Understanding and adherence level of community health workers to breast cancer screening according to the protocol established in the Itaberaí Project

Abstract

Objective: The objective of this study was to evaluate the level of understanding and adherence of CHW according to
the protocol of the Itaberaí Project (PI), aiming at breast cancer screening. Methodology: This is a clinical, controlled,
randomized, multicenter, phase III trial, where the unit of observation was the engagement of community health workers
(CHW) in the PI. With randomization, CHW were randomly allocated to the control group (CG) and intervention group
(IG). For evaluation and comparison between groups of CHW understanding and adherence levels to the Project, a specific questionnaire was developed, with closed questions, according to the Likert scale and filled out anonymously.
Results: Out of the 74 CHW active in the Primary Health Care Network in Itaberaí, 65 participated in the research, with
34 (52.3%) in the CG and 31 (47.7%) in the IG. The average length of time working as a CHW was 17.09 years ± 7.15 in the
CG and 16.38 ± 8.02 in the IG (p=0.69). There was no significant difference in educational level between groups (p=0.59).
Regarding understanding, there was no significant difference between the Groups, as 100% of CHW understand that their
role is to guide women on early detection and diagnosis, identify possible breast changes, and refer them to basic health
units (BHUs). Regarding what could improve women’s adherence to the PI, 25 (73.5%) CHW from the CG and 29 (93.5%)
from the IG reported that investing in greater Project publicity through media would be beneficial. Regarding the level
of CHW adherence to the PI according to the Likert scale, a higher prevalence of “extremely committed” was observed,
with 28 (82.3%) CHW from the CG and 24 (77.4%) CHW from the IG. Conclusion: The results suggest that CHWs have an
understanding of their role in the PI and grasp its importance for breast cancer screening.