Out of necesity breeds resourcefulness: Carving out the role of CHWs in cancer screening programs

The importance of grant funding for screening services in reducing the burden of cancer among underserved communities cannot be overstated. In Appalachia Ohio, where life expectancy trends often mirror those of third world countries, the world's largest Amish settlement resides within some of the most resourced-starved sections of the state. Breast cancer screening programs have been funded through several grant sources, but the pressure to produce a program that provides the full continuum of care from screening to diagnosis to treatment to survivorship has increased with programs led by community health workers already stretched to the limit with program and grant responsibilities.

Project Hoffnung (German for “Hope”) was established in 1997 to address the disproportionately high breast cancer mortality rates found among the largest Amish and Mennonite communities in rural Ohio. This community-led volunteer group established many partnerships over the years to provide culturally competent breast health interventions, but the increased need from funders to provide data from the patient perspective created a delineated model aimed at increasing the number of volunteers in a follow-up design that elevates the importance of community health workers in what was typically perceived as a medical model of cancer care.

The purpose of this presentation is to provide a roles and responsibilities matrix of all aspects of the Project Hoffnung Screening and Follow-up Models that centers on the critical tasks needed of a CHW in cancer screening programs.