Improving CHW’s Work in the Spectrum of Cancer Care Across Minnesota

yetundeYetunde is a 2nd year trainee at the University of Minnesota – Twin Cities. She is currently finishing up her MPH and dietetic internship at the UMN School of Public Health. She earned her Bachelor in Science in Nutrition – Dietetics at Auburn University in 2017. Her interests include maternal and child health, mental health, and nutritional counseling. She hopes to primarily work with women and children of color. 

Community health workers (CHWs) are public health workers that typically come from the same culture, ethnicity and/or socioeconomic background, and speak the same language as the communities they serve. Because they often have similar life experiences as those they assist, they are able to build trusting relationships with their communities and are therefore an important link between health services and the people. CHWs are also involved in a number of other activities that seek to increase the health knowledge of both individuals and the community such as informal counseling, education, support, advocacy, outreach, and providing resources (1).

The Minnesota CHW Curriculum cancer course focuses on the role of the CHW when working with patients with cancer and their families. It places emphasis on understanding cancer, its risk factors, screening for detection and diagnosis, and the types of cancer treatments. It also seeks to understand the emotional factors involved when a cancer diagnosis is made, its treatment, and cultural considerations that must be addressed. Lastly, it helps CHWs in identifying resources and ensuring client access to those resources, as well as aid and support clients and families (2). However, the literature still reveals gaps in cancer training among CHWs in Minnesota.

The goal of my culminating experience (Master’s project) was to better understand the needs and barriers of CHWs and their health care employers as it relates to cancer detection, treatment, and survivorship of clients and their families across the state of Minnesota. Understanding these barriers could improve CHWs’ role in the spectrum of cancer care. I had the privilege of completing this project under the direction of the Program Coordinator of the Comprehensive Cancer Control at the Minnesota Department of Health, the Minnesota Cancer Alliance, and the Cancer Health Equity Network.

After completing a literature review, planning for data collection, and conducting 8 key informant interviews (2 more written responses to the interview questions were received totaling 10 participants), 9 top themes were discovered after thematic analysis: 1. Enrolling clients in screening programs; 2. Providing education; 3. Involvement in the community; 4. Providing culturally appropriate care; 5. Care coordination; 6. Transportation for clients; 7. Integration into the healthcare team; 8. Training for CHWs and 9. Defining the scope of the CHW. Based on the results of the interviews, there are a few recommendations that could be made to help elevate the work that CHWs do in the spectrum of cancer care in Minnesota: 1. Further formal training for CHWs, 2. Integration of CHWs into the primary care team, and 3. Clear scope of practice for CHWs.

CHWs have been shown to play a beneficial role on any interprofessional team, and this also applies to serving clients on the spectrum of cancer care. With further research and implemented recommendations, CHWs have the ability to enhance their work in the spectrum of cancer care in the state of Minnesota.

Through my research project, I acquired the Critical Thinking, Communication, Cultural Competency, and Working with Communities and Systems MCH Competencies.

References:

  1. https://www.health.state.mn.us/facilities/ruralhealth/emerging/chw/docs/2016chwtool.pdf
  2. http://mnchwalliance.org/wp-content/uploads/2012/12/Minnesota-CHW-Curriculum-Outline-Updated-Feb-2015.pdf

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