Lessons learned on integrating a CHW-led research project on cervical cancer screening in 2 safety-net clinics

Background: In this narrative we describe a Community Health Worker (CHW) and clinical partnership to improve cervical cancer screening among Hispanic/Latino and Haitian women.

Methods: Two CHWs (one Latino and one Haitian) were part of an NCI supplement examining HPV self-sampler acceptability and feasibility among women at two safety net clinics. CHWs received formal training in cervical cancer prevention and HPV self-sampling and were tasked with recruiting a total of 180 women into the study. In this narrative we summarize feedback from each CHW on the barriers and facilitators to integrating this research study into routine clinic operations.These 2 CHWs are co-authors who helped conceptualizing this abstract, were individually and separately interviewed for data collection, and if selected, will co-present, preferably in a panel, roundtable discussion or even poster format in Eng/Spanish and Haitian Creole).

Results: In 9 months the CHWs assessed over 1,900 women of whom 202 were study eligible. Of these, they were able to recruit 133 Latinas and 46 Haitians into the study.  Among important facilitators highlighted by both CHWs was the design of study procedures that did not result in any disruptions or delay on patient intake or routine clinical care. Additionally,CHW efforts were enhanced by their willingness to serve as additional educational and service resource for patients and clinic staff. Barriers in these resource challenged settings included lack of staff time to engage in simple protocol checklists or collection of few data items at clinic patient intake, both of which would have greatly facilitated the research.

Conclusions: CHWs were able to successfully integrate the research study into a clinical setting. Their experiences reflect the importance and the feasibility of involving CHWs within a health system to improve practice-based research.