Assessment of a continuing education program for community health workers for breast cancer screening: Itaberaí Project

Abstract

Objective: The objective of this study was to evaluate a theoretical-practical continuing training program for community
health workers (CHW) in breast cancer screening, according to the actions of the Itaberaí Project. Methodology: The
CHW training program is developed according to the following stages: face-to-face theoretical-practical, distance learning
(DL), and ongoing on-site training. This program corroborates with the phases of the Itaberaí Project, which is a clinical
trial, controlled, randomized, multicenter, phase III, where the unit of observation was the CHW in their National Health
Strategies (NHS), randomly allocated to control group (CG) and intervention group (IG). The theoretical-practical training
and DL course were evaluated using a questionnaire containing closed-ended questions, with a Likert Scale (ranging from
1 poor to 4 excellent), and open-ended questions. The completion was anonymously done by the participants. Results: Out
of the 74 CHW active in the Project, 66 (89.2%) completed the DL course and participated in this research. Regarding the
course evaluation, content, methodology, speakers, and the platform used, 33 (50.8%), 46 (69.7%), 37 (56.9%), 47 (72.3%),
and 44 (66.7%) CHW indicated as “excellent,” respectively. As a suggestion for improvement, the most cited was “adaptation to a more accessible language.” Regarding the face-to-face theoretical-practical training, 67 CHW (90.5%) responded
to the questionnaire, with 29 CHW (43.2%) from the CG and 38 (56.7%) from the IG. The evaluation of the training overall,
content, methodology, and duration was considered “excellent” by 52 CHW (77.6%), 49 (73.1%), 50 (74.6%), and 40 (59.7%),
respectively. There was no significant difference between groups for the evaluated responses. Regarding practice for the
IG, 31 (%) CHW indicated “increased confidence” in performing the physical examination of the breast. Conclusion: The
evaluation of the training program showed positive results among CHW and increased their confidence in carrying out
the actions of the Itaberaí Project.