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Gwathmey TM, Williams KL, Caban-Holt A, Starks TD, Foy CG, Mathews A, Byrd GS. Building a Community Partnership for the Development of Health Ministries Within the African American Community: The Triad Pastors Network. J Community Health 2024; 49:559-567. [PMID: 38265538 PMCID: PMC10981582 DOI: 10.1007/s10900-023-01315-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/25/2024]
Abstract
African Americans continue to have worse health outcomes despite attempts to reduce health disparities. This is due, in part, to inadequate access to healthcare, but also to the health care and medical mistrust experienced by communities of color. Churches and worship centers have historically served as cultural centers of trusted resources for educational, financial, and health information within African American communities and a growing number of collaborations have developed between academic institutions and community/faith entities. Herein, we describe the infrastructure of a true and sustainable partnership developed with > 100 prominent faith leaders within the Piedmont Triad region of North Carolina for the purpose of developing or expanding existing health ministries within houses of worship, to improve health literacy and overall health long-term. The Triad Pastors Network is an asset-based partnership between the Maya Angelou Center for Health Equity at Wake Forest University School of Medicine and faith leaders in the Piedmont Triad region of North Carolina that was created under the guiding principles of community engagement to improve health equity and decrease health disparities experienced by African American communities. A partnership in which co-equality and shared governance are the core of the framework provides an effective means of achieving health-related goals in a productive and efficient manner. Faith-based partnerships are reliable approaches for improving the health literacy needed to address health disparities and inequities in communities of color.
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Affiliation(s)
- TanYa M Gwathmey
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
- Hypertension and Vascular Research Center, Department of Surgery, Wake Forest University School of Medicine, Biotech Place - 575 N. Patterson Avenue, Suite #340, Winston-Salem, NC, 27101, USA.
| | - K Lamonte Williams
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Allison Caban-Holt
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Takiyah D Starks
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Capri G Foy
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Allison Mathews
- COMPASS Initiative Faith Coordinating Center, Wake Forest University School of Divinity, Winston-Salem, NC, USA
| | - Goldie S Byrd
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Knott CL, Miech EJ, Woodard N, Huq M. The role of organizational capacity in intervention efficacy in a church-based cancer education program: A configurational analysis. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2023; 3:284-294. [PMID: 38107832 PMCID: PMC10723821 DOI: 10.1007/s43477-023-00089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/29/2023] [Indexed: 12/19/2023]
Abstract
It is well-established in the field of implementation science that the context in which an intervention is delivered can play a crucial role in how well it is implemented. However, less is known about how organizational context or capacity relates to efficacy outcomes, particularly with health promotion interventions delivered outside of healthcare settings. The present study examined whether organizational capacity indicators were linked to key efficacy outcomes in an evidence-based cancer control intervention delivered in 13 African American churches in Maryland. Outcomes included increases in colorectal cancer knowledge and self-report colonoscopy screening behavior from baseline to follow-up. We used Coincidence Analysis to identify features of organizational capacity that uniquely distinguished churches with varying levels of cancer knowledge and screening. Indicators of organizational capacity (e.g., congregation size, prior health promotion experience) were from an existing measure of church organizational capacity for health promotion. A single solution pathway accounted for greater increases in colorectal cancer knowledge over 12 months, a combination of two conditions: conducting 3 or more health promotion activities in the prior 2 years together with not receiving any technical assistance from outside partners in the prior 2 years. A single condition accounted for greater increases in colonoscopy screening over 24 months: churches that had conducted health promotion activities in 1-4 different topical areas in the prior 2 years. Findings highlight aspects of organizational capacity (e.g., prior experience in health promotion) that may facilitate intervention efficacy and can help practitioners identify organizational settings most promising for intervention impact.
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Affiliation(s)
- Cheryl L. Knott
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | - Edward J. Miech
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Nathaniel Woodard
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | - Maisha Huq
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
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Gourley M, Starkweather S, Roberson K, Katz CL, Marin DB, Costello Z, DePierro J. Supporting Faith-Based Communities Through and Beyond the Pandemic. J Community Health 2023; 48:593-599. [PMID: 36790556 PMCID: PMC9929242 DOI: 10.1007/s10900-023-01193-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 02/16/2023]
Abstract
The COVID-19 pandemic brought widespread and notable effects to the physical and mental health of communities across New York City with disproportionate suffering Black/African American and Hispanic/Latino communities alongside additional stressors such as racism and economic hardship. This report describes the adaptation of a previously successful evidence-based community engagement health education program for the deployment of resilience promoting workshop program in faith-based organizations in BIPOC communities in New York City. From June 2021 to June 2022, nine faith-based organizations implemented 58 workshops to 1,101 non-unique workshop participants. Most of the workshops were delivered online with more women (N = 803) than men (N = 298) participating. All organizations completed the full curriculum; the workshop focused on self-care and physical fitness was repeated most frequently (N = 13). Participants in the workshops ranged from 4 to 73 per meeting and were largely female. The Building Community Resilience Project is an easy and effective way to modify an existing, evidence-based community health education program to address new and relevant health needs such as resilience and stress amidst the COVID-19 pandemic among faith communities serving BIPOC populations. More research is needed regarding the impact of the workshops as well as adaptability for other faith traditions.
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Affiliation(s)
- Michele Gourley
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Sydney Starkweather
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katheryn Roberson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Global Health and Health Systems Design, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Global Health and Health Systems Design, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Woodard N, Chen C, Huq MR, He X, Knott CL. Prior health promotion experience and intervention outcomes in a lay health advisor intervention. HEALTH EDUCATION RESEARCH 2022; 37:266-277. [PMID: 35726480 PMCID: PMC9340964 DOI: 10.1093/her/cyac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/26/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Training lay community members to implement health promotion interventions is an effective method to educate medically underserved populations. Some trainings are designed for individuals who already have a health-related background; however, others are developed for those with no previous health promotion experience. It is unknown whether those with backgrounds in health promotion are more effective in this role than those without. This study assessed the relationship between health promotion experience among trained community health advisors (CHAs) and their self-efficacy to implement an evidence-based cancer control intervention, as well as cancer knowledge and screening behavior outcomes among intervention participants. Data were collected from 66 trained CHAs and 269 participants in CHA-led cancer awareness and early detection workshops. CHAs reported high self-efficacy to implement the intervention independent of their health promotion experience. CHA health promotion experience was neither indicative of differences in participant colorectal or breast cancer knowledge at 12 months, nor of changes in participant-reported cancer screening. However, participant prostate cancer knowledge at 12 months was greater when taught by CHAs with previous health promotion experience (P < 0.01). Prior health promotion experience of trained health advisors may not be pivotal across all contexts, but they may affect specific knowledge outcomes.
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Affiliation(s)
| | - Chang Chen
- Department of Epidemiology and Biostatistics, University of Maryland, SPH Building, 4200 Valley Drive, Rm 2234, College Park, MD 20742-2611, USA
| | - Maisha R Huq
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, SPH Building, 4200 Valley Drive, Rm 1234, College Park, MD 20742-2611, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland, SPH Building, 4200 Valley Drive, Rm 2234, College Park, MD 20742-2611, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, SPH Building, 4200 Valley Drive, Rm 1234, College Park, MD 20742-2611, USA
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Marin DB, Karol AB, Sharma V, Wetmore J, Costello Z, Henry B, Robinson M, Thompson L, Peña I, Jandorf L. M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA. JOURNAL OF RELIGION AND HEALTH 2022; 61:2527-2538. [PMID: 34751869 DOI: 10.1007/s10943-021-01453-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education.
