Table 23CHW cancer screening: clinical breast examination

Author, Year
Study Design
Population Setting
Sample Size
Quality
Intensity of CHW InterventionStudy GroupsResults
Sung et al., 199761; Sung et al., 199262

RCT

Inner-city African Americans, state unspecified

195

Fair
HighG1: CHW home visits, education on breast and cervical cancer, breast self-exam, educational materials on screening, facilitation to address logistical barriers to screening

G2: Mailed educational materials on cancer screening
Pretest/posttest change in self-report of receiving CBE for entire sample: G1: 55.2%/64.5%
G2: 55.7%/59.5%, difference in change: 4.9 (95% CI, −6.1–4.1)

Pretest/posttest change in self-report of receiving CBE, postintervention respondents only: G1: 59.1%/72.0%
G2: 57.8%/61.8%, difference in change: 8.9% (95% CI, 1.1–16.7)

Posttest rate of self-report of receiving CBE, women not previously on recommended screening schedules, whole sample: G1: 37.0%
G2: 28.6%, difference in change: 8.4% (95% CI, −6.9–23.7)

Posttest rate of self-report of receiving CBE, women not previously on recommended screening schedules, postintervention respondents only: G1: 71.1%
G2: 46.5%, difference in change: 24.6%
(95% CI, 3.9–45.3)
Hiatt et al., 2008125

Prospective cohort

Public health clinics and the low-income neighborhoods in San Francisco and Contra Costa County, California

1,616

Fair
ModerateG1: One-on-one visits at various events and locations; presentations to community-based organizations (agencies); and Women’s Health Days, offering free mammograms, Pap tests, and breast self-examination instruction

G2: No intervention (control)
Ever completed clinical breast examination (Total N [%] pretest/Total N [%] posttest): G1: 801 (94)/812 (95)
Χ 2 = NR, not significant
G2: 798 (82)/803 (87)
Χ 2 = NR, P=0.006

Completed clinical breast examination in past year (Total N [%] pretest/Total N [%]posttest): G1: 800 (75)/809 (74)
Χ 2 = NR, not significant
G2: 796 (56)/803 (60)
Χ 2 = NR, not significant

Completed 3 or more clinical breast examinations in past 5 years (Total N [%]pretest/Total N [%] posttest): G1: 793 (73)/809 (73)
Χ 2 = NR, not significant
G2: 792 (54)/800 (54)
Χ 2 = NR, not significant
Navarro et al., 1998;111
Navarro et al., 1995;110
Navarro et al., 2000112

RCT

Low-income Latinas, southeast San Diego County, California

365

Poor
ModerateG1: CHW delivering community living skills sessions, details NR

G2: CHW delivering cancer education sessions, 12 weekly group sessions conducted over 3 months plus 2 additional sessions offered within a year of beginning of group meetings
Pretest-posttest changes in percentage of women who had CBE within past year:

Participant unit of analysis (n = 359)
G1: 15.5
G2: 17.7
P = 0.589
t = 0.54

CHW unit of analysis (n = 35)
G1: 19.3
G2: 19.5
P = 0.967
t = 0.04

Odds of CBE 1-year and 2-year followup for cancer screening group (P value): Year 1: 1.21 (0.556)
Year 2: 1.93 (0.038)
Wilson et al., 2008116

Repeated cross-sectional survey of women attending salons randomly assigned to experimental and control groups

Neighborhood hair salons, Brooklyn, New York

40 salons/1,210 respondents

Poor
ModerateIntervention consisted of education, counseling, and information on location of screening services during salon appointment

G1: Control, before intervention
G2: Stylist group, before intervention

G3: Control, after intervention
G4: Stylist group, after intervention
CBE in past 3 months: G1: 27%
G2: 27%, P = 0.85 for differences between
G1 and G2
G3: 27%
G4: 29%
AOR, 1.2; adjusted 95% CI, 0.9–1.7

Adj, adjusted; CBE, clinical breast examination; CHW, community health worker; CI, confidence interval; NR, not reported; OR, odds ratio; RCT, randomized controlled trial; t, t-test.

From: 3, Results

Cover of Outcomes of Community Health Worker Interventions
Outcomes of Community Health Worker Interventions.
Evidence Reports/Technology Assessments, No. 181.
Viswanathan M, Kraschnewski J, Nishikawa B, et al.

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