The role of community health workers (CHWs) in improving cervical cancer screening rates and access to treatment in underserved US populations: a scoping review
The purpose of this study is to explore the impact CHWs have in increasing access to cervical cancer screening and treatments for underserved US women while examining the importance of utilizing culturally tailored theoretical frameworks and evidence-based strategies in the design and delivery of the CHW-led interventions. The five-step process outlined by Arksey and O'Malley as well as the recommendations from the Joanna Briggs Institute (JBI) was used for the data extraction, analysis, and presentation of the results. A total of 12 eligible studies published between 2002 and 2023 were retained for analysis. Across all studies, the role of the CHWs led to successful cervical cancer screening interventions as well as improved knowledge levels on pap smears and cancer prevention in underserved US female communities. Barriers experienced by CHWs and underserved women were sorted into the five levels of the socio-ecological (SEM) model. Several theoretical frameworks were used, including the social cognitive theory, the health belief model, the theory of reasoned action (n = 2), the transtheoretical model (n = 1), the Popular Education Theory (n = 1), and the Social Marketing Theory. Major themes were identified qualitatively across studies using thematic analysis regarding monitoring patients, clinical processes, generalizability of study results, and cultural sensitivity. Findings highlight that providing culturally tailored CHW-led interventions improves informed decision-making by underserved US women surrounding cervical cancer screenings and treatment. Our review provides recommendations to strengthen the impact of CHWs on cervical cancer screenings and treatment in underserved US populations.