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Affiliation(s)
- Deborah B Marin
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
| | - Alex B Karol
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Vansh Sharma
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - John Wetmore
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Brittney Henry
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Mimsie Robinson
- Bethel Gospel Assembly, 2-26 East 120th Street, New York, NY, 10035, USA
| | - Linda Thompson
- Health Ministry Leader, Abyssinian Baptist Church, 132 Odell Clark Place, New York, NY, 10030, USA
| | - Israel Peña
- Department of Psychology, Boricua College, Bronx, NY, 10451, USA
- The FLOW Kingdom Ministries, 901 East Tremont Avenue, Bronx, NY, 10460, USA
| | - Lina Jandorf
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
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Knott CL, Miech EJ, Slade J, Woodard N, Robinson-Shaneman BJ, Huq M. Evaluation of organizational capacity in the implementation of a church-based cancer education program. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:22-33. [PMID: 35392361 PMCID: PMC8983006 DOI: 10.1007/s43477-021-00033-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Implementation evaluations have increasingly taken into account how features of local context help determine implementation outcomes. The purpose of this study was to determine which contextual features of organizational capacity led directly to the RE-AIM Framework implementation outcomes of intervention reach and number of days taken to implement, in an implementation trial of a series of cancer education workshops conducted across 13 African American churches in Maryland. We used a configurational approach with Coincidence Analysis to identify specific features of organizational capacity that uniquely distinguished churches with implementation success from those that were less successful. Aspects of organizational capacity (e.g., congregation size, staffing/volunteers, health ministry experience) were drawn from an existing measure of church organizational capacity for health promotion. Solution pathways leading to higher intervention reach included: having a health ministry in place for 1-4 years; or having fewer than 100 members; or mid-size churches that had conducted health promotion activities in 1-4 different topics in the past 2 years. Solution pathways to implementing the intervention in fewer number of days included: having conducted 1-2 health promotion activities in the past 2 years; or having 1-5 part-time staff and a pastor without additional outside employment; or churches with a doctorally prepared pastor and a weekly attendance of 101-249 members. Study findings can inform future theory, research, and practice in implementation of evidence-based health promotion interventions delivered in faith-based and other limited-resource community settings. Findings support the important role of organizational capacity in implementation outcomes in these settings.
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Affiliation(s)
- Cheryl L. Knott
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA.,Corresponding author: Cheryl L. Knott, PhD, University of Maryland School of Public Health, 1234W School of Public Health Building, College Park, MD 20742. Phone: 301-405-6659; Fax: 301-314-9167; ; Twitter: ChampUMD; Tumblr: champlabumd
| | - Edward J. Miech
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Jimmie Slade
- Community Ministry of Prince George’s County, PO Box 250, Upper Marlboro, MD 20773, USA
| | - Nathaniel Woodard
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | | | - Maisha Huq
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
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Huq MR, Woodard N, Okwara L, McCarthy S, Knott CL. Recommendations for breast cancer education for African American women below screening age. HEALTH EDUCATION RESEARCH 2022; 36:530-540. [PMID: 34533195 DOI: 10.1093/her/cyab033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Although statistically unlikely, early-onset breast cancer tends to be more aggressive and leads to greater mortality than breast cancer among women of screening age. Young African American women are disproportionately impacted by early-onset breast cancer compared to women of other races. Given the racial disparities and because young women are typically not the primary audience for breast cancer educational messaging, there is a need to identify recommendations for age-appropriate breast cancer education for African American women below mammogram eligibility. Through N = 30 key informant interviews with young African American breast cancer survivors, family members of young survivors, community organization leaders and healthcare providers, we identified breast cancer educational message content and communication channels relevant for these women. Participants recommended that message content should emphasize the need to address family cancer history and self-advocacy in healthcare encounters in addition to concerns about loss of womanhood, financial costs and opportunity costs associated with preventive healthcare visits. Breast cancer messages for this audience should consider the influences of earlier life stage, culture and race. Recommended communication channels highlighted use of social media and videos. Findings will inform future age-appropriate educational messaging aimed at eliminating early-onset breast cancer disparities disproportionately impacting young African American women.
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Hill TG, Langley JE, Kervin EK, Pesut B, Duggleby W, Warner G. An Integrative Review on the Feasibility and Acceptability of Delivering an Online Training and Mentoring Module to Volunteers Working in Community Organizations. Front Digit Health 2021; 3:688982. [PMID: 34723241 PMCID: PMC8551809 DOI: 10.3389/fdgth.2021.688982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Volunteer programs that support older persons can assist them in accessing healthcare in an efficient and effective manner. Community-based initiatives that train volunteers to support patients with advancing illness is an important advance for public health. As part of implementing an effective community-based volunteer-based program, volunteers need to be sufficiently trained. Online training could be an effective and safe way to provide education for volunteers in both initial training and/or continuing education throughout their involvement as a volunteer. Method: We conducted an integrative review that synthesized literature on online training programs for volunteers who support older adults. The review included both a search of existing research literature in six databases, and an online search of online training programs currently being delivered in Canada. The purpose of this review was to examine the feasibility and acceptability of community-based organizations adopting an online training format for their volunteers. Results: The database search identified 13,626 records, these went through abstract and full text screen resulting in a final 15 records. This was supplemented by 2 records identified from hand searching the references, for a total of 17 articles. In addition to identifying Volunteers Roles and Responsibilities; Elements of Training; and Evaluation of Feasibility and Acceptability; a thematic analysis of the 17 records identified the categories: (1) Feasibility Promoting Factors; (2) Barriers to Feasibility; (3) Acceptability Promoting Factors; and (4) Barriers to Acceptability. Six programs were also identified in the online search of online training programs. These programs informed our understanding of delivery of existing online volunteer training programs. Discussion: Findings suggested that feasibility and acceptability of online training were promoted by (a) topic relevant training for volunteers; (b) high engagement of volunteers to prevent attrition; (c) mentorship or leadership component. Challenges to online training included a high workload; time elapsed between training and its application; and client attitude toward volunteers. Future research on online volunteer training should consider how online delivery can be most effectively paced to support volunteers in completing training and the technical skills needed to complete the training and whether teaching these skills can be integrated into programs.
