The Role of Community Health Advisors’ Cancer History in Implementation and Efficacy of a Cancer Control Intervention

Abstract Purpose: Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what criteria makes for an effective CHA. We examined the relationship between CHAs’ personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial.Methods: Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N=375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops and efficacy as workshop participants’ cancer knowledge scores at 12-month follow-up, controlling for baseline scores. Results: CHA’s personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (p=.03). In addition, there was a significant, positive association between male CHAs’ family history of cancer and male workshop participants’ prostate cancer knowledge scores at 12 months (estimated beta coefficient=0.49, p<.01) after adjusting for workshop participant baseline knowledge scores, the CHAs’ competence score, and the CHAs’ education levels. Conclusions: Findings suggest CHAs with family history of cancer may be particularly suitable for cancer peer education, though further research is needed to confirm this and identify other factors conducive to CHAs’ success.

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Using community health advisors to increase lung cancer screening awareness in the Black Belt: A pilot study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.117 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 117-117

Author(s):

Soumya J. Niranjan ◽

William Opoku-Agyeman ◽

Tara Bowman ◽

Claudia M. Hardy ◽

Monica L. Baskin ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Family History ◽

Community Health ◽

Lung Cancer Screening ◽

Black Belt ◽

Disease Stage ◽

Cancer Knowledge ◽

Community Health Advisors ◽

History Of

117 Background: Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection continues to elude populations with the highest risk for lung cancer death. Consistent with the national rate, current screening rate in Alabama is dismal at 4.2%. While public awareness of LCS may be a likely cause there are no studies that have thoroughly evaluated current knowledge of LCS within the Deep South. Therefore, we measured (LCS) knowledge before and after receiving education delivered by Community Health Advisors (CHAs) among high-risk individuals living in medically-underserved communities of Alabama and to determine impact of psychological, demographic, health status and cognitive factors on rate of lung cancer screening participation. Methods: Participants were recruited from one urban county and six rural Black Belt counties (characterized by poverty, rurality, unemployment, low educational attainment and disproportionate lack of access to health services).100 individuals (i) aged between 55 to 80 years (ii) Currently smoke or have quit within the past 15 years. (iii) Have at least a total of 30-pack-year smoking history were recruited. Knowledge scores to assess lung cancer knowledge were calculated. Paired t-test was used to assess pre and post knowledge score improvement. Screening for lung cancer was modeled as a function of predisposed factors (age, gender, insurance, education, fatalism, smoking status, and history of family lung cancer). Results: Average age was 62.94(SD = 6.28), mostly female (54%); mostly current smokers (53% ). Most participants (80.85%) reported no family history of cancer. Fatalism was low, with a majority of the participants disagreeing that a cancer diagnosis is pre-destined (67.7%) and that there are no treatments for lung cancer (88.66%). Overall, lung cancer knowledge increased significantly from baseline of 4.64(SD = 2.37) to 7.61(SD = 2.26). Of the 100 participants, only 23 underwent screening due to lack of access to primary care providers and reluctance of PCPs to provide referral to LCS. 65% of those who were screened reported family history of lung cancer. Regression analysis revealed no significant association between risk factors and the decision to get screened by participants. Conclusions: Our study demonstrates that while CHA delivered education initiatives increases lung cancer screening knowledge, there are significant structural barriers that prohibit effective utilization of LCS which needs to be addressed.

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Racial/Ethnic Differences in the Association Between Family History of Cancer and Smoking Status Among US Adults

Annals of Epidemiology ◽

10.1016/j.annepidem.2020.08.025 ◽

2020 ◽

Vol 52 ◽

pp. 103-104

Author(s):

I. Jackson ◽

K. Okhawere ◽

G. Oboli ◽

A. Opiegbe ◽

O. Eromosele

Keyword(s):

Family History ◽

Ethnic Differences ◽

Smoking Status ◽

Family History Of Cancer ◽

History Of ◽

Racial Ethnic ◽

History Of Cancer

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Family history of cancer in first degree relatives and risk of cancer of unknown primary

European Journal of Cancer Care ◽

10.1111/ecc.13485 ◽

2021 ◽

Author(s):

Alexander L. R. Grewcock ◽

Karlijn E. P. E. Hermans ◽

Matty P. Weijenberg ◽

Piet A. Brandt ◽

Caroline Loef ◽

...

Keyword(s):

Family History ◽

Cancer Of Unknown Primary ◽

Unknown Primary ◽

Family History Of Cancer ◽

First Degree Relatives ◽

History Of ◽

Risk Of Cancer ◽

History Of Cancer

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Clinical, Pathological and Molecular Characteristics of Chilean Patients with Early-, Intermediate- and Late-Onset Colorectal Cancer

Cells ◽

10.3390/cells10030631 ◽

2021 ◽

Vol 10 (3) ◽

pp. 631

Author(s):

Karin Alvarez ◽

Alessandra Cassana ◽

Marjorie De La Fuente ◽

Tamara Canales ◽

Mario Abedrapo ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Age Of Onset ◽

Late Onset ◽

Molecular Characteristics ◽

Family History Of Cancer ◽

Molecular Features ◽

Age Of Diagnosis ◽

History Of ◽

History Of Cancer

Colorectal cancer (CRC) is the second most frequent neoplasm in Chile and its mortality rate is rising in all ages. However, studies characterizing CRC according to the age of onset are still lacking. This study aimed to identify clinical, pathological, and molecular features of CRC in Chilean patients according to the age of diagnosis: early- (≤50 years; EOCRC), intermediate- (51–69 years; IOCRC), and late-onset (≥70 years; LOCRC). The study included 426 CRC patients from Clinica Las Condes, between 2007 and 2019. A chi-square test was applied to explore associations between age of onset and clinicopathological characteristics. Body Mass Index (BMI) differences according to age of diagnosis was evaluated through t-test. Overall (OS) and cancer-specific survival (CSS) were estimated by the Kaplan–Meier method. We found significant differences between the age of onset, and gender, BMI, family history of cancer, TNM Classification of Malignant Tumors stage, OS, and CSS. EOCRC category was characterized by a family history of cancer, left-sided tumors with a more advanced stage of the disease but better survival at 10 years, and lower microsatellite instability (MSI), with predominant germline mutations. IOCRC has shown clinical similarities with the EOCRC and molecular similarities to the LOCRC, which agrees with other reports.

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