A community health worker-led multimedia intervention to increase cervical cancer screening uptake among South Asian women: study protocol for a cluster randomized wait-list controlled trial

Abstract

Background Marked ethnic disparities on cervical cancer screening have been observed among South Asian women. Multiple barriers, such as language difficulties, poor access to screening services, values, and beliefs, were identified. Multimedia interventions led by community health workers (CHWs) would likely reduce screening disparities and increase cervical screening uptake among South Asian women. This study aims to assess the effects of a CHW-led multimedia intervention on the uptake of cervical cancer screening among South Asian women. Methods This study is a cluster randomized wait-list controlled trial. A total of 408 South Asian women from Pakistan, India or Nepal will be recruited from six ethnic minority associations. Each association will be randomized to one of the two arms: an intervention arm ( n = 3) that will undergo immediate treatment (CHW-led multimedia intervention) or a wait-list control arm ( n = 3) that will receive delayed treatment. Each recruited CHW will be allocated to either arm according to the association she is affiliated with. The intervention arm will receive a CHW-led intervention comprising two components: multimedia education, and monthly telephone follow-up and navigation assistance. Participants in the control arm ( n = 3) will be offered the CHW-led intervention after those in the intervention arm have completed the intervention. The primary outcome measure is the uptake of cervical cancer screening. Secondary outcomes include readiness to undergo screening and beliefs regarding cervical cancer screening. Outcomes assessments will be performed at baseline, immediately after, and 3 months after completion of the intervention. Discussion The results of this study will potentially provide significant practical implications for addressing the needs and increasing the uptake of cervical cancer screening among South Asian women. Trial registration Chinese Clinical Trial Registry, ChiCTR1800017227 . Registered on 18 July 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3378-4) contains supplementary material, which is available to authorized users.

Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon

“…CHW-led interventions constitute an important step to increase participation in cervical cancer screening programs. They contribute to optimizing the participation as they use their cultural knowledge and ensure that message are delivered in a culturally appropriate fashion according to women’s preferences and needs in rural areas where the screening rate is very low, which differ from those of women living closer to the city [ 14 , 26 ]. As shown in Tables 1 and 2 , women recruited by CHW tended to be less educated, had more children, used fewer condoms, and consumed more tobacco.…”

Effects of a Community Health Worker-Led Multimedia Intervention on the Uptake of Cervical Cancer Screening among South Asian Women: A Pilot Randomized Controlled Trial

“…As suggested by Cocks and Torgerson [16], the sample size for a pilot trial should be about 10% of that required in the main trial. As the sample size of the main trial was 408 (as discussed in [17]), about 41 subjects were deemed sufficient.…”

“…The process of subject recruitment, intervention development, and outcome measures used are described in [17]. Briefly, six South Asian community centers or organizations located in various districts of Hong Kong were randomized into either the intervention arm or wait-list control arm.…”

“…An information booklet containing information on cervical cancer was provided to each participant to recap what they had learned during the health talks. The content of the intervention is reported in [17].…”

“My motivation was to save”: a qualitative study exploring factors influencing motivation of community healthcare workers in a cervical cancer screening program in Dschang, Cameroon

“…It ensures continuity between CHWs and the community, maintains their practical and theoretical knowledge and experience, and avoids having to recruit and train new CHWs [ 24 , 25 ]. It also helps to optimize their performance and implement thriving health programs [ 26 , 27 ].…”