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Affiliation(s)
- Taylor G Hill
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jodi E Langley
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Emily K Kervin
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Barbara Pesut
- Nursing, University of British Columbia, Okanagan, BC, Canada
| | | | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
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Lowe D, Ryan R, Schonfeld L, Merner B, Walsh L, Graham-Wisener L, Hill S. Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. Cochrane Database Syst Rev 2021; 9:CD013373. [PMID: 34523117 PMCID: PMC8440158 DOI: 10.1002/14651858.cd013373.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person-centred and so better able to meet the needs of and provide care for individuals. Globally, governments recommend consumer involvement in healthcare decision-making at the systems level, as a strategy for promoting person-centred health services. However, the effects of this 'working in partnership' approach to healthcare decision-making are unclear. Working in partnership is defined here as collaborative relationships between at least one consumer and health provider, meeting jointly and regularly in formal group formats, to equally contribute to and collaborate on health service-related decision-making in real time. In this review, the terms 'consumer' and 'health provider' refer to partnership participants, and 'health service user' and 'health service provider' refer to trial participants. This review of effects of partnership interventions was undertaken concurrently with a Cochrane Qualitative Evidence Synthesis (QES) entitled Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis. OBJECTIVES To assess the effects of consumers and health providers working in partnership, as an intervention to promote person-centred health services. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2000 to April 2019; PROQUEST Dissertations and Theses Global from 2016 to April 2019; and grey literature and online trial registries from 2000 until September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs of 'working in partnership' interventions meeting these three criteria: both consumer and provider participants meet; they meet jointly and regularly in formal group formats; and they make actual decisions that relate to the person-centredness of health service(s). DATA COLLECTION AND ANALYSIS Two review authors independently screened most titles and abstracts. One review author screened a subset of titles and abstracts (i.e. those identified through clinical trials registries searches, those classified by the Cochrane RCT Classifier as unlikely to be an RCT, and those identified through other sources). Two review authors independently screened all full texts of potentially eligible articles for inclusion. In case of disagreement, they consulted a third review author to reach consensus. One review author extracted data and assessed risk of bias for all included studies and a second review author independently cross-checked all data and assessments. Any discrepancies were resolved by discussion, or by consulting a third review author to reach consensus. Meta-analysis was not possible due to the small number of included trials and their heterogeneity; we synthesised results descriptively by comparison and outcome. We reported the following outcomes in GRADE 'Summary of findings' tables: health service alterations; the degree to which changed service reflects health service user priorities; health service users' ratings of health service performance; health service users' health service utilisation patterns; resources associated with the decision-making process; resources associated with implementing decisions; and adverse events. MAIN RESULTS We included five trials (one RCT and four cluster-RCTs), with 16,257 health service users and more than 469 health service providers as trial participants. For two trials, the aims of the partnerships were to directly improve the person-centredness of health services (via health service planning, and discharge co-ordination). In the remaining trials, the aims were indirect (training first-year medical doctors on patient safety) or broader in focus (which could include person-centredness of health services that targeted the public/community, households or health service delivery to improve maternal and neonatal mortality). Three trials were conducted in high income-countries, one was in a middle-income country and one was in a low-income country. Two studies evaluated working in partnership interventions, compared to usual practice without partnership (Comparison 1); and three studies evaluated working in partnership as part of a multi-component intervention, compared to the same intervention without partnership (Comparison 2). No studies evaluated one form of working in partnership compared to another (Comparison 3). The effects of consumers and health providers working in partnership compared to usual practice without partnership are uncertain: only one of the two studies that assessed this comparison measured health service alteration outcomes, and data were not usable, as only intervention group data were reported. Additionally, none of the included studies evaluating this comparison measured the other primary or secondary outcomes we sought for the 'Summary of findings' table. We are also unsure about the effects of consumers and health providers working in partnership as part of a multi-component intervention compared to the same intervention without partnership. Very low-certainty evidence indicated there may be little or no difference on health service alterations or health service user health service performance ratings (two studies); or on health service user health service utilisation patterns and adverse events (one study each). No studies evaluating this comparison reported the degree to which health service alterations reflect health service user priorities, or resource use. Overall, our confidence in the findings about the effects of working in partnership interventions was very low due to indirectness, imprecision and publication bias, and serious concerns about risk of selection bias; performance bias, detection bias and reporting bias in most studies. AUTHORS' CONCLUSIONS The effects of consumers and providers working in partnership as an intervention, or as part of a multi-component intervention, are uncertain, due to a lack of high-quality evidence and/or due to a lack of studies. Further well-designed RCTs with a clear focus on assessing outcomes directly related to partnerships for patient-centred health services are needed in this area, which may also benefit from mixed-methods and qualitative research to build the evidence base.
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Affiliation(s)
- Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Siddiq H, Alemi Q, Mentes J, Pavlish C, Lee E. Preventive Cancer Screening Among Resettled Refugee Women from Muslim-Majority Countries: A Systematic Review. J Immigr Minor Health 2021; 22:1067-1093. [PMID: 31900753 DOI: 10.1007/s10903-019-00967-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As refugee populations continue to age in the United States, there is a need to prioritize screening for chronic illnesses, including cancer, and to characterize how social and cultural contexts influence beliefs about cancer and screening behaviors. This study examines screening rates and socio-cultural factors influencing screening among resettled refugee women from Muslim-majority countries of origin. A systematic and integrative review approach was used to examine articles published from 1980 to 2019, using PubMed, CINAHL, and PsycINFO. A total of 20 articles met the inclusion criteria. Cancer screening rates among refugee women are lower when compared to US-born counterparts. Social and cultural factors include religious beliefs about cancer, stigma, modesty and gender roles within the family context. The findings of this review, suggest that resettled refugee women underutilize preventive services, specifically mammography, Pap test and colonoscopy screening, and whose perceptions and behaviors about cancer and screening are influenced by social and cultural factors.
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Affiliation(s)
- Hafifa Siddiq
- Division of General Internal Medicine and Health Services Research, School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Qais Alemi
- School of Behavioral Health, Loma Linda University, 1898 Business Center Dr., San Bernardino, CA, 92408, USA
| | - Janet Mentes
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
| | - Carol Pavlish
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
| | - Eunice Lee
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
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Knott CL, Chen C, Bowie JV, Mullins CD, Slade JL, Woodard N, Robinson-Shaneman BJR, Okwara L, Huq MR, Williams R, He X. Cluster-randomized trial comparing organizationally tailored versus standard approach for integrating an evidence-based cancer control intervention into African American churches. Transl Behav Med 2021; 12:673-682. [PMID: 34255087 DOI: 10.1093/tbm/ibab088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The field of implementation science has devoted increasing attention to optimizing the fit of evidence-based interventions to the organizational settings in which they are delivered. Institutionalization of health promotion into routine organizational operations is one way to achieve this. However, less is known about how to maximize fit and achieve institutionalization, particularly in settings outside of the healthcare system. This paper reports on findings from a parallel cluster-randomized trial that compared an organizationally tailored with a standard (core components only) approach for institutionalizing ("integrating") an evidence-based cancer control intervention into African American churches. Churches randomized to the organizationally tailored condition identified three or more implementation strategies from a menu of 20, with an implementation time frame for each. The primary study outcome was assessed through the Faith-Based Organization Health Integration Inventory, a measure of institutionalization of health promotion activities in church settings, completed by pastors at baseline and 12-month follow-up. Seventeen churches were randomized and 14 were analyzed as 3 did not implement the study protocol. Though the percent increase in total integration score was greater in the tailored condition (N = 9; 18%) than in the standard condition (N = 5; 12%), linear mixed-effect models did not detect a statistically significant group × time interaction. Despite the challenges of integrating health promotion activities outside of healthcare organizations, the current approach shows promise for fostering sustainable health promotion in community settings and merits further study.
