Table 1.

Summary of community health worker interventions for BC screening by target group

First author (ref.)Target populationCHW number and characteristicsLength; type of trainingIntervention descriptionControl description
African American
 Earp (46)Rural, African American women 50+ years170 volunteer lay health advisors3–5 sessions, 10–12 hours instruction; role playing, BC, and screening practices.2 community outreach activities per monthUC in comparison counties
4 paid community outreach specialists (indigenous community leaders)Lay health advisors conducted 2 weekly individual sessions
 Erwin (47)Rural, African American women, Mississippi River Delta, AR7 African American BC survivorsTraining provided; interviewing strategies, breast health educationChurch-based group about early detection and screeningUC in comparison counties
Free mammogram vouchers
 Paskett (55)Predominately African- American women 40+ years, low-income housing, Winston–Salem, NC (intervention) and Greensboro, NC (control)NDNDEducational sessions by lay health educators Church program conducted by lay health educatorUC in comparison city
 Sung (60)Low-income, inner city African American womenLay health workers recruited from National Black Women's Health Project10 weeks; interviewing and health educationTwo home visits, 1 booster session. Education about breast and cervical cancer, Pap test and breast exam videoCancer screening educational materials
Reproductive health education
 West (63)Rural, low-income African American women 50–80Indigenous African American female health care workers.Training provided; semi-structured interview's content, counseling stylePersonalized reminder letters followed by intensive phone counselingEligible for a no-cost mammogram; tailored letter describing risk for BC
Phone call included semi-structured interview eliciting barriers, facilitators to mammography
Problem solving to overcome barriers
Provided phone numbers for scheduling mammography
 Zhu (64)Single African American women 65+, living in public housingAfrican American women from same housing complexFour 3-hour sessions; BC, screening practices, possible barriersHome-based BC screening education Taught participants to overcome barriers BrochuresPublic housing complexes, no intervention
 Fernandez (48)Hispanic farm workersLay health workersLay health workers given training curriculum including teaching guide (12 lessons)Individual and group intervention sessions with lay health workerComparison clinics, no intervention
Education sessions included videos, flip charts, discussions of breast and cervical screening
 Navarro (53)Low-income Latinas, San Diego, CA36 consejerasTraining provided; conducting small group sessions on health topics12-week, 90-minute group session program12-week Community Living Skills program
Consejeras taught cancer prevention with culturally-appropriate materials.
 Navarro (54)Latinas, San Diego, CA36 consejerasTraining provided; following consejera manual to conduct weekly educational group sessions12-week group sessions on breast and cervical cancer early detection12-week Community Living Skills program
 Navarro (51)Latinas, San Diego, CA36 consejerasTraining provided; conducting small group sessions on breast and cervical cancer screening12-week group cancer screening intervention following educational materials12-week Community Living Skills program
 Navarro (52)Low-income, low acculturated Latinas, San Diego, CA17 consejerasFive 2-hour sessions; 14 program sessions, recruitment strategies, role playing to lead sessionsTwelve 90-minute weekly group sessions and 2 monthly sessions focusing on breast and cervical cancerFriends and/or family (learning partners) who received information from class participants
 Sauaia (57)Latinas, CO“Peer counselors,” 4 Catholic churches, Denver, CO (Promotoras)Training providedBimonthly meetings after mass and other church events209 Catholic churches sent:
Respected leader delivered homilies addressing breast health at least twice at each church 1–3 home-based health groups per churchLetter describing project Bilingual printed materials display unit short messages for delivery at pulpit and church bulletin
 Suarez (59)Low-income Mexican American women 40+, TexasMexican-American volunteers, Spanish speakersNDVerbal and newsletter cancer-screening educationComparison community, no intervention
 Welsh (62)Latinas, CO“Peer counselors”, 4 Catholic churches, Denver, COTraining provided; standardized curriculumMonthly visits to each church Promotoras approached peers after Sunday masses and during church fairs, other church related activities Promotoras facilitated home-based platicas (health groups) about breast health209 churches mailed: introductory letter NCI BC screening educational materials display unit messages to be delivered at pulpit or church bulletins
Asian American/Pacific Islander
 Bird (43)Vietnamese-American women 18+, California16 indigenous lay health worker neighborhood leaders 68 neighborhood assistantsTraining provided; delivery of prevention education Provided training manualSmall-group home-based educational sessions Focused on general prevention, routine checkups, breast and cervical cancer screening Flip chart and facilitated discussionComparison city, no intervention
 Gotay (49)Native Hawaiian women, 18+, Oahu, HINative-Hawaiian lay health educatorsTraining provided; breast, cervical cancer screening.Small-group, traditional Hawaiian “talk-story” methodsComparison area, no intervention
Free mammogram and Pap test vouchers
Audiovisual aids used
Other Populations
 Allen (41)Women who work in sites with Service Employees International Union representation80 female employee peer health advisors16 hours; cancer screening guidelines, epidemiology, early detection methods, community resources16-month program, 6 small group discussions, role modeling individual outreach, counseling, social support focused on screening.Workshop at study conclusion
2 worksite-wide campaigns
 Andersen (42)Women 50–80, rural WashingtonWomen from participating communitiesTraining providedTelephone intervention using barrier-specific counseling to promote mammographyControl communities, no intervention
 Calle (44)African American and White women 40+80 ACS volunteer peer educators, Jacksonville, Orlando, FLHalf-day; mammography and mammography facilities, breast health guidelines, intervention process, intervention practice sessions, BC fact sheet, resource guide for mammography centersPhone intervention emphasized importance of regular mammograms Set and confirmed date appointment would be scheduled and completed.No intervention
 Duan (45)African-American, Latina, and White women 50–80, churches in Los Angeles County, CAPart-time peer counselorsNDPeer counselors provided telephone barrier-focused mammography counseling annually for 2 yearsChurches, no intervention
Women provided information about risk status, BC prevalence rates, encouraged to ask physician for referral
 Margolis (50)African American, Native American, and White women 40+, non–primary-care outpatient clinicsLow-income, lay female senior aides (lay health advisors)One month; peer education techniques, breast health, communication skills, cultural diversity, principles of randomization, adherence to research protocolAppointments scheduled with female nurse practitioner for those due for screening Women who declined screening encouraged to follow up with health care provider Women who were up-to-date were encouraged to get regular screening and offered mailed reminderUC
 Paskett (56)African-American, Native American, and White women from rural areas and low-income background.2 Native American and African American lay health advisors1 week plus follow-up sessions; breast health, practice on breast models, resource manual, practice intervention sessions3 in-person individual visits, follow-up phone calls, mailings over 9–12 months. Educational materials about cancer risk, overcoming barriers to mammography Discussion of mammography, BC, breast self-exam, scheduling mammography 2 postcard mailings addressing women's readiness to changeLetter and NCI brochure about cervical cancer screening; after follow up, letter and NCI brochure about mammography
 Slater (58)Low-income women, public housingACS and resident volunteersTraining provided; volunteers provided intervention scripts and protocols.60 minute “Friend to Friend” program with health professional speaker, small group discussions, assistance in obtaining mammogram, mammogram reminderDelayed intervention
Free mammograms
Assistance with appointment scheduling
Free transportation
 Weber (61)African-American, Latina, and White low-income, urban women 52–77, 6 primary care facilities Rochester, NY6 women from local community (4 African American, 1 Hispanic, 1 White)ND1 personalized mammography reminder letter from physician 1 low literacy mammography reminder letter from community health educator1 personalized mammography reminder letter from physician plus usual care
Patient education and reminders
Identification and removal of barriers

Abbreviations: ND, not described; UC, usual care.