By Lynn Swinburne, Senior Health Promotion Officer, National Screening Service
We’ve published an evaluation of our Community Champions pilot project. This health promotion project aims to enable community health workers to implement local interventions to support people to take part in screening.
Background to the project
Population-based screening programmes play a crucial role in finding the early signs of disease, which can significantly improve health outcomes through earlier treatment. One of the challenges in the successful delivery of screening programmes is making sure that diverse communities have access to the information they need to make an informed choice about taking part in screening. Community health workers can play a vital role in this.
We wanted to develop a project for community health workers to become community champions in screening - to identify people in their communities who do not take part in screening or who might not take part regularly; and to identify the barriers that stop people from taking part and respond using evidence-based interventions.
Who are community champions?
Community champions are community health workers who are trusted, respected and influential within their communities. They are typically advocates, or individuals who have strong ties to a specific group or population. Their role is to bridge the gap between healthcare providers and people in their community, fostering trust and encouraging participation in health initiatives, including screening programmes.
Developing the project
We developed a training programme and new resources to support community health workers to become screening champions in their communities. The resources include:
- an interventions toolkit
- animated videos that explain what happens at screening
- presentations about our four screening programmes
- a communications partner pack.
We also provided access to an online training platform which has additional tools and resources to support our champions, as well as access to advice from our access officers, screening programme staff and health promotion team.
The pilot
In 2024 we trained 40 people across five pilot sites in Ireland:
- HSE Cork Area D
- HSE Kerry Area