# Implementation and Impact of Cancer Screening Navigation by Community Health Workers in Two National Screening Programs

> **NIH NIH K01** · UNIVERSITY OF WASHINGTON · 2021 · $163,054

## Abstract

PROJECT ABSTRACT
Significant disparities in breast, cervical, and colorectal cancer mortality persist among marginalized
populations, partially attributable to lower guideline concordant screening. Patient navigation is an evidence-
based practice to improve adherence to cancer screening guidelines among marginalized populations in order
to reduce cancer disparities. Cancer screening navigation activities may be implemented using professional
(e.g. nurse) or lay (e.g. community health worker, CHW) navigator models, the latter in clinical or community
settings. Implementation of CHW-led cancer screening navigation is more feasible in low-resource settings
compared to nurse-led cancer screening navigation and is associated with improved screening outcomes.
However, we lack a comprehensive understanding of how this is accomplished, both from the perspective of
CHWs as well as from the perspective of the clients they serve. Furthermore, rigorous evaluation of CHW-led
cancer screening activities in relation to screening outcomes is lacking. The purpose of this study is to
characterize factors that affect implementation of cancer screening navigation activities by CHWs in the
context of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal
Cancer Control Program (CRCCP), two federal screening programs established to provide vulnerable
populations access to timely cancer screening and diagnostic services. Using the Consolidated Framework for
Implementation Research (CFIR), we will identify implementation domains that affect CHW-led cancer
screening navigation including: outer setting (e.g. program policies), inner setting (e.g. CHW training), and
individual characteristics (e.g. CHW social support) via key informant interviews with CHWs (n=25). We will
compare domains across cancer- (i.e. breast, cervical, and colorectal) and community-type (i.e. urban and
rural) to understand potential differences. We will also recruit program clients of CHWs (n=250) to study
associations between the presence, type, intensity, and quality (e.g. client satisfaction) of CHW-led cancer
screening navigation activities as well as subsequent screening outcomes over a one-year period. Finally, we
will use community-based participatory research (CBPR) principles to engage program stakeholders at all
stages of the research process which will culminate in a consensus conference to generate best practices for
the implementation of CHW-led cancer screening navigation activities. These findings will inform multi-level
health service interventions to improve the effectiveness of cancer screening navigation using CHW models of
delivery. The proposed career development in implementation science, leading practice-based research, and
applying and evaluating CBPR processes will prepare the candidate to excel as an independent researcher
focused on addressing cancer disparities in partnership with marginalized communities and health systems.

## Key facts

- **NIH application ID:** 10236346
- **Project number:** 5K01CA229996-04
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Wendy Elizabeth Barrington
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $163,054
- **Award type:** 5
- **Project period:** 2018-09-15 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10236346

## Citation

> US National Institutes of Health, RePORTER application 10236346, Implementation and Impact of Cancer Screening Navigation by Community Health Workers in Two National Screening Programs (5K01CA229996-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10236346. Licensed CC0.

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