{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:28:21Z","timestamp":1793604501961,"version":"4.5.0"},"reference-count":12,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1177\/15248399241308198","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T07:59:47Z","timestamp":1736150387000},"page":"1040-1043","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["From the Ground Up: Building and Implementing a Successful CHW\/Promotor(a) Program for Cancer Screening, Training, Education, and Prevention"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-2992","authenticated-orcid":false,"given":"Arica","family":"Brandford","sequence":"first","affiliation":[{"name":"Houston Methodist Academic Institute, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marivel","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Pitones","sequence":"additional","affiliation":[{"name":"Texas A&amp;M University, College Station, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Bolin","sequence":"additional","affiliation":[{"name":"Houston Methodist Academic Institute, Houston, TX, USA"},{"name":"Texas A&amp;M University, College Station, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"e_1_3_2_2_1","author":"American Cancer Society","year":"2022","unstructured":"American Cancer Society. (2022). Colorectal cancer facts & figures 2020-2022.","journal-title":"Colorectal cancer facts & figures 2020-2022"},{"key":"e_1_3_2_3_1","unstructured":"American Cancer Society. (2023). Cancer facts & figures for Hispanic\/Latino people 2021-2023. https:\/\/www.cancer.org\/content\/dam\/cancer-org\/research\/cancer-facts-and-statistics\/cancer-facts-and-figures-for-hispanics-and-latinos\/hispanic-latino-2021-2023-cancer-facts-and-figures.pdf"},{"key":"e_1_3_2_4_1","unstructured":"American Public Health Association. (2023). Community health workers. https:\/\/www.apha.org\/apha-communities\/member-sections\/community-health-workers"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Brandford A. Adegboyega A. Combs B. Hatcher J. (2019). Training community health workers in motivational interviewing to promote cancer screening. Health Promotion Practice 20(2) 239\u2013250. https:\/\/doi.org\/10.1177\/1524839918761384","DOI":"10.1177\/1524839918761384"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Ibekwe L. N. Fern\u00e1ndez-Esquer M. E. Pruitt S. L. Ranjit N. Fern\u00e1ndez M. E. (2023). Associations between perceived racial discrimination racial residential segregation and cancer screening adherence among low-income African Americans: A multilevel cross-sectional analysis. Ethnicity & Health 28(3) 313\u2013334. https:\/\/doi.org\/10.1080\/13557858.2022.2043246","DOI":"10.1080\/13557858.2022.2043246"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Liu D. Schuchard H. Burston B. Yamashita T. Albert S. (2021). Interventions to reduce healthcare disparities in cancer screening among minority adults: A systematic review. Journal of Racial and Ethnic Health Disparities 8 107\u2013126. https:\/\/doi.org\/10.1007\/s40615-020-00763-1","DOI":"10.1007\/s40615-020-00763-1"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Mayhand K. N. Handorf E. A. Ortiz A. G. Gonzalez E. T. Devlin A. Sorice K. A. Esnaola N. Fisher S. Lynch S. M. (2021). Effect of neighborhood and individual-level socioeconomic factors on colorectal cancer screening adherence. International Journal of Environmental Research and Public Health 18(9) 4398. https:\/\/doi.org\/10.3390\/ijerph18094398","DOI":"10.3390\/ijerph18094398"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Okasako-Schmucker D. L. Peng Y. Cobb J. Buchanan L. R. Xiong K. Z. Mercer S. L. Sabatino S. A. Melillo S. Remington P. L. Kumanyika S. K. Glenn B. Breslau E. S. Escoffery C. Fernandez M. E. Coronado G. D. Glanz K. Mullen P. D. Vernon S. W. & Community Preventive Services Task Force. (2023). Community health workers to increase cancer screening: 3 community guide systematic reviews. American Journal of Preventive Medicine 64(4) 579\u2013594. https:\/\/doi.org\/10.1016\/j.amepre.2022.10.016","DOI":"10.1016\/j.amepre.2022.10.016"},{"key":"e_1_3_2_10_1","unstructured":"President\u2019s Cancer Panel. (2022). Closing gaps in cancer screening: Connecting people communities and systems to improve equity and access [A report from the President s Cancer Panel to the President of the United States]. https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2022\/cancer-screening-presidents-cancer-panel-report"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Scheppers E. van Dongen E. Dekker J. Geertzen J. Dekker J. (2006). Potential barriers to the use of health services among ethnic minorities: A review. Family Practice 23(3) 325\u2013348. https:\/\/doi.org\/10.1093\/fampra\/cmi113","DOI":"10.1093\/fampra\/cmi113"},{"key":"e_1_3_2_12_1","unstructured":"Texas Cancer Registry. (2018). Liver and intrahepatic bile duct cancer in Texas. https:\/\/www.dshs.texas.gov\/sites\/default\/files\/tcr\/data\/cancersites\/Liver-Cancer-in-Texas-Web-Report.pdf"},{"key":"e_1_3_2_13_1","unstructured":"Texas Cancer Registry. (2024). Cervical Cancer in Texas. Texas Department of State Health Services (DSHS). https:\/\/www.dshs.texas.gov\/sites\/default\/files\/tcccp\/pdf\/fact%20sheets\/Cervical_Cancer_Fact_Sheet_Texas.pdf"}],"container-title":["Health Promotion Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399241308198","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15248399241308198","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399241308198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:09:17Z","timestamp":1793603357000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15248399241308198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,6]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/15248399241308198"],"URL":"https:\/\/doi.org\/10.1177\/15248399241308198","relation":{},"ISSN":["1524-8399","1552-6372"],"issn-type":[{"value":"1524-8399","type":"print"},{"value":"1552-6372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,6]]}}}