title: The Outcome Evaluation of a CHW Cancer Prevention Intervention: Testing Individual and Multilevel Predictors Among Hispanics Living Along the Texas-Mexico Border.
abstract: This paper evaluates the effectiveness of community health workers/promotores (CHWs) in promoting cancer preventive behaviors in the 2011-2013 Education to Promote Improved Cancer Outcomes (ÉPICO) project. The ÉPICO project utilized CHWs to disseminate cancer education to predominately Spanish-speaking Hispanics living in colonias in the Lower Rio Grande Valley of Texas. The CHWs received training to become Texas-certified CHW instructors and specialized training in message tailoring, and they delivered more than 5000 units of resident education on cancer prevention/detection, treatment, and survivorship for breast, cervical, and colorectal cancer. Using panel data to examine overtime changes in cancer knowledge among Lower Rio Grande Valley residents, the evaluation found significant changes from baseline to both times 1 and 2. Additional individual-level analysis indicated that the increase in resident cancer knowledge was predicted by residents' perceptions of CHW credibility and intention to change their lifestyles. Multilevel analysis also showed that the increase in cancer prevention knowledge among residents was predicted by attributes of the CHWs who taught them. In particular, CHWs with higher education levels had the most impact on residents' increased knowledge over time. Unexpectedly, CHWs with more years of experience were less effective teachers than their early-career counterparts.
authors.affiliation: Texas A&M Health Science Center, Center for Community Health Development, National CHW Training Center, 1266 TAMU, College Station, TX, 77843, USA. knimmons@tamhsc.edu.
authors.forename: Katharine
authors.initials: K
authors.lastname: Nimmons
authors.affiliation: Department of Communication, Texas A&M University, 4234 TAMU, College Station, TX, 77843, USA.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Beaudoin
authors.affiliation: Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, 1718 Pine Street, Abilene, TX, 79601, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: St John
mesh_terms: D003150:Community Health Workers / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000379:methods*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013781:Texas
keywords: Cancer education; Community health workers; Hispanic populations