Access to Care

Community health workers can help poor and minority groups access some cancer screening services

Community health workers can improve appropriate use of some cancer screening services among minority and low-income patients and may boost their health knowledge, according to a new evidence report by the Agency for Healthcare Research and Quality (AHRQ). However, the report could not determine other ways these workers influence health behaviors, health outcomes, or use of other health services because of conflicting or absent study findings.

Community health workers often work as extensions of the health care system in medically underserved areas. They are viewed as important to strategies for narrowing health care gaps among low-income, less educated, and minority groups, as well as Americans as a whole. Because they tend to be from the same background as the patients in the community they serve, community health workers can provide culturally competent health education and counseling about diseases, preventive health care, and use of health services.

Researchers at the AHRQ-supported RTI International-University of North Carolina Evidence-based Practice Center reviewed studies on the effectiveness of community workers compared with other health education methods, such as nurse-led education, mass marketing of health information, and usual care. They found evidence that community health workers can improve people's knowledge of preventive health measures and boost their use of cervical cancer screening, mammography screening, and asthma self-management. However, the researchers did not find evidence that community health workers were more effective than other health care interventions when it comes to getting people into the clinic for clinical breast examination, colorectal cancer screening, management of their chronic diseases, and for most maternal and child health indicators. 

The evidence report, Outcomes of Community Health Worker Interventions, is available at http://www.ahrq.gov/clinic/tp/comhworktp.htm.

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