Dataset Information

Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers.

ABSTRACT: Objective:Community health worker (CHW)-led education is an important strategy to increase awareness and access to breast cancer screening in medically-underserved communities. This study aimed to develop a context-specific, culturally-appropriate training intervention for South Florida CHWs to educate Latinx immigrant farmworkers on breast cancer and early detection.

Methods:A community-based participatory research (CBPR) study, conducted 2017-2019, informed the design of a training curriculum for CHWs and educational dissemination materials. Twenty-two CHWs were trained and knowledge gains were measuring using a one-group pre-and post-test design. Triangulated evaluation consisted of field observations of CHW-client interactions, CHW self-reports, and rapid assessment surveys of community members.

Results:A community stakeholder-informed breast cancer training curriculum resulted in significant, sustained breast cancer knowledge gains among CHWs when comparing pre-, post-, and 4-6 month post-training follow-up test scores. Field observations of educational material dissemination, CHW self-reported evaluations, and community rapid assessment surveys at three health fairs demonstrated this was an effective strategy to engage female Latinx farmworkers in breast cancer education.

Conclusions:Community and key stakeholder participation in the development of a breast cancer educational intervention allowed for tailored design priorities around knowledge-based content, comprehensiveness, relevance, appropriateness, and ease of dissemination to community members. This model of participatory CHW training intervention design can enable future train-the-trainer approaches to disseminate and scale-up evidence-based health education interventions.

SUBMITTER: Rodriguez NM

PROVIDER: S-EPMC7571710 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers.

Rodriguez Natalia M NM Casanova Felicia F Pages Gabriela G Claure Layla L Pedreira Marian M Touchton Michael M Knaul Felicia F

PloS one 20201019 10

<h4>Objective</h4>Community health worker (CHW)-led education is an important strategy to increase awareness and access to breast cancer screening in medically-underserved communities. This study aimed to develop a context-specific, culturally-appropriate training intervention for South Florida CHWs to educate Latinx immigrant farmworkers on breast cancer and early detection.<h4>Methods</h4>A community-based participatory research (CBPR) study, conducted 2017-2019, informed the design of a train ...[more]

PMID: 33075111

Similar Datasets

Project description:BackgroundWhile integral to decentralising health reforms, Community Health Workers (CHWs) in South Africa experience many challenges. During COVID-19, CHW roles changed rapidly, shifting from communities to clinics. In the contexts of new roles and re-engineered primary healthcare (PHC), the objectives were to: (a) implement a training intervention to support local decision-making capability of CHWs; and (b) assess learning and impacts from the perspectives of CHWs.MethodsCHWs from three rural villages (n = 9) were trained in rapid Participatory Action Research (PAR) with peers and community stakeholders (n = 33). Training equipped CHWs with tools and techniques to convene community groups, raise and/or respond to local health concerns, understand concerns from different perspectives, and facilitate action in communities and public services. CHWs' perspectives before and after the intervention were gained through semi-structured interviews. Data were collected and analysed using the decision space framework to understand local actors' power to affect devolved decision-making.ResultsCHWs demonstrated significant resilience and commitment in the face of COVID-19. They experienced multiple, intersecting challenges including: limited financial, logistical and health systems support, poor role clarity, precarious employment, low and no pay, unstable organisational capacity, fragile accountability mechanisms and belittling treatment in clinics. Together, these restricted decision space and were seen to reflect a low valuing of the cadre in the system. CHWs saw the training as a welcome opportunity to assert themselves as a recognised cadre. Regular, spaces for dialogue and mutual learning supported CHWs to gain tools and skills to rework their agency in more empowered ways. The training improved management capacity, capabilities for dialogue, which expanded role clarity, and strengthened community mobilisation, facilitation and analysis skills. Development of public speaking skills was especially valued. CHWs reported an overall 'tripe-benefit' from the training: community-acceptance; peer support; and dialogue with and recognition by the system. The training intervention was recommended for scale-up by the health authority as an implementation support strategy for PHC.ConclusionsLack of recognition of CHWs is coupled with limited opportunities for communication and trust-building. The training supported CHWs to find and amplify their voices in strategic partnerships, and helped build functionality for local decision-making.

