According to the CDC and American Cancer Society, Texas ranks 41st in colorectal cancer (CRC) screening rates and 35th in breast cancer screening. Furthermore, Texas has one of the highest cervical cancer incidence and mortality rates in the nation. Disparities related to socio-demographic factors such as race/ethnicity, rural residence, and poverty contribute to low screening rates and poor cancer outcomes. These statistics indicate a need to develop statewide strategies to promote cancer education, improve screening rates, and increase early-stage diagnoses.

Utilizing community health workers (CHWs) is a nationally recognized, evidence-based culturally appropriate approach for improv...

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According to the CDC and American Cancer Society, Texas ranks 41st in colorectal cancer (CRC) screening rates and 35th in breast cancer screening. Furthermore, Texas has one of the highest cervical cancer incidence and mortality rates in the nation. Disparities related to socio-demographic factors such as race/ethnicity, rural residence, and poverty contribute to low screening rates and poor cancer outcomes. These statistics indicate a need to develop statewide strategies to promote cancer education, improve screening rates, and increase early-stage diagnoses.

Utilizing community health workers (CHWs) is a nationally recognized, evidence-based culturally appropriate approach for improving population health. This proposal targets four priority geographic areas with significant disparities related to cancer incidence, mortality, screening, and risk factors: Lower Rio Grande Valley, Coastal Bend region, the extended Brazos Valley, and Northeast Texas. Each of these regions is predominately rural and experiences barriers to cancer education, screening, and treatment.

In this proposal, Texas A&M Health Science Center proposes to package and disseminate CHW components from four of its successful CPRIT-funded prevention projects related to breast, cervical, and colorectal cancer (CRC) education, navigation, and outreach:

• PP110176, Enhanced CRC Screening in a Family Medicine Residency Program Serving Low-Income & Underserved: Translating Research into Practice;

• PP130090, Enhanced Breast and Cervical Cancer Prevention for Low-income and Underserved Women Using Transdisciplinary Collaboration in a Family Medicine Setting;

• PP150025, Continuation and Expansion of Texas A&M’s CRC Screening, Training, Education and Prevention (Texas C-STEP); and

• PP110241, ÉPICO: Education to Promote Improved Cancer Outcomes.

CHWs in the priority regions will have access to certified training via in-person training workshops and CHWs across the state will be able to access online training modules. Organizations with CHW programs in the priority regions will be identified as partner organizations. Through in-person training, online resources, and ongoing technical assistance, this proposal will equip these partner programs to implement successful cancer education and navigation programs of their own.

This proposal has two specific goals: 1) Train CHWs to disseminate resources from CPRIT-funded Texas A&M projects for prevention, detection, treatment, survivorship, and navigation for breast, cervical, and colorectal cancers; 2) Equip programs employing CHWs with best practices to implement resources related to prevention, detection, treatment, survivorship, and navigation for breast, cervical, and colorectal cancers over two years.

This proposal will disseminate successful models for CHW cancer prevention, detection, treatment, survivorship, and navigation projects. CHW programs and trained CHWs can effectively diffuse culturally competent education and navigation strategies to others in their communities. The project’s online component will further disseminate the training and materials for other organizations and CHWs to utilize, even beyond the targeted geographic regions.

Effective, culturally relevant, sustainable, tailored strategies for addressing cancer prevention, detection, treatment, survivorship, and navigation are greatly needed for areas with substantial at-risk populations. From a broader perspective, experiences expanding cancer education and navigation interventions, to impact at-risk populations in more areas, will add to the knowledge base and inform local, state, and national cancer prevention and education strategies.

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