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Affiliation(s)
- Cheryl L Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD , USA
| | - Chang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Janice V Bowie
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Daniel Mullins
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Jimmie L Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD , USA
| | | | - Leonore Okwara
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD , USA
| | - Maisha R Huq
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD , USA
| | - Ralph Williams
- Access to Wholistic and Productive Living, Inc., Colmar Manor, MD, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
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12
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Woodard N, Williams RM, Fryer CS, Wang MQ, Zhang J, Knott CL. Correlates of Health Promotion in a Community Sample of African American Churches. J Community Health 2021; 45:828-835. [PMID: 32107711 DOI: 10.1007/s10900-020-00799-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Though many African American churches offer health promotion activities to their members, less is known about organizational factors that predict the availability of this programming. This study examines organizational capacity as a predictor of the amount and type of health programming offered by a convenience sample of 119 African American churches. Leaders completed a survey of health promotion activities provided in the previous 12 months and a measure of organizational capacity. Churches offered an average of 6.08 (SD = 2.15) different health programs targeting 4.66 (SD = 3.63) topics. Allocation of space and having a health ministry were positively associated with both the number of health programs and health topics addressed. When seeking to initiate health programming in an African American church setting, it is recommended that stakeholders partner with churches that have existing structures to support health promotion such as a health ministry, or help them build this capacity.
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Affiliation(s)
- Nathaniel Woodard
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA.
| | - Randi M Williams
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Craig S Fryer
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Jing Zhang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
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13
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Haughton J, Takemoto ML, Schneider J, Hooker SP, Rabin B, Brownson RC, Arredondo EM. Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program. Implement Sci Commun 2020; 1:51. [PMID: 32885207 PMCID: PMC7427873 DOI: 10.1186/s43058-020-00043-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support. Conclusions While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.
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Affiliation(s)
- Jessica Haughton
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | | | - Jennifer Schneider
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA USA
| | - Borsika Rabin
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO USA.,Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO USA
| | - Elva M Arredondo
- School of Public Health, San Diego State University, San Diego, CA USA
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14
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Holt CL, Tagai EK, Santos SLZ, Scheirer MA, Bowie J, Haider M, Slade J. Web-based versus in-person methods for training lay community health advisors to implement health promotion workshops: participant outcomes from a cluster-randomized trial. Transl Behav Med 2020; 9:573-582. [PMID: 29955889 DOI: 10.1093/tbm/iby065] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Project HEAL (Health through Early Awareness and Learning) is an implementation trial that compared two methods of training lay peer community health advisors (CHAs)-in-person ("Traditional") versus web-based ("Technology")-to conduct a series of three evidence-based cancer educational workshops in African American churches. This analysis reports on participant outcomes from Project HEAL. Fifteen churches were randomized to the two CHA training methods and the intervention impact was examined over 24 months. This study was conducted in Prince George's County, MD, and enrolled 375 church members age 40-75. Participants reported on knowledge and screening behaviors for breast, prostate, and colorectal cancer. Overall, cancer knowledge in all areas increased during the study period (p < .001). There were significant increases in digital rectal exam (p < .05), fecal occult blood test (p < .001), and colonoscopy (p < .01) at 24 months; however, this did not differ by study group. Mammography maintenance (56% overall) was evidenced by women reporting multiple mammograms within the study period. Participants attending all three workshops were more likely to report a fecal occult blood test or colonoscopy at 24 months (p < .05) than those who attended only one. These findings suggest that lay individuals can receive web-based training to successfully implement an evidence-based health promotion intervention that results in participant-level outcomes comparable with (a) people trained using the traditional classroom method and (b) previous efficacy trials. Findings have implications for resources and use of technology to increase widespread dissemination of evidence-based health promotion interventions through training lay persons in community settings.
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Affiliation(s)
- Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Erin K Tagai
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Sherie Lou Zara Santos
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Janice Bowie
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Muhiuddin Haider
- School of Public Health, Institute for Applied Environmental Health, University of Maryland, College Park, MD, USA
| | - Jimmie Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
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15
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Knott CL, Bowie J, Mullins CD, Santos SLZ, Slade J, Rosenberg E, Woodard N, Williams R, Williams RM. An Approach to Adapting a Community-Based Cancer Control Intervention to Organizational Context. Health Promot Pract 2020; 21:168-171. [PMID: 31959002 DOI: 10.1177/1524839919898209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There has been increasing attention in implementation science to optimizing the fit of evidence-based interventions to the organizational settings where they are delivered. However, less is known about how to maximize intervention-context fit, particularly in community-based settings. We describe a new strategy to customize evidence-based health promotion interventions to community sites. Specifically, leaders in African American churches completed a memorandum of understanding where they were asked to identify two or more health promotion implementation strategies from a menu of 20 and select a planned implementation time frame for each. In a pilot phase with three churches, the menu-based strategy and protocols were successfully implemented and finalized in preparation for a subsequent randomized trial. The three pilot churches identified between two and nine strategies (e.g., form a health ministry, allocate space or budget for health activities, include health in church communications/sermons). The selected strategies varied widely, reinforcing the need for interventions that can be customized to fit the organizational context. Despite the challenges of integrating health promotion activities into non-health focused organizations, this approach has promise for fostering sustainable health activities in community settings.
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Affiliation(s)
- Cheryl L Knott
- University of Maryland, College Park, MD, USA.,University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | | | | | | | - Jimmie Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | | | | | - Ralph Williams
- Access to Wholistic and Productive Living, Inc, Brentwood, MD, USA
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16
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Oh A, Gaysynsky A, Knott CL, Nock NL, Erwin DO, Vinson CA. Customer discovery as a tool for moving behavioral interventions into the marketplace: insights from the NCI SPRINT program. Transl Behav Med 2019; 9:1139-1150. [PMID: 31313817 PMCID: PMC7184906 DOI: 10.1093/tbm/ibz103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The National Cancer Institute established a dissemination and implementation accelerator program called Speeding Research-tested INTerventions (SPRINT) in order to expedite the translation of behavioral research into practice. The goal of SPRINT is to introduce researchers to a new method for moving their research into practice in order to increase the real-world impact of their evidence-based interventions. The goal of this article is to present case studies on three teams that have completed the SPRINT program to date. Each case study provides a description of the intervention the team came into the program with, the team's motivation for participating in the SPRINT program, the team's experience in the program, lessons learned from "customer discovery" interviews conducted by the team during the course, and the team's future plans for their intervention. The case studies suggest that by focusing on behavioral researchers, SPRINT addresses an unmet need in the commercialization training space; that the definition of "success" can vary across SPRINT projects; that identifying and engaging "payors" for behavioral interventions is an ongoing challenge; and that there are potential "misalignments" between the research process and market demands. Overall, these examples show that customer discovery is a potentially useful method for making interventions more responsive to the needs of stakeholders, and that researchers can benefit from learning the "language" of business and working with individuals who have business experience before trying to move their research from the lab to the real world.