Project description:BACKGROUND:Latinx families are among the highest users of smartphones, yet few health-focused Web programs have been developed for this audience. Parent-based smartphone apps designed for Latinx families may help increase access to evidence-informed parenting programming and ultimately reduce health disparities among children and adolescents. To maximize uptake of such apps, the Center for eHealth Research and Disease Management (CeHRes) Roadmap for electronic health (eHealth) development recommends 5 phases of development: (1) contextual inquiry, (2) value specification, (3) design, (4) operationalization, and (5) evaluation. OBJECTIVE:Guided by the CeHRes Roadmap, our objective was to apply a community-based participatory research (CBPR) approach to mobile app development. We present a formative evaluation to inform the design of an eHealth mobile app for Latinx parents of adolescents based on a face-to-face parenting program, Padres Informados/Jovenes Preparados (PIJP). METHODS:Community participants in the process included Latinx parents and stakeholders. We conducted a parent survey (N=115) and interviews (N=20) to understand the context and obtain feedback on a mockup and prototype of the app, facilitator workshops to streamline content, and stakeholder interviews (N=4) to discuss values and app requirements. RESULTS:We report results from the first 3 phases of the CeHRes Roadmap. In the survey, 96.5% (111/115) of parents reported they had access to a cell phone, 85.6% (89/104) reported they would use a parenting app in the next month if they had access, and 80.2% (89/111) reported intentions to use a stress reduction app. Parents reported that setting goals about parenting and tracking those goals were important potential features of an app. In logistic regression analyses, technology attitudes and barriers were not related to parent's intentions to use a parenting mobile app (95% CI 0.51-1.17 and 95% CI 0.28-2.12, respectively). Qualitative interviews confirmed Latinx parents' technology engagement and desire for education and child development information online. Stakeholder interviews identified 3 community values: familism, the promotion of adolescent health, and delivery of economic value. Community stakeholders participated in defining the mobile app requirements. On the basis of community and parent input, the mobile app prototype was designed with 3 sections: (1) 8 modules of video-based parenting skills instruction with content from the face-to-face PIJP program, (2) breath rate information from a wearable device to support awareness of stress levels that could affect parenting, and (3) goal setting and tracking capacities. CONCLUSIONS:The findings of this study highlight the utility of an iterative, participatory design process. The CBPR approach and community collaboration enhanced the CeHRes Roadmap by promoting power sharing, facilitating recruitment, and building trust among community members. Experiences applying community research to the initial 3 phases of the CeHRes Roadmap in a Latinx community are discussed, along with plans for the 2 final phases.

Project description:BackgroundDespite improvements in mortality rates over the past several decades, cardiovascular (CV) disease remains the leading cause of death for African-Americans (AAs). Innovative approaches through mobile health (mHealth) interventions have the potential to support lifestyle change for CV disease prevention among AAs. We aimed to translate a behavioral theory-informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for AAs. We describe the design and development of a culturally relevant, CV health and wellness digital application (app) and pilot testing using a community-based participatory research (CBPR) approach with AA churches.MethodsThis mixed methods study used a 4-phase iterative development process for intervention design with the AA community. Phase 1 included focus groups with AA community members and church partners (n = 23) to gain insight regarding potential app end user preferences. In Phase 2, the interdisciplinary research team synthesized Phase 1 input for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with church partners (n = 13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4, a single group pilot study among AA church congregants (n = 50), assessed app acceptability, usability, and satisfaction.ResultsPhase 1 focus groups indicated general and health-related apps preferences: multifunctional, high-quality graphics/visuals, evidence-based, yet simple health information and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Phase 3 feedback was used to refine the app prototype for pilot testing. Phase 4 pilot testing indicated high app acceptability, usability, and satisfaction.ConclusionsThis study illustrates integration of formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities among AAs. Given the positive app perceptions, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.Trial registrationClinicaltrials.gov NCT03084822.

Dataset Information

Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers.

Publications

Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets