How CHW Teams Improve Breast Cancer Screening

Contributors Monique Cuvelier and Wajeeh Khan

Breast cancer doesn’t come from one obvious cause, and it doesn’t affect everyone equally. That makes it challenging to address and manage though breast cancer screening. When 1 in 8 U.S. women will develop invasive breast cancer in the course of her life—it’s an urgent problem. And it’s one that managed care agencies, healthcare systems, and communities have struggled with for decades. How do you systematically address something so unsystematic?

[RELATED: CHWTraining Opens New Course on Breast Cancer Screening for 2020]

The Role of CHWs

Community health workers are one part of the answer. They have a knack for making paths through hard-to-reach areas and populations. They’re powerful allies in the battle against breast cancer, especially in underserved communities, where they live, work, or understand deeply.

The WHO highlights that CHWs must respond to the local, cultural, and societal norms to ensure community ownership and approval.

Their impact on women with breast cancer or at high risk is broad. They can connect people directly with providers for treatment. They can give clients and patients resources about disease management. They can bust myths about breast cancer (no, mammograms don’t cause cancer) and provide other education about lowering risk. They can also be there just to listen and provide social support and advise on health insurance and financial assistance.

In a recent study, participants that took part in a CHW intervention reported increased rates of screening mammography. Mammography is the standard screening procedure for breast cancer in developed countries, but this is not feasible for population-based interventions.

CHWs have a positive effect in increasing mammography rates. A meta-analysis of 18 studies reported that CHW interventions related to breast cancer screening resulted in a significant increase in mammography rates and clinical visits. These results were strongest for urban and medical settings and where communities and CHWs were ethnically similar (Wells et al., 2011). In another study that compared the screening rates in Vietnamese women by lay health workers and media education, lay health workers significantly increased clinical breast examination and mammography rates.

If you’re not sure if CHWs can help improve breast cancer screening in your agency, or what kinds of job skills are needed, take a look at some of these benefits below to give you an idea.

6 Ways CHWs Improve Breast Cancer Outcomes

  1. Increase breast cancer screening
  2. Connect people directly to providers for treatment
  3. Reduce barriers to screening and healthylifestyle changes
  4. Give clients and patients resources about disease management
  5. Bust myths about breast cancer
  6. Provide guidance about lowering risk

1. Increase Breast Cancer Screening

Promoting breast cancer screening is the top boost CHWs can give clients to catch breast cancer early. Making CHWs part of cancer interventions can increase breast cancer screening rates.  The Community Preventive Services Task Force recommends CHWs because they “increase demand for screening services using group education, one-on-one education, client reminders, or small media” and “improve access to screening services by reducing structural barriers.”

Research shows that CHW interventions work. In a study conducted on rural African-American women, CHWs intervention reported an 11 percent increase in clinical mammography rates compared to women who were not contacted by CHWs.

An ASTHO study shows that patient navigator and CHW efforts have led to increases in cancer screening rates between 11-17 percent. They also led to increases in rates of adherence to diagnostic follow-up care up to 29 percent.

2. Connect People Directly to Providers for Treatment

CHWs are links or bridges between the community and local health systems. They can act as patient navigators in the continuum of breast cancer screening, diagnosis, and treatment. The role of CHWs is highly effective in increasing access to local health services. This helps significantly reduce potential delays in diagnosis.

For example, in South Africa, CHWs act as treatment buddies for HIV patients, similarly they can act as navigators for breast cancer patients. They can provide support both emotional and logistic, increasing access to healthcare.

3. Reduce Barriers to Screening and Healthy Lifestyle Changes

Breast cancer screening programs have been introduced worldwide, but many hurdles stand between clients and success. Clients don’t get screened for reasons ranging from lack of knowledge regarding the disease, low income, and no prior history of breast cancer. CHWs can help address and remove those barriers and provide education.

Some examples how:

  • Lack of health insurance –provide information on signing up for insurance and resources such as the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for free or low-cost breast and cervical cancer screenings.
  • Geographic barriers – help find sources of transportation or mobile screening vangs
  • Guidelines education – provide proper information regarding screening, including when and how often
  • Structural and interpersonal barriers – give social support and advice to promote screening

4. Give Clients and Patients Resources About Disease Management

Linguistic and health literacy interventions from CHWs are helpful to address breast cancer screening in racial and socioeconomic minority groups. These interventions have been cost-effective and successful.

For example, Kin Keeper Cancer Prevention trained female CHWs to provide at-home education in selected communities in English, Spanish and Arabic. They conducted surveys with enrollees, and the literacy rates improved in all participants.

5. Bust Myths About Breast Cancer

CHWs can clear up many of the myths about breast cancer through education. Myths range from fuzzy misunderstandings to directly harmful. For example, some people think lifestyle choices such as maintaining a healthy diet, exercising regularly, and limiting alcohol eliminates the chance of breast cancer. While this can lower the risk, it doesn’t eliminate it.

On the other end, some misinformation states mammograms cause breast cancer rather than detect it.

6. Provide Guidance About Lowering Risk

Many breast cancer risk factors come down to lifestyle, including how much a person smokes, eats poorly, and gets physical activity. CHWs can provide clients the information and support they need to make these challenging lifestyle changes.

They can often provide more than basic education. They can help clients and patients really understand what a healthy lifestyle is, how to implement a doctor’s advice, and find the motivation to continue on a positive path.

The longer a CHW program is established in any given community, the more successful it becomes. The success of any CHW program depends upon the support of the community, along with continuous resource provision and training. Regular training is the most effective strategy in increasing the productivity of the program in the community. Breast cancer screening can be integrated into regular primary healthcare visits performed by CHWs.

The Top CHW Conferences of 2020

Every year more people become community health workers across the United States, and every year there are more conferences to support them. Conferences, workshops, annual meetings, and symposiums are excellent opportunities to brush up on your skills, learn new skills, and hear from the experts and thinkers in the community and public health industry. They’re also great for meeting and networking with peers in the community health community if you want to start your CHW training program.

Last year we researched and gathered a list of the top CHW conferences, and we’ve done it again. Here’s this year’s list, ordered by date. Pull out your calendar, scroll through this list, and find some that sound exciting. We’ve arranged these events by date and state. This will be updated regularly, so check back often.

Contact us if you would like to add a CHW conference to this list. To be considered, please send us a message containing all details including the conference name, dates of the event, location, and a link to the event’s website.

Top CHW Conferences of 2020

    1. CHW Employer Event – “CHWs and Sustainability in RI” (North Providence, RI)
    2. Western Forum for Migrant and Community Health (Sacramento, CA)
    3. Northwest Rural Health Conference (Spokane, WA)
    4. CCHF (Christian Community Health Fellowship) Conference 2021 (Cincinnati, OH)
    5. Indiana CHW/CRS Annual Conference (Plainfield, IN)
    6. The Academy of Oncology Nurse & Patient Navigators (AONN+) (Baltimore, MD)
    7. MNCHWA Conference (Plymouth, MN)
    8. Annual Rural Health Conference (Online)
    9. Kansas Community Health Worker (CHW) Symposium (Online)
    10. ACHI 2020 National Conference (Cleveland, OH)
    11. South Carolina Community Health Worker Annual Conference (Columbia, SC)
    12. Community Health Workers: Taking Action and Changing the Community
    13. Florida Community Health Worker Coalition Summit (Orlando, FL)
    14. Visión y Compromiso’s 18th Annual Conference (Los Angeles, CA)
    15. Community Health Institute & EXPO (San Diego, CA)
    16. APHA’s Annual Meeting (Online)
    17. TGCCPA Annual Conference (Houston, TX)

    CHW Employer Event – “CHWs and Sustainability in RI”

    Date: January 31, 2020
    Location: North Providence, RI
    Cost: Free

    This event brings together employers, insurers, and other healthcare/social services stakeholders in Rhode Island to discuss progress and plans for making the Community Health Worker workforce more sustainable in our state.

    • Learn lessons from a Massachusetts health sector innovator on forging collaboration among Medicaid, state DOH, Accountable Care Organizations (AOs) and Community Partners
    • Understand better what your CHWs and Peer Recovery Specialists do by getting a special training on supporting employees recovering from substance use disorder
    • Enjoy lunch with partners doing the same work
    • Discuss ways the Community Health Worker Association of RI can best help you to secure CHWs with the appropriate and most current training and to supervise them effectively

    Western Forum for Migrant and Community Health

    Date: February 19-21, 2020
    Location: Sacramento, CA
    Cost: $150-$350

    The Western Forum is a regionally celebrated and nationally recognized conference known for innovative content, expert speakers, and a diverse audience from various disciplines. We look forward to hosting another engaging and vibrant conference. We hope to see you at our annual conference.

    Northwest Rural Health Conference

    Date: TBD
    Location: Spokane, WA
    Cost: N/A

    Conference goals are: Highlight rural health public policy issues, – Identify changes in the delivery of and access to rural health care, – Identify ways that data & technology are improving health in rural communities, – Examine issues that impact rural hospitals and – Collaborate with peers on innovative models for rural health care delivery.

    Who should attend? – Rural hospital leadership and Board of Directors – Rural clinic administrators & staff – Quality managers ~ Risk Managers – Public health officers – State and local leaders – Policy makers – EMS staff – Home health staff

    CCHF (Christian Community Health Fellowship) Conference 2021

    Date: March 25-27, 2021
    Location: Cincinnati, OH
    Cost: $95-$325

    Hundreds of practitioners and students from all over the United States gather annually at the CCHF conference to share knowledge, skills, and experiences, and spend time worshipping and seeking God. If you’re serious about domestic medical missions, this conference is a must. Scholarships are available for medical students and residents.

    Indiana CHW/CRS Annual Conference

    Date: April 21, 2020
    Location: Plainfield, IN
    Cost: Webinars available online

    The Indiana CHW/CRS Annual Conference is an opportunity for Community Health Workers and Certified Recovery Specialists to connect and network with other helping professionals and learn knowledge and skills beneficial to the important work that they do.

    To make sure Community Health Workers and Certified Recovery Specialists across the state still received relevant education that can help them be more effective in their communities, Mental Health America of Northeast Indiana, in partnership with the Indiana Division of Mental Health and Addiction, converted all conference sessions into webinars.

    Recordings from most of these webinars can be accessed below.
    CHW/CRS Annual Conference

    The Academy of Oncology Nurse & Patient Navigators (AONN+)

    Date: November 4-8, 2020
    Location: Baltimore, MD
    Cost: $115-$165

    Oncology navigators and care providers gather to advance the development, implementation, utilization, and metrics of multidisciplinary oncology navigation. It is designed to address the questions of navigators, social workers, physicians, and administrators in regard to cancer care, and offer practical solutions from experts and peers in implementing effective programs and measuring their outcomes.

    2020 MNCHWA Conference

    Date: Canceled
    Location: Plymouth, MN
    Cost: N/A

    The Annual Minnesota Community Health Worker Alliance Statewide Conference brings together community health workers, supervisors, educators, providers, payers, policy makers and many others from across the state for a day of learning, exchange, networking and charting action on next-stage work.


    Annual Rural Health Conference

    Date: Jun 16-19, 2020 and on demand
    Location: Online
    Cost: $368-$735

    NRHA’s Annual Rural Health Conference is the nation’s largest rural health conference, created for anyone with an interest in rural health care, including rural health practitioners, hospital administrators, clinic directors and lay health workers, social workers, state and federal health employees, academics, community members and more.

    NRHA’s 43rd Annual Rural Health Conference, the nation’s largest gathering of rural health professionals, is the Association’s first virtual, online-only event occurring live June 16-19. The entire event will be available on-demand afterward.

    Kansas Community Health Worker (CHW) Symposium

    Date: June 11, 2020
    Location: Wichita, KS
    Cost: Free

    Provide a venue where all stakeholders can better understand the progress and barriers associated with CHWs specific to Kansas. Offer an opportunity for networking among the CHWs and their organizations across the state. Focus on designing CHW infrastructure and systems rather than skill building. The long-term goal of the CHW Symposium is to help reduce health disparities and increase access to care through CHWs in Kansas.

    ACHI 2020 National Conference

    Date: Canceled
    Location: Cleveland, OH
    Cost: N/A

    The Association for Community Health Improvement’s National Conference convenes over 700 population and community health professionals to learn from experts and exchange the latest tools, approaches and ideas from the field. Attendees will have the opportunity to participate in interactive workshops, site visits, breakout and plenary sessions.

    In light of the latest COVID-19 developments and CDC recommendations, the American Hospital Association has canceled the ACHI National Conference scheduled for June 15-17 in Cleveland, as well as all affiliated events. Please see: ACHI 2020 National Conference

    South Carolina Community Health Worker Annual Conference

    Date: Fri, August 14, 2020 – 9:00 AM – 4:00 PM EDT
    Location: The River Center, 5605 Bush River Road, Columbia, SC Cost: $25-$45

    This conference will provide Community Health Workers with a day of learning and networking. Although this conference is designed for CHWs, it is also a conference for supervisors, stakeholders, and policy makers to come and learn about the CHW’s scope of practice.

    Community Health Workers: Taking Action and Changing the Community

    Date: August 20, 2020
    Location: Online
    Cost: $15

    Over the past few months, communities and organizations across the nation have been impacted by COVID-19. These are unprecedented times and it is our priority to cautiously and responsibly plan for the upcoming Community Health Worker Conference. Key factors that have been considered include conference size and the geographical spread of attendees. In considering these factors along with CDC recommendations, Spectrum Health Healthier Communities has made the decision to hold the Community Health Worker Conference virtually.

    Florida Community Health Worker Coalition Summit

    Date: September 10-11, 2020
    Location: Orlando, FL
    Cost: N/A

    Florida Community Health Worker Coalition is a statewide partnership dedicated to the support and promotion of the CHW profession through collaboration, training, advocacy and leadership development. The Summit is for CHWs/promotores de salud, outreach workers, allies, employers, insurers, clinical staff, academic centers, community organizations, state and local leaders from across the state. We hope to see you at our annual conference! For more information, please contact us at 850-888-2495 or via email at flchwcoalition@gmail.com.

    Visión y Compromiso’s 18th Annual Conference

    Date: October 1-3, 2020
    Location: Los Angeles, CA Cost: N/A

    The goal of the conference is to create a space where experiences and ideas can be exchanged among promotores and other participants that foster the learning of new skills, knowledge and advocacy for our communities. The annual conference for promotores and community health workers is organized by Visión y Compromiso in collaboration with a planning committee that is comprised of promotores and other leaders in the community and organizations.

    2020 Community Health Institute & EXPO

    Date: Canceled
    Location: San Diego, CA
    Cost: N/A

    The NACHC Community Health Institute (CHI) and EXPO is the largest annual gathering of health center clinicians, executives, consumer board members, along with State/Regional Primary Care Associations and Health Center Controlled Networks. The conference August 30-September 1, 2020 is scheduled to kick off in San Diego, CA, at a time when health centers are charting a new course in a rapidly changing health environment and being called upon to assume a larger role in the nation’s health care system.

    APHA’s Annual Meeting

    Date: Oct. 24-28, 2020
    Location: Online
    Cost: N/A

    Violence and the threat of violence limit the ability of individuals, families and communities to have healthy, whole lives. Yet research and practice have demonstrated violence is not inevitable and can be prevented. Public health must work with other sectors to prevent violence in all of its forms and across the lifespan. Using a public health approach, we can address the structures and root causes that contribute to this burden and work to change these underlying conditions in homes, schools and communities. We must continue to implement prevention efforts that help provide the opportunity for all to live their lives to their greatest potential.

    As the COVID-19 pandemic changes how we connect, live and learn, we continue to plan for a streamlined in-person meeting Oct. 24 – 28 in San Francisco, with a virtual component to enable our attendees, presenters and exhibitors to participate and connect with the largest audience possible. This hybrid meeting will feature the scientific sessions, presentations and networking so essential to the public health workforce. Safety is our key concern, and planning decisions are being guided by science-based recommendations from health officials.

    Registration and housing will open on July 1.