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Affiliation(s)
- April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Engagement and Transformation, ICF Next, Rockville, MD, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Nora L Nock
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Cynthia A Vinson
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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17
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Maxwell AE, Lucas-Wright A, Santifer RE, Vargas C, Gatson J, Chang LC. Promoting Cancer Screening in Partnership With Health Ministries in 9 African American Churches in South Los Angeles: An Implementation Pilot Study. Prev Chronic Dis 2019; 16:E128. [PMID: 31538568 PMCID: PMC6795066 DOI: 10.5888/pcd16.190135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose and Objectives We conducted a pilot study to assess the degree to which an intervention led by community health advisors (CHAs) to promote cancer screening was delivered as intended and to estimate the potential effect of the intervention on receipt of screening. In contrast to previous studies and to maximize its potential public health impact, the intervention targeted 4 screening tests and only participants who were not up to date with screening guidelines for at least 1 cancer. Because CHAs had to both determine baseline adherence and provide counseling on 4 screening tests, the protocol was complex. Complex protocols can reduce implementation fidelity. Intervention Approach In partnership with health ministries at 9 African American churches in South Los Angeles, we conducted a 1-group pretest–posttest pilot study to assess the feasibility of implementing the intervention. CHAs recruited and obtained consent from church members aged 50 to 75 years; assessed adherence to national screening guidelines for breast, cervical, colorectal, and prostate cancer; and provided evidence-based strategies (one-on-one counseling, print materials, reminder calls) to encourage screening for tests that were overdue. Evaluation Methods We assessed implementation fidelity by reviewing baseline screening assessments and counseling scripts completed by CHAs. We estimated potential effect of the intervention on receipt of screening by using data from 3-month follow-up surveys, conducted by the research team, of participants who were nonadherent at baseline. Results From June 2016 to June 2018, 44 CHAs conducted baseline assessments of 775 participants, of whom 338 (44%) were nonadherent to national guidelines for 1 or more cancer screening tests. CHAs provided counseling to most nonadherent participants. At follow-up, about one-third of participants reported that they had discussed cancer screening with their provider and a smaller proportion reported receipt of a screening test; 13% of men and 25% of women reported receipt of colorectal cancer screening. Implications for Public Health This study demonstrates that with training and ongoing technical assistance, CHAs at African American health ministries can implement complex research protocols with good fidelity.
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Affiliation(s)
- Annette E Maxwell
- Center for Cancer Prevention and Control Research, University of California, Los Angeles Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.,UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900.
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Rhonda E Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Claudia Vargas
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - Juana Gatson
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
| | - L Cindy Chang
- Center for Cancer Prevention and Control Research, University of California, Los Angeles Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.,Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, California
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18
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Maxwell AE, Santifer R, Chang LC, Gatson J, Crespi CM, Lucas-Wright A. Organizational readiness for wellness promotion - a survey of 100 African American church leaders in South Los Angeles. BMC Public Health 2019; 19:593. [PMID: 31101096 PMCID: PMC6525409 DOI: 10.1186/s12889-019-6895-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/25/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Churches are an important asset and a trusted resource in the African American community. We needed a better understanding of their readiness to engage in health promotion before launching a large-scale health promotion effort in partnership with South Los Angeles churches. METHODS In 2017, we conducted surveys with leaders of 100 churches. Surveys were conducted face-to-face (32%) or by telephone (68%) with senior pastors (one per church) and lasted on average 48 min. We compared small (less than 50 active members), medium (50-99 active members) and large churches (at least 100 active members), and assessed which church characteristics were associated with the implementation of wellness activities. RESULTS Medium and large churches conducted significantly more wellness activities than small churches and were more likely to have wellness champions and health policies. Regardless of church size, insufficient budget was the most commonly cited barrier to implement wellness activities (85%). A substantial proportion of churches was not sure how to implement wellness activities (61%) and lacked volunteers (58%). Forty-five percent of the variation in the number of wellness activities in the last 12 months was explained by church characteristics, such as size of congregation, number of paid staff, leadership engagement, having a wellness ministry and barriers. CONCLUSIONS Many churches in South Los Angeles are actively engaged in health promotion activities, despite a general lack of resources. We recommend a comprehensive assessment of church characteristics in intervention studies to enable the use of strategies (e.g., stratification by size) that reduce imbalances that could mask or magnify study outcomes. Our data provide empirical support for the inner settings construct of the Consolidated Framework for Implementation Research in the context of health promotion in African American churches.
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Affiliation(s)
- Annette E Maxwell
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Rhonda Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - L Cindy Chang
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.,Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Juana Gatson
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center; UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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19
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Renfro T, Johnson E, Lambert DN, Wingood G, DiClemente RJ. The MEDIA model: An innovative method for digitizing and training community members to facilitate an HIV prevention intervention. Transl Behav Med 2019; 8:815-823. [PMID: 29471535 DOI: 10.1093/tbm/iby012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As human immunodeficiency virus (HIV) continues to disproportionately affect African American women, practitioners remain committed to developing innovative strategies to reduce HIV prevalence. These strategies include training community organizations, such as churches, and utilizing digital media to make intervention dissemination more sustainable. This article describes one such effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV prevention intervention. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. Formative evaluations, consultation with experts in the digital platform of choice, and the experience of two P4 for Women Master Trainers informed our translation. The model guided the translation process as our research team worked alongside topical experts and a production company to develop storyboards for core curriculum activities, which were later scripted and filmed with mock participants. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. Lessons learned from this study indicate future attempts at digitizing TOFs should keep in mind that digitization can be a time-consuming process, pilot testing in the new format is necessary even for a previously tested intervention, and the structure provided by facilitators in face-to-face training must be embedded into the format of digitized trainings.
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Affiliation(s)
- Tiffaney Renfro
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Erin Johnson
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,American Institutes for Research (AIR), Washington, DC, USA
| | | | - Gina Wingood
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA.,Center for AIDS Research, Emory University, Atlanta, GA, USA
| | - Ralph J DiClemente
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,Center for AIDS Research, Emory University, Atlanta, GA, USA
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20
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Jones LP, Slade JL, Davenport F, Santos SLZ, Knott CL. Planning for Community Scale-Up of Project HEAL: Insights From the SPRINT Initiative. Health Promot Pract 2019; 21:944-951. [PMID: 30678512 DOI: 10.1177/1524839918824087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Project HEAL (Health through Early Awareness and Learning) is an evidence-based intervention rooted in health behavior change theory and aims to increase cancer awareness and early detection through African American faith-based organizations. This study explored the potential for broader scale-up and dissemination of Project HEAL with the team's participation in a training program called Speeding Research-Tested INTerventions (SPRINT). The SPRINT training was framed using tools from the Business Model Canvas and the Value Proposition Canvas to guide trainees in designing (1) compelling value propositions, (2) a minimal viable product, and (3) questions to gain critical insight from various stakeholders during a process called Customer Discovery. We report on our experiences and insights on intervention scale-up that we gained from the training, including key findings from 41 discovery interviews conducted with various stakeholders of the church. We learned several valuable lessons from the discovery interviews such as scale-up will likely be more incremental than immediate. Additional refinement is needed to scale up the intervention for "real-world" application, such as making our technology more user-friendly and including additional health topics beyond cancer. We discuss how insights from the training refined our plans for future scale-up and dissemination in a constituent-informed way.
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Affiliation(s)
| | - Jimmie L Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
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21
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Holt CL, Shelton RC, Allen JD, Bowie J, Jandorf L, Zara Santos SL, Slade J. Development of tailored feedback reports on organizational capacity for health promotion in African American churches. EVALUATION AND PROGRAM PLANNING 2018; 70:99-106. [PMID: 30041105 PMCID: PMC6077099 DOI: 10.1016/j.evalprogplan.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/12/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Abstract
Standard community-engaged research methods involve reporting research findings back to study participants. Project HEAL is an implementation trial conducted in 14 African American churches. This paper reports on a strengths-based approach to reporting Project HEAL organizational capacity data back to church leadership, through use of individualized church reports. Pastors in each church completed a church organizational capacity assessment. The study team, including community partners representing church leadership, co-created a channel and content to disseminate the capacity data back to Project HEAL church leaders. This consisted of a 4-page lay report that included the church's capacity scores, and recommendations for future evidence-based health promotion programming matched to their capacity. The study team was able to meet with nine of the 14 churches to review the report, which took an average of six and a half weeks to schedule. The individualized church reports were well-received by pastors, who expressed an intention to share the information with others in the church and to sustain health promotion activities in their organizations. Though the individualized reports were embraced by the pastors, it is unknown whether this process will result in sustainable health promotion in these organizations without further follow-up.
