Introduction/objective: Community health workers (CHWs) can play a vital role in many aspects of healthcare, particularly for underserved communities, but it is unclear what factors are most important in determining the success of CHW-based programs. We wanted to assess what factors contribute to the effectiveness of CHWs in a smoking cessation program.
Methods: We trained CHWs in 3 areas regarding smoking cessation: knowledge, attitude, and practice (KAP). The training program utilized the 5A's as approach. CHWs actively sought out people addicted to cigarettes to participate. Patients received support from CHWs and a team of medical professionals for a year. At the conclusion of the program, focus group discussions with a group of CHWs, a group of patients, and a group of medical professionals were conducted.
Results: On average, patients reduced their cigarettes/day by 7.2% and 29% of patients were completely cigarette free at a 1-year follow-up. Patients marginally decreased exhalation CO levels and increased lung capacity. CHWs gained a good understanding of health risks associated with smoking and common methods to help quit. Their attitude became more sympathetic and caring. CHWs exhibited patient-specific solutions to help with smoking cessation and actively sought out people to participate in the smoking cessation program.
Conclusions: A smoking cessation program combining CHWs and pharmacists was effective. Key factors were having CHWs that are respected and established in their communities, using CHWs who know their patients and can provide individually tailored solutions, and empowering CHWs with intensive training.
Keywords: community health worker; focus group; pharmacist; primary care; smoking cessation.