    TGCCPA Annual Conference

    Date: 2020
    Location: Houston, TX
    Cost: N/A

    The Texas Gulf Coast CHW/Promotors Association (TGCCPA) is a nonprofit association with a mission to meet the needs of the diverse CHW workforce throughout the Texas gulf coast by improving communication, providing access to resources, and improving job opportunities. The TGCCPA has established chapters of the association to accommodate CHWs in various metropolitan areas. Who Should Attend: Community Health Workers / Promotores de Salud; CHW Instructors; Prospective CHW Employers; Community-based organization representatives. CEUs: Combination of DSHS-certified and non-certified CHW and CHW-I CEUs.

    The 14th Annual CHW Conference of Houston, TX will be coming up in 2020.

    Originally published Jan. 14, 2020; updated June 23, 2020.

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CHWTraining Opens New Course on Breast Cancer Screening for 2020

Enrollment is now underway for the latest in a series of cutting-edge courses designed to address the urgent need for managing chronic illnesses in communities

WOBURN, Mass. June 12, 2020 — CHWTraining is adding a new, community-focused breast cancer screening course to its 2020 portfolio. The cutting-edge online course, created by cancer prevention experts at the national and state level, is one of several that fill the industry’s skills gap by providing training in key areas such as breast cancer screening, cancer prevention, women’s health, communication skills, outreach and more.

“Breast cancer screenings can save lives, and CHWTraining is leading the way toward mobilizing women to get annual mammograms,” says Monique Cuvelier, Executive Director of CHWTraining Subscriptions. “Women face many barriers to accessing clinical screenings, and community-focused health teams are vital to educating and supporting women to overcome those hurdles.”

CHWTraining’s education and training cater to community-facing teams by addressing chronic conditions including the following, among others:

Breast Cancer Screening: communicate to clients the importance of screening, who should be screened, and what to expect.

Breast Cancer Genetics: understand how and why breast cancer happens and how to support women through a diagnosis.

Cervical Cancer: evaluate the major barriers to cervical cancer screening, plus how and when to encourage boys, girls, and women to be screened and vaccinated for HPV.

Diabetes: develop an understanding of the types of diabetes and how to manage them, including motivating clients to change lifestyle habits.

Asthma: discover how to reduce triggers during home visits and understand and follow asthma action plans.

COPD: acquire the skills needed to help clients through this group of lung conditions including chronic bronchitis and pulmonary emphysema.

Registration for all 2020 training bundles is now open. For more information about enrollment, visit our Learning Tracks page (https://chwtraining.org/learning-tracks/).

About CHWTraining subscriptions

CHWTraining training and certifications are available to healthcare teams seeking to quickly expand non-clinical skillsets as community health needs evolve. CHWTraining provides healthcare professionals around the country with the best practices, guidelines, and practical advice through education programs designed especially for them. In addition to industry-focused online programs, CHWTraining offers teams the opportunity to attend customized programs tailored specifically for their companies. For more information, please visit: chwtraining.org/contact

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Where To Find Public Health Funding in 2020

Individuals and small businesses have recently received financial assistance in the form of stimulus packages. However, many public health are chronically underfunded.

[Related: 5 Ways To Save Your Budget with a Sustainable CHW Training Program]

State public health departments—always scraping for more in their budgets—and other programs funded by grants or the CDC are experiencing huge staffing cuts and declining spending.

This is at odds with the fact that public health initiatives can reduce overall healthcare spending while improving outcomes. This includes those programs employing community health workers/promotores (CHWs/Ps) and other community-focused health workers can help improve outcomes. But their programs are often the first to go.

Finding funding isn’t always straightforward, so it can pay to think crooked. We worked with program leaders from states around the US to uncover and brainstorm creative possibilities for funding. Here they are, grouped into categories.

National Funding Resources for Healthcare Agencies

  • Various Funding Categories
  • General Funding Sources
  • COVID-19 Grants and Funding
  • Private Donors
  • Unexpected Departments and Sectors
  • Partners
  • Strategy Ideas
  • Mixing Funding Streams

Various Funding Categories

Before starting on any grant-seeking expedition, it pays to understand the terminology around different kinds of funding and what it means. Spend some time with a glossary. This could help you structure projects that fit in areas you might not have considered. For example:

  • seed funding
  • place-based funding
  • capacity-building
  • supporting the non-profit sector

General Funding Sources

National Network of Libraries of Medicine

The National Network of Libraries of Medicine (NNLM) is a collaboration of members with the shared goal of advancing medicine and improving public health by giving health professionals access to biomedical information and improving individuals’ access to information to enable them to make informed decisions about their health. It’s comprised of academic health sciences libraries, hospital, pharmaceutical and other special biomedical libraries, public libraries, information centers, and community-based organizations.