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Affiliation(s)
- Cheryl L Holt
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W Public Health Building (255), College Park, MD 20742, USA.
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Columbia's Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA.
| | - Jennifer D Allen
- Department of Community Health, Tufts University, 574 Boston Avenue-Suite 208, Medford, MA 02155, USA.
| | - Janice Bowie
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD 21205, USA.
| | - Lina Jandorf
- Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, 1425 Madison Avenue, New York, NY 10029, USA.
| | - Sherie Lou Zara Santos
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 1234W Public Health Building (255), College Park, MD 20742, USA.
| | - Jimmie Slade
- Community Ministry of Prince George's County, P.O. Box 250, Upper Marlboro, MD 20773, USA.
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22
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Johnston JA, Konda K, Ablah E. Building Capacity Among Laity: A Faith-Based Health Ministry Initiative. JOURNAL OF RELIGION AND HEALTH 2018; 57:1276-1284. [PMID: 28689271 DOI: 10.1007/s10943-017-0445-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A systematic review of topic-specific faith-based health programs determined that health outcomes can be improved though faith-based health interventions. A university research team, in partnership with the Kansas United Methodist Church and a United Methodist philanthropy, facilitated planning and development of a statewide initiative to increase the capacity of laity-led health ministry teams. The purpose of this paper is to describe the processes utilized to design and implement an initiative to increase capacity for laity-led comprehensive health ministry among Kansas United Methodist Church congregations and to share the key elements of the initiative.
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Affiliation(s)
- Judy A Johnston
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA.
| | - Kurt Konda
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA
| | - Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA
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Williams RM, Wilkerson T, Holt CL. The role of perceived benefits and barriers in colorectal cancer screening in intervention trials among African Americans. HEALTH EDUCATION RESEARCH 2018; 33:205-217. [PMID: 29757376 PMCID: PMC5961187 DOI: 10.1093/her/cyy013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
The Health Belief Model (HBM) is widely used in health behavior interventions. The lack of diverse samples in the development of this theory warrants additional study on how it performs among minorities. While studies have utilized HBM to address colorectal cancer (CRC) screening, limited information exists confirming how these constructs influence screening. Data from three CRC screening trials were used to examine how perceived benefits/barriers perform among African Americans (AA) and whether they serve as mechanisms of the intervention effects on screening. The data were collected in AA churches (Study 1: N = 103; Study 2: N = 285; Study 3: N = 374) where lay members conducted CRC education to increase screening. Participants perceived benefits from colonoscopy (M = 2.4/3, SD = 0.87) and perceived few barriers (M = 0.63/8, SD = 1.1). Benefits were perceived for the fecal occult blood test (M = 11.4/15, SD = 2.1), and few barriers were reported (M = 11.7/30, SD = 3.4). Benefits more consistently predicted pre-intervention screening relative to barriers. For Study 3, individuals with fewer barriers reported a greater increase in colonoscopy screening at 12-months versus those with higher barriers (OR = 0.595, 95% CI = 0.368-0.964), P = 0.035). Benefits/barriers did not mediate the relationship. Potential measurement limitations, particularly for barriers, were uncovered and further research on how to assess factors preventing AA from screening is needed.
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Affiliation(s)
| | - Thomas Wilkerson
- Department of Epidemiology and Biostatistics, University of Maryland, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
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Slade JL, Holt CL, Bowie J, Scheirer MA, Toussaint E, Saunders DR, Savoy A, Carter RL, Santos SL. Recruitment of African American Churches to Participate in Cancer Early Detection Interventions: A Community Perspective. JOURNAL OF RELIGION AND HEALTH 2018; 57:751-761. [PMID: 29488060 PMCID: PMC5916822 DOI: 10.1007/s10943-018-0586-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This article describes the process used to engage and recruit African American churches to serve as participants in two multi-year behavioural cancer research interventions from a community perspective. Community-based organizations used purposive sampling in engaging and recruiting advisory panel members and churches to participate in these interventions. Trust, respect, open dialogue with participants, and commitment to address community health needs contributed to successful engagement and recruitment of African American churches to serve as participants in these cancer research projects. Our results may help others engage and recruit African American churches to participate in future interventions.
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Affiliation(s)
- Jimmie L Slade
- Community Ministry of Prince George's County, Post Office Box 250, Upper Marlboro, MD, 20773, USA.
| | - Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Janice Bowie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ebony Toussaint
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Darlene R Saunders
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Alma Savoy
- Community Ministry of Prince George's County, Post Office Box 250, Upper Marlboro, MD, 20773, USA
| | - Roxanne L Carter
- Community Ministry of Prince George's County, Post Office Box 250, Upper Marlboro, MD, 20773, USA
| | - Sherie Lou Santos
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
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25
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Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach. Transl Behav Med 2018; 7:517-528. [PMID: 28733726 DOI: 10.1007/s13142-017-0513-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.
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Williams RM, Tagai EK, Santos SLZ, Slade JL, Carter RL, Holt CL. The Role of Leadership Support in a Church-Based Cancer Education Implementation Study. JOURNAL OF RELIGION AND HEALTH 2018; 57:146-156. [PMID: 28597333 PMCID: PMC5723241 DOI: 10.1007/s10943-017-0427-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Leadership plays a role in the success of an organization's initiatives. We examined church leaders' support-as perceived by lay community health advisor (CHA) interventionists-and implementation outcomes in a cancer early detection trial. CHAs perceived that their pastors: helped promote the intervention (M = 3.1/4, SD 1.2) and attended about half (M = 1.6/3, SD 1.3) the workshops. CHAs used marginally more techniques to recruit members when they perceived pastors were engaged in promoting the program (r s = .44, p = .08). Pastor attendance was positively associated with member enrollment (r s = .50, p < .05). Pastor support may be related to receptivity of both CHAs and congregants to engage in church health promotion.
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Affiliation(s)
- Randi M Williams
- Department of Behavioral and Community Health, School of Public Health (255), University of Maryland, 4200 Valley Drive, College Park, MD, 20742, USA.
| | | | - Sherie Lou Zara Santos
- Department of Behavioral and Community Health, School of Public Health (255), University of Maryland, 4200 Valley Drive, College Park, MD, 20742, USA
| | - Jimmie L Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | - Roxanne L Carter
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | - Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health (255), University of Maryland, 4200 Valley Drive, College Park, MD, 20742, USA
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Adekeye OA, Adesuyi BF, Takon JG. Barriers to Healthcare among African Immigrants in Georgia, USA. J Immigr Minor Health 2018; 20:188-193. [PMID: 28213691 DOI: 10.1007/s10903-017-0549-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
African-born immigrants are among the fastest growing immigrant groups in the US, yet they are underrepresented in healthcare research, particularly, cancer research and tend to be categorized as African American or Black, obscuring any cultural nuances that exist. A survey designed to provide insight on the barriers to healthcare, knowledge of common cancers, and cancer risks was utilized during a health fair. Data analyses included descriptive statistics to examine participant demographics and other study variables of interest. Most of the participants reported African origin (approximately 97%), were males (59%), were aged 18-40 years (49%), had a minimum of some college education (78%), a household income of >$50,000 (35%) and were mostly uninsured (45%). The cost of medical treatment 19 (45.2%) was reported as a major barrier to healthcare access. The Health Fair presented the opportunity to provide free health screenings, education/awareness, and referral to follow-up resources. The findings are evidence of the importance and impact of health fairs in communities of greatest need.
