title: Evaluation of a training program to prepare community health representatives to promote breast and cervix cancer screening among native american women.
abstract: BACKGROUND
  Native American women have very poor 5-year breast and cervix cancer survival rates compared to other US population groups. We evaluated a training program that prepares community health representatives (CHRs) to promote prevention and early detection of these diseases. Two questions guided the evaluation: (1) Are CHRs an appropriate focus of training? and (2) Does training empower CHRs and, indirectly, their facilities to educate about breast and cervix cancer, promote screening, and teach breast self-exam skills to American Indian and Alaska Native women?
  
  
  METHODS
  Twenty CHRs (3 Indian Health Service regions, 9 separate employers) responded to a telephone survey consisting of Likert scale and multiple option and short-answer questions. Analysis relied on descriptive statistics and measures of central tendency.
  
  
  RESULTS
  By tenure, cultural and community membership, and ability to adapt to audience needs and setting demands, CHRs make appropriate training recipients. Training improves skills and their use and appears to increase employers' reliance on CHRs for screening promotion and education about cancer. Posttraining, more women hear and heed the screening message.
  
  
  CONCLUSIONS
  CHRs are an appropriate focus of training. Training leads to increased screening-related activities and should be continued and expanded.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN 55905, USA. petersen.wesley@mayo.edu
authors.forename: Wesley O
authors.initials: WO
authors.lastname: Petersen
authors.forename: Mary Alice
authors.initials: MA
authors.lastname: Trapp
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sellers
authors.forename: Ann M
authors.initials: AM
authors.lastname: Nicometo
authors.forename: Judith S
authors.initials: JS
authors.lastname: Kaur
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000517:prevention & control*; D003153:Community Health Services; D003625:Data Collection; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D007198:Indians, North American; D008403:Mass Screening; D015397:Program Evaluation; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000517:prevention & control*