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BACKGROUND: The colorectal cancer (CRC) screening uptake rate is substantially lower in ethnic minority populations than in the general population. Racial and ethnic minority individuals experience more barriers in obtaining a screening test for CRC when compared with the non-Hispanic White population. OBJECTIVE: To examine the effectiveness of community health worker-led interventions in improving the CRC screening uptake rate in racial and ethnic minority populations. METHODS: Five databases, EMBASE, CINAHL, MEDLINE, Scopus, and PubMed, were systematically searched, and reference lists of the identified articles were manually searched for relevant articles in May 2022. Only randomized controlled trials were included. RESULTS: A total of 10 randomized controlled trials conducted in the United States were included in this review. The findings of the meta-analysis showed that CRC screening uptake was enhanced in participants receiving community health worker-led interventions compared with those receiving no intervention (odds ratio, 2.25; 95% confidence interval, 1.48-3.44; P < .001). The subgroup analysis by diverse racial and ethnic groups and number of components (single vs multiple) of the community health worker-led interventions showed that multicomponent interventions were more effective in increasing the CRC uptake rate among all racial and ethnic groups regardless of their background. CONCLUSIONS: Multicomponent community health worker-led interventions can improve CRC screening uptake in racial and ethnic minority populations. IMPLICATIONS FOR PRACTICE: The findings of the present review show that multicomponent community health worker-led interventions are shown to be effective to improve the CRC screening uptake targeting other racial and ethnic minority groups in other countries.
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Objective: Nurses play a crucial role in cancer control. Prior reviews presented the effectiveness of nursing interventions such as tobacco cessation counseling and cervical cancer screening but did not focus on low- and middle-income countries (LMICs). This scoping review addresses a gap in the literature by describing the roles and activities of nurses in cancer prevention and early detection in LMICs. Methods: Following Arksey and O'Malley's scoping review framework, we searched seven databases using subject headings and keywords from 1990 to January 2021 and updated in April 2022. The reference lists of relevant studies were also searched. Two reviewers independently screened the relevance of studies through Rayyan, assessed full text articles, and extracted data using a Google Form. Conflicts were resolved by a third reviewer. Results: A total of 180 studies were included, representing all six World Health Organization regions and 48 LMICs. The largest number of studies were from the African region (n â= â72), the Americas (n â= â49), and South-East Asia region (n â= â29). The main nursing roles featured were patient/community education (n â= â113), history taking and cancer risk assessment (n â= â63), performing screening exams (n â= â136), care coordination (n â= â57), and training other healthcare professionals (n â= â9). Conclusions: This scoping review provides a comprehensive picture of nurses' role in cancer prevention and early detection in LMICs, across all six World Health Organization regions. Additional cancer workforce data sources at the country level are needed to fully understand the activities of nurses in cancer prevention. Future research is also needed to measure the impact of nursing educational and other interventions in both primary and secondary cancer prevention.
RESUMO
BACKGROUND: Cancer survivors are required to manage their health, healthcare, and a myriad of symptoms through self-management. OBJECTIVE: The aim of this study was to develop a comprehensive framework of competencies and performance criteria that identifies the requisite knowledge and skills for nursing practice in the provision of self-management support for cancer survivors and their families. METHODS: The competency framework was developed using the following 3-stage consensus building approach: (1) development of a preliminary list of self-management support competencies and performance criteria informed by relevant literature, (2) a 2-round modified Delphi conducted with a panel of cancer nurse experts, and (3) a research team consensus meeting to finalize framework components. RESULTS: Seventy-one items, comprising 13 core competencies and 58 performance criteria, across 6 domains were generated. In round 1 of the modified Delphi, a panel of 21 oncology nurses produced consensus on retaining 28 items for inclusion in the final framework. Thirty-one items (including new items generated in round 1) were sent to round 2 for further rating. A panel of 19 nurses produced consensus on retaining a further 20 items in the framework in round 2. Of the 11 items that did not reach consensus, the research team proposed to include 7 in the final framework. Fifty-nine items were included in the final framework. CONCLUSIONS: This study provides a comprehensive, self-management support competency framework for oncology nurses. IMPLICATIONS FOR PRACTICE: This framework is the first step toward the development of training program curricula that prepares nurses in self-management for cancer and associated coaching knowledge and skills.