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Affiliation(s)
- Oluwatoyosi A Adekeye
- Department of Community Health and Preventive Medicine, Satcher Health Leadership Institute, NCPC A-216C, Morehouse School of Medicine, 720 Westview Drive S.W., Atlanta, GA, 30310, USA.
| | - Bola F Adesuyi
- Redeemer's Medical Center, 5875 Peachtree Industrial Blvd #370, Norcross, GA, 30092, USA
| | - Joseph G Takon
- Redeemer's Medical Center, 5875 Peachtree Industrial Blvd #370, Norcross, GA, 30092, USA
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Tagai EK, Scheirer MA, Santos SLZ, Haider M, Bowie J, Slade J, Whitehead TL, Wang MQ, Holt CL. Assessing Capacity of Faith-Based Organizations for Health Promotion Activities. Health Promot Pract 2017; 19:714-723. [PMID: 29058956 DOI: 10.1177/1524839917737510] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Faith-based organizations (FBOs) are important venues for health promotion, particularly in medically underserved communities. These organizations vary considerably in their structural capacities, which may be linked to variability in implementation success for health promotion initiatives. Lacking an existing validated assessment of organizational capacity specific to FBOs, an initial prototype assessment was developed. METHOD The Faith-Based Organization Capacity Inventory (FBO-CI) assesses three structural areas of capacity: Staffing and Space, Health Promotion Experience, and External Collaboration. The multidisciplinary team, including FBO leaders, codeveloped the initial instrument. The initial reliability from a convenience sample of 34 African American churches including descriptions of FBOs representing three capacity levels is reported. RESULTS The FBO-CI demonstrated feasibility of administration using an in-person interview format, and the three subscales had acceptable internal reliability (α ~ .70). Most churches had an established health ministry (n = 23) and had conducted activities across an average of seven health areas in the previous 2 years. CONCLUSIONS This initial FBO-CI prototype is promising, and future work should consider validation with a larger sample of churches and domain expansion based on the conceptual model. The FBO-CI has a number of potential uses for researchers, FBO leaders, and practitioners working with FBOs in health promotion initiatives.
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Affiliation(s)
| | | | | | | | | | - Jimmie Slade
- 4 Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | | | - Min Qi Wang
- 1 University of Maryland, College Park, MD, USA
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Maxwell AE, Crespi CM, Arce AA, Bastani R. Exploring the effects of longstanding academic-community partnerships on study outcomes: A case study. Prev Med Rep 2017; 8:101-107. [PMID: 28948137 PMCID: PMC5601301 DOI: 10.1016/j.pmedr.2017.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Abstract
While sustained academic and community partnerships can improve relationships between research partners, they could also influence study outcomes. Research on this issue is limited. We conducted a trial (2010–15) to test two implementation strategies for an evidence-based intervention to promote colorectal cancer (CRC) screening at community organizations in Los Angeles (N = 17). For both strategies, trained community health advisors (CHAs) recruited Filipino Americans (N = 673) who were non-adherent to CRC screening guidelines. The main study outcome was CRC screening status of participants at 6-month follow-up. This case study compares outcomes among organizations that had participated in our prior effectiveness trial and new organizations with which we had no prior relationship. Using multilevel logistic regression with multiple imputation for missing outcomes, we compared CRC screening rates among previous versus new partners controlling for study condition and organizational, CHA and participant characteristics. Screening rates were substantially higher among participants of previous versus new partner organizations in unadjusted analysis (77% versus 55%, OR 2.8, p = 0.12), after adjusting for organization-level variables (81% versus 42%, OR 7.5, 95% CI [2.0–28.7], p = 0.003) and after additionally adding CHA and participant level factors to the model (79% versus 47%, OR 5.9, CI [1.3–27.3], p = 0.02). Analyses using complete cases and assuming not-screened for missing outcomes indicated similar differences in screening rates (30 and 33 percentage points, respectively). Study outcomes that are achieved with long-term community partners may not be generalizable to new partners. However, inclusion of new community partners is important for external validity of dissemination efforts in community settings. NCT01351220 (ClinicalTrials.gov) Long-term partnerships between academia and community can affect study outcomes. Study outcomes achieved with long-term community partners may not be generalizable. Inclusion of new partners may improve external validity of dissemination efforts. We recommend further examination of this issue in future studies. Inclusion of this construct in theoretical formulations should be considered.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Catherine M Crespi
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Anthony A Arce
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
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Shea CM, Young TL, Powell BJ, Rohweder C, Enga ZK, Scott JE, Carter-Edwards L, Corbie-Smith G. Researcher readiness for participating in community-engaged dissemination and implementation research: a conceptual framework of core competencies. Transl Behav Med 2017; 7:393-404. [PMID: 28341897 PMCID: PMC5645278 DOI: 10.1007/s13142-017-0486-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher's attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university's Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder's experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.
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Affiliation(s)
- Christopher M Shea
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA.
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA.
| | - Tiffany L Young
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- UNC Center for Health Equity, Department of Social Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Byron J Powell
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Catherine Rohweder
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Zoe K Enga
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
| | - Jennifer E Scott
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Lori Carter-Edwards
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Public Health Leadership Program, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7426, Chapel Hill, NC, 27599-7426, USA
| | - Giselle Corbie-Smith
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- UNC Center for Health Equity, Department of Social Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Scheirer MA, Santos SLZ, Tagai EK, Bowie J, Slade J, Carter R, Holt CL. Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study. Implement Sci 2017; 12:43. [PMID: 28351405 PMCID: PMC5371253 DOI: 10.1186/s13012-017-0576-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 03/21/2017] [Indexed: 11/13/2022] Open
Abstract
Background Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101:2059-2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL. Methods We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities, c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project’s management database; and open-ended comments from CHAs, staff, and community partners. Results Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops. Additional data confirm the maintenance of community partnerships, some changes in church health policies, and continued attention to health issues by churches and CHAs. Conclusions The multiple dimensions of sustainability require different data sources and levels of analysis and show varied sustainability outcomes in this project. The findings reinforce the dynamic nature of evidence-based health interventions in community contexts. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0576-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Sherie Lou Z Santos
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD, USA
| | - Erin K Tagai
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD, USA
| | - Janice Bowie
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jimmie Slade
- Community Ministry of Prince George's County, Seat Pleasant, MD, USA
| | - Roxanne Carter
- Community Ministry of Prince George's County, Seat Pleasant, MD, USA
| | - Cheryl L Holt
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, College Park, MD, USA.
