Abstract
Family health history (FHH) is an evidence-based genomics tool used in cancer prevention and education. Chinese Americans, the largest Asian American group, face unique barriers in FHH collection and communication. This study aimed to evaluate the efficacy of culturally and linguistically appropriate community health worker (CHW)–delivered FHH-based breast cancer (BC) education and services to Chinese Americans. A total of 1129 Chinese Americans received FHH-based BC education and service delivered by our trained Chinese American CHWs. Participants responded to evaluation surveys before, immediately after, and 3 months after the education and service. Participating Chinese Americans showed significant increases in rates of collecting FHH of BC, discussing FHH of BC with family members, informing their primary care physicians of their FHH of BC, and discussing their FHH of BC with their primary care physicians at 3 months post-education and service compared to the baseline data (all Ps < 0.01). Attitudes, intention, and self-efficacy related to FHH of BC communication and collection and FHH of BC knowledge were improved both immediately after and 3 months after the delivery of the education and services (all Ps < 0.01). Within 3 months, ~ 14.3% of participants who had a high risk of BC based on FHH reported visiting geneticists for genetic evaluation. Our Chinese American CHW-delivered FHH-based BC education and services showed initial success in increasing knowledge, collection and communication of BC-related FHH, and genetic service utilization among Chinese American participants. This study can serve as a starting point for conducting more robust studies, such as randomized controlled trials, in the future.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
The data supporting the findings of this study are available upon request from the corresponding author.
References
Pew Research Center (2021) Key facts about Asian origin groups in the U.S. https://www.pewresearch.org/short-reads/2021/04/29/key-facts-about-asian-origin-groups-in-the-u-s/. Accessed 11 Jul 2023
Centers for Disease Prevention and Control (2021) Cancer incidence and 5-year survival among Asian/pacific islanders, United States—2008–2017. https://www.cdc.gov/cancer/uscs/about/data-briefs/no22-cancer-incidence-survival-Asian-Pacific-Islanders-2008-2017.htm. Accessed 11 Jul 2023
Centers for Disease Prevention and Control (2022) What are the risk factors for breast cancer? https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm. Accessed 11 Jul 2023.
Centers for Disease Prevention and Control (2023) Breast and ovarian cancer and family health history. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/breast_ovarian_cancer.htm. Accessed 11 Jul 2023
Wu RR, Myers RA, Neuner J, McCarty C, Haller IV, Harry M et al (2022) Implementation-effectiveness trial of systematic family health history based risk assessment and impact on clinical disease prevention and surveillance activities. BMC Health Serv Res 22(1):1486. https://doi.org/10.1186/s12913-022-08879-2
Chen LS, Li M, Talwar D, Xu L, Zhao M (2016) Chinese Americans views and use of family health history: a qualitative study. PLoS One 11(9):e0162706. https://doi.org/10.1371/journal.pone.0162706
LeBan K, Kok M, Perry HB (2021) Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities. Health Res Policy Syst 19(Suppl 3):116. https://doi.org/10.1186/s12961-021-00756-4
Sharma N, Harris E, Lloyd J, Mistry SK, Harris M (2019) Community health workers involvement in preventative care in primary healthcare: a systematic scoping review. BMJ Open 9(12):e031666. https://doi.org/10.1136/bmjopen-2019-031666
Hand T, Rosseau NA, Stiles CE, Sheih T, Ghandakly E, Oluwasanu M et al (2021) The global role, impact, and limitations of community health workers (CHWs) in breast cancer screening: a scoping review and recommendations to promote health equity for all. Glob Health Action 14(1):1883336. https://doi.org/10.1080/16549716.2021.1883336
Mojica CM, Morales-Campos DY, Carmona CM, Ouyang Y, Liang Y (2016) Breast, cervical, and colorectal cancer education and navigation: results of a community health worker intervention. Health Promot Pract 17(3):353–363. https://doi.org/10.1177/1524839915603362
Cancer Prevention & Research Institute of Texas (n.d.) Funding cancer prevention & research to help Texans conquer cancer. https://www.cprit.state.tx.us/. Accessed 11 Jul 2023
Gupta R, Yick AG (2001) Preliminary validation of the acculturation scale on Chinese Americans. J Soc Work Res Eval 2(1):43–56
Terpstra J, Coleman KJ, Simon G, Nebeker C (2011) The role of community health workers (CHWs) in health promotion research: ethical challenges and practical solutions. Health Promot Pract 12(1):86–93. https://doi.org/10.1177/1524839908330809
Li M, Zhao S, Young CM, Foster M, Huei-Yu Wang J, Tseng TS et al (2021) Family health history–based interventions: a systematic review of the literature. Am J Prev Med 61(3):445–454. https://doi.org/10.1016/j.amepre.2021.03.022
Chatterji P, Li Y (2021) Effects of the COVID-19 pandemic on outpatient providers in the United States. Med Care 59(1):58–61. https://doi.org/10.1097/mlr.0000000000001448
National Human Genome Research Institute (n.d.) Genetic counseling FAQ. https://www.genome.gov/FAQ/Genetic-Counseling. Accessed 11 Jul 2023
Papanicolas I, Woskie LR, Jha AK (2018) Health care spending in the United States and other high-income countries. JAMA 319(10):1024–1039. https://doi.org/10.1001/jama.2018.1150
Roland KB, Milliken EL, Rohan EA, DeGroff A, White S, Melillo S et al (2017) Use of community health workers and patient navigators to improve cancer outcomes among patients served by federally qualified health centers: a systematic literature review. Health Equity 1(1):61–76. https://doi.org/10.1089/heq.2017.0001
Funding
This work was funded by the Cancer Prevention and Research Institute of Texas (PP180110).
Author information
Authors and Affiliations
Contributions
Conceptualization: LSC; data curation and analysis: YY, ZZ, and HW; funding acquisition: LSC; methodology: LSC, YY, HW, and ZZ; project administration: LSC, YY, ZZ; writing—original draft: BA; writing—review and editing: all authors.
Corresponding author
Ethics declarations
Ethics Approval
The study protocol was reviewed by the Texas A&M University Institutional Review Board. All data used were de-identified.
Competing Interests
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Assoumou, B., Yeh, YL., Wang, H. et al. Efficacy of Community Health Worker–Delivered Family Health History-Based Breast Cancer Education and Services Among Chinese Americans. J Canc Educ (2024). https://doi.org/10.1007/s13187-024-02412-1
Accepted:
Published:
DOI: https://doi.org/10.1007/s13187-024-02412-1