to CHW work and overall delivery. Top rated sessions included HBOC overview and family history collection. On average, participants reported discussing HBOC with 17 individuals at 3-month follow-up.

CONCLUSION

Championing a diverse cancer and genomics workforce can help address the goals of the National Cancer Plan to improve early detection and health equity. Through this training, CHWs gained critical cancer and genomics knowledge that was then applied to their primary roles.

摘要

简介

只有不到一半的符合条件的黑人女性接受遗传风险评估,只有 28%的人接受推荐的遗传性乳腺癌和卵巢癌(HBOC)风险降低干预措施。社区卫生工作者是值得信赖的人,他们作为卫生系统和社区之间的联络人,以改善服务的可及性并支持癌症预防工作,尽管他们是支持遗传风险评估的被忽视的资源。为了解决社区卫生工作者的需求和培训差距,我们开发并评估了一个在线培训计划,以提高社区卫生工作者在癌症基因组学方面的能力,并利用健康信息技术为高风险个体提供适当的遗传服务。

方法

课程和 10 个培训模块是通过在三轮德尔菲过程中邀请一组专家来开发的。招募的重点是在临床环境中工作或为黑人女性提供外展或卫生服务的社区卫生工作者。我们评估了以下方面:关于 HBOC 和基因组学的知识和态度的变化,以及对培训的质量和实施的看法。

结果

在招募后,有 46 人对培训表示了兴趣。38 人符合培训条件,26 人完成了课程。我们发现,课程结束后,知识和基因组学能力立即有所提高,但这些提高中的大多数在 3 个月的随访中并未持续。培训因其与社区卫生工作者工作的相关性和总体交付而得到高度评价。评价最高的课程包括 HBOC 概述和家族史收集。平均而言,参与者报告在 3 个月的随访中与 17 个人讨论了 HBOC。

结论

支持多样化的癌症和基因组学劳动力可以帮助实现国家癌症计划的目标,即提高早期发现和健康公平。通过这种培训,社区卫生工作者获得了关键的癌症和基因组学知识,然后将其应用于他们的主要角色。

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