NNLM offers funding for projects that improve access to health information, increase engagement with research and data, expand professional knowledge, and support outreach that promotes awareness and use of NLM resources in local communities. It includes many funding opportunities you might not think of, such as grants for holding training in libraries.

Candid Newsletters

Candid, a merger of the Foundation Center and GuideStar, publishes a handful of helpful newsletters focused on fundraising, boards, best practices, and more. The Candid Newsletters include the Funding Watches are monthly newsletters that summarize news in subject-based philanthropy, links to resources, funding opportunities for individuals and organizations, and job listings. There are also a selection of regional newsletters and the useful RFP Bulletin.

Council on Foundations

The Council on Foundations is a philanthropic network and nonprofit leadership association of grantmaking foundations and corporations. You can use the Council on Foundations website to scan through members to find out who is giving grants. The membership directory is for members only, but the website is still full of references and keywords that can help in a search.

Grantmakers in Health 

Grantmakers in Health is a networking group for funders that reveals trends and directions in grant making. The site provides announcements of grant funding, such as “The Well Being Trust, a national foundation dedicated to advancing the mental, social, and spiritual health of the nation, recently announced new grant funding for twenty-six initiatives as part of their California Mental Health and Wellness Initiative.”

COVID-19 Grants and Funding

The coronavirus is creating some funding opportunities meant to offset the disruption caused by the virus. According to an article by Moss Adams, “Large sums have been designated for health care industry purposes. The federal agencies will award the funds directly to health care providers as well as to states or state agencies, which will then pass the funds to hospitals and provider recipients.”

Some funding opportunities include FEMA public assistance awards,

Community Health Center (FQHC) Grants, telehealth grants, and a helpful grant Distance Learning and Telemedicine Grants from the Department of Agriculture Utilities Programs useful for any organization trying out online training for the first time.

Private Donors

Many agencies make a habit of looking at the general funding sources listed above. But they ignore many private sources of funding that are less well publicized. Some examples are:

Unexpected Departments and Sectors

Think outside of public health for funding other than or connected to health, like science, transportation, or other areas dedicated to social determinate of health. Note to examine your buzzwords, neutralize them, and learn the buzzwords in other sectors.

Some ideas:

  • Department of Transportation and Highway Safety, which wants to use CHWs to promote the use of car seats.
  • Reproductive Health provides funding to boost maternal health programs.
  • Partnering with doula organizations for post-partum maternal health, for what is a doula but a CHW?
  • Departments of Housing, e.g., Healthy Homes, Housing Trust Fund
  • CitizenScience, which works largely in technology and environments but also population health (Smoke Sense is a project that aims to understand the extent to which exposure to wild land fire smoke affects health and productivity, as well as inform health risk communication strategies that protect public health during smoke days; SONYC is a smart cities initiative focused on developing a cyber-physical system (CPS) for the monitoring, analysis and mitigation of urban noise pollution; GoViral is a free and real-time online Cold & Flu surveillance system administered by researchers at New York University. Participants will get a Do-It-Yourself flu saliva collection system that they can keep and use at home if they are feeling sick.)
  • Keep looking for federal, but also state and community funding sources.

Partners

Partners can help share the load and also open up possibilities for new grants. Some examples:

  • Indian Health grant for diabetes
  • Good Health and Wellness (Indian) – careful of duplicating efforts
  • CHRs
  • EMS (guiding CHWs to getting certified in CPR and First Aid)
  • Gaming Commissions often need to spend their money on communities

Strategy Idea: Mixing Funding Streams

Lastly, think about strategy when looking for funding. Remember that funding seeds funding. Funders look at successful programs that have already received money as potential sources for additional funding. They want their investment to succeed.

Sometimes you can increase funding if you tell one funder that you’ve received funding from another. They can provide a matching grant for the same cause.

Disclaimer: This article is a basic resource and is not comprehensive. We’ll continue to update it to add more information as funding opportunities become available or change.

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