Photo Credit: instedd.org (Innovative Support for Emergencies, Disease, and Disasters)
Community Health Workers are trusted members of the community with a passion for helping community members prevent or manage cancer and chronic disease. Locally, the Community Health Worker Program through the Penn State Cancer Institute attempts to link communities and systems of care. Specifically, its goal is to decrease morbidity and mortality from cancer and chronic disease among the medically underserved African American community of Dauphin County through techniques like:
- Navigating clients to resources and services
- Providing education and skills
- Removing barriers that block access to care
- Supporting client with follow-up and follow through to completing their medical objectives
Community Health Worker Program in more detail:
Treatment of breast cancer at an early stage reduces the risk of death from breast cancer. However, the percentage of women with breast cancer that is detected at an early stage is relatively low among medically underserved populations such as those who are of a racial/ethnic minority or reside in a rural community. To increase the likelihood that cancer is detected at an early stage, women at average risk are recommended to have regular clinical breast exams and mammography. However, access to mammography, especially newer digital mammography, is not equivalent for all women because of patient (e.g., financial; fear) or system barriers (e.g., local availability of services). To overcome these barriers, the Community Guide for Preventive Services1 found evidence in the scientific literature to recommend one-on-one education and group education as methods to overcome these barriers. Specifically, the Community Guide recommends community health workers (CHWs) (also known as lay health advisors and promotoras) as a mode for delivery of one-on-one or group education. Importantly, the recommendation for CHWs to overcome these barriers is not limited to screening for breast cancer, but also includes screening for other cancers and reducing cancer risk behaviors.
2012 | 2013 | 2014 | 2015 | 2016 | Total | |
Mammograms | 8 | 31 | 63 | 126 | n/a | 228 |
Breast cancers | 0 | 1 | 1 | 3 | n/a | 5 |
Breast health education | 450 | 150 | 400 | 600 | 120 | 1,720 |
Transportation services | 0 | 0 | 50 | 61 | 0 | 111 |
BMI screenings | 0 | 150 | 189 | 113 | 89 | 541 |
Colorectal cancer education | 312 | 60 | 40 | 79 | 149 | 640 |
Cervical cancer education | 100 | 76 | 39 | 27 | 47 | 289 |
Nutrition and physical activity education | 111 | 84 | 51 | 67 | 23 | 336 |
Nutrition workshops | 0 | 48 | 65 | 50 | n/a | 163 |
Annual cancer education summit | 125 | 93 | 114 | 110 | 115 | 557 |
To address cancer disparities in the city of Harrisburg, the Community Sciences and Health Outcomes (CSHO) Shared Resource of the Penn State Cancer Institute (Cancer Institute) established a Community Health Worker Program (CHWP) in 2011. The program objective is to identify and equip CHWs to assist their peers increase the use of evidence-based cancer screening among women who are of average risk and cancer preventing behaviors among all individuals. The CHWP serves as a bridge between the patient and access to care. CHWs are lay persons who are trusted members of the target community and have a passion for improving the health of their peers. The Cancer Institute provides initial (16 hours) and ongoing training (4 hours per quarter) to each CHW. The program’s initial focus was on breast cancer screening, but is expanding to include cervical and colorectal cancer screening, as well preventive behaviors, such as physical activity and balanced nutrition. With a staff of 15 CHWs, most of whom have been with the program since its inception, the CHWP is expanding to rural and other medically underserved communities in Pennsylvania. In addition, the CHWP now works inside Penn State clinics, accepting direct referrals from physicians and nurse practitioners.
The community health worker program is supported in part with funding from the Pennsylvania Department of Health (SAP 4100073089), the Appalachia Community Cancer Network (U01 CA114622) and the Penn State Cancer Institute. The CSHO Shared Resource is grateful to the Northern Appalachia Cancer Network and its community and clinical partners. For more information, contact:
Patricia A. Robinson, CHW and Program Manager
Penn State Cancer Institute
500 University Drive, Hershey, PA 17033
717-531-1050
or:
Eugene J. Lengerich, VMD, MS
Faculty Director, Community Sciences and Health Outcomes (CSHO) Shared Resource
Associate Director, Health Disparities and Engagement
Penn State Cancer Institute
717-531-7178; elengerich@psu.edu
- The Guide to Community Preventive Services. Centers for Disease Control and Prevention, 2017. (Accessed 3/31/2017, at http://www.thecommunityguide.org/about/default.htm.)