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Santos SLZ, Tagai EK, Scheirer MA, Bowie J, Haider M, Slade J, Wang MQ, Holt CL. Adoption, reach, and implementation of a cancer education intervention in African American churches. Implement Sci 2017; 12:36. [PMID: 28292299 PMCID: PMC5351199 DOI: 10.1186/s13012-017-0566-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 03/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Use of technology is increasing in health promotion and has continued growth potential in intervention research. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this paper reports on the adoption, reach, and implementation of Project HEAL (Health through Early Awareness and Learning)-a community-based implementation trial of a cancer educational intervention in 14 African American churches. We compare adoption, reach, and implementation at the organizational and participant level for churches in which lay peer community health advisors (CHAs) were trained using traditional classroom didactic methods compared with a new online system. METHODS Fifteen churches were randomized to one of two study groups in which two CHAs per church were trained through either classroom ("Traditional"; n = 16 CHAs in 8 churches) or web-based ("Technology"; n = 14 CHAs in 7 churches) training methods. Once trained and certified, all CHAs conducted a series of three group educational workshops in their churches on cancer early detection (breast, prostate, and colorectal). Adoption, reach, and implementation were assessed using multiple data sources including church-level data, participant engagement in the workshops, and study staff observations of CHA performance. RESULTS The project had a 41% overall adoption rate at the church level. In terms of reach, a total of 375 participants enrolled in Project HEAL-226 participants in the Traditional group (43% reach) and 149 in the Technology group (21% reach; p < .10). Implementation was evaluated in terms of adherence, dosage, and quality. All churches fully completed the three workshops; however, the Traditional churches took somewhat longer (M = 84 days) to complete the workshop series than churches in the Technology group (M = 64 days). Other implementation outcomes were comparable between both the Traditional and Technology groups (p > .05). CONCLUSIONS Overall, the Project HEAL intervention had reasonable adoption, though reach could have been better. Implementation was strong across both study groups, suggesting the promise of using web-based methods to disseminate and implement evidence-based interventions in faith-based settings and other areas where community health educators work to eliminate health disparities.
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Affiliation(s)
- Sherie Lou Zara Santos
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 4200 Valley Dr., 1101 E SPH Building 255, College Park, MD, 20742, USA.
| | - Erin K Tagai
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 4200 Valley Dr., 1101 E SPH Building 255, College Park, MD, 20742, USA
| | | | - Janice Bowie
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Muhiuddin Haider
- Institute for Applied Environmental Health, University of Maryland, School of Public Health, College Park, MD, USA
| | - Jimmie Slade
- Community Ministry of Prince George's County, Upper Marlboro, MD, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 4200 Valley Dr., 1101 E SPH Building 255, College Park, MD, 20742, USA
| | - Cheryl L Holt
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 4200 Valley Dr., 1101 E SPH Building 255, College Park, MD, 20742, USA
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Kump B, Moskaliuk J, Cress U, Kimmerle J. Cognitive foundations of organizational learning: re-introducing the distinction between declarative and non-declarative knowledge. Front Psychol 2015; 6:1489. [PMID: 26483739 PMCID: PMC4588122 DOI: 10.3389/fpsyg.2015.01489] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/16/2015] [Indexed: 11/29/2022] Open
Abstract
Contemporary research into socio-cognitive foundations of organizational learning tends to disregard the distinction between declarative and non-declarative knowledge. By reviewing the literature from organizational learning research and cognitive psychology we explain that this distinction is crucial. We describe the foundations of organizational learning by referring to models that consider the interplay between individual and collective knowledge-related processes in organizations. We highlight the existence of a research gap resulting from the finding that these approaches have widely neglected the existence of different types of knowledge. We then elaborate on characteristics of declarative and non-declarative knowledge in general, consider organizations as structures of distributed cognition, and discuss the relationship between organizational knowledge and practice. Subsequently, we examine the role of declarative and non-declarative knowledge in the context of organizational learning. Here, we analyze (1) the cognitive and social mechanisms underlying the development of declarative and non-declarative knowledge within structures of distributed cognition; and (2) the relationship between alterations in declarative and non-declarative types of knowledge on the one hand and changes in organizational practice on the other. Concluding, we discuss implications of our analysis for organizational learning research. We explain how our integrative perspective may offer starting points for a refined understanding of the sub-processes involved in organizational learning and unlearning and may support a better understanding of practical problems related to organizational learning and change.
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Affiliation(s)
- Barbara Kump
- Knowledge Construction Lab, Knowledge Media Research Center, Tuebingen Germany ; Department of Human Resources and Organisation, University of Applied Sciences for Management and Communication, Vienna Austria
| | - Johannes Moskaliuk
- Department of Applied Cognitive Psychology and Media Psychology, University of Tuebingen Tuebingen, Germany
| | - Ulrike Cress
- Knowledge Construction Lab, Knowledge Media Research Center, Tuebingen Germany
| | - Joachim Kimmerle
- Knowledge Construction Lab, Knowledge Media Research Center, Tuebingen Germany ; Department of Applied Cognitive Psychology and Media Psychology, University of Tuebingen Tuebingen, Germany
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35
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Ilbawi AM, Anderson BO. Global cancer consortiums: moving from consensus to practice. Ann Surg Oncol 2015; 22:719-27. [PMID: 25623597 DOI: 10.1245/s10434-014-4346-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE AND DESIGN The failure to translate cancer knowledge into action contributes to regional, national, and international health inequities. Disparities in cancer care are the most severe in low-resource settings, where delivery obstacles are compounded by health infrastructure deficits and inadequate basic services. Global cancer consortiums (GCCs) have developed to strengthen cancer care expertise, advance knowledge on best practices, and bridge the cancer gap worldwide. Within the complex matrix of public health priorities, consensus is emerging on cost-effective cancer care interventions in low- and medium-resource countries, which include the critical role of surgical services. Distinct from traditional health partnerships that collaborate to provide care at the local level, GCCs collaborate more broadly to establish consensus on best practice models for service delivery. To realize the benefit of programmatic interventions and achieve tangible improvements in patient outcomes, GCCs must construct and share evidence-based implementation strategies to be tested in real world settings. REVIEW AND CONCLUSIONS Implementation research should inform consensus formation, program delivery, and outcome monitoring to achieve the goals articulated by GCCs. Fundamental steps to successful implementation are: (1) to adopt an integrated, multisectoral plan with local involvement; (2) to define shared implementation priorities by establishing care pathways that avoid prescriptive but suboptimal health care delivery; (3) to build capacity through education, technology transfer, and surveillance of outcomes; and (4) to promote equity and balanced collaboration. GCCs can bridge the gap between what is known and what is done, translating normative sharing of clinical expertise into tangible improvements in patient care.
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Affiliation(s)
- André M Ilbawi
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA,
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Santos SLZ, Tagai EK, Wang MQ, Scheirer MA, Slade JL, Holt CL. Feasibility of a web-based training system for peer community health advisors in cancer early detection among african americans. Am J Public Health 2014; 104:2282-9. [PMID: 25320894 PMCID: PMC4232123 DOI: 10.2105/ajph.2014.302237] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 12/26/2022]
Abstract
We describe the feasibility of a Web-based portal for training peer community health advisors (CHAs). We conducted a community-based implementation trial in African American churches between 2012 and 2014. The Web-based portal allows CHAs to log in and view 13 training videos, preparing them to deliver 3 cancer early detection workshops in their churches. Of 8 churches, 6 completed the training, each certifying 2 CHAs. These CHAs took an average of 26 days to complete the training, requiring little technical assistance. Additional technical assistance was required to implement the workshops. The Web-based system appears to be a feasible method for training lay individuals for the CHA role and has implications for increasing the reach of evidence-based interventions.
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Affiliation(s)
- Sherie Lou Z Santos
- Sherie Lou Z. Santos, Erin K. Tagai, Min Qi Wang, and Cheryl L. Holt are with the Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park. Mary Ann Scheirer is with Scheirer Consulting, Princeton, NJ. Jimmie L. Slade is with Community Ministry of Prince George's County, Upper Marlboro, MD
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