From the Ground Up: Building and Implementing a Successful CHW/Promotor(a) Program for Cancer Screening, Training, Education, and Prevention

In this practice note, we examine the implementation and impact of the Texas Cancer Screening, Training, Education, and Prevention (C-STEP) program, which aims to reduce cancer disparities in medically underserved and rural areas. The program utilizes community health workers (CHWs) or promotor(a)s to provide outreach, education, and early detection services for breast, cervical, colorectal, and lung cancers. C-STEP employs a multidisciplinary approach, partnering with the Center for Community Health Development National Community Health Worker Training Center to certify CHWs in cancer prevention and detection. The program establishes community and clinical partnerships to promote cancer screening uptake in priority populations. Key outcomes include training over 33 CHWs, establishing more than 1500 partnerships, providing cancer education to over 30,000 individuals, conducting over 8300 screening exams and 600 diagnostic procedures, and diagnosing 69 cancers. Successes encompass increased screening rates, community engagement, and partnership development. Challenges involve financial inequities, technology literacy, role complexity, and outreach difficulties. Lessons learned highlight the need for proactive planning, diverse recruitment, and consistent communication with partners. Our findings suggest that integrating CHWs into cancer screening programs effectively increases awareness and screening rates, particularly among low-income populations. Future implications suggest the importance of strategic planning, systematic training, and creative partnership approaches to recognize CHWs as vital health care team members. The findings highlight the potential of community-based interventions in addressing cancer disparities and improving health outcomes practices in rural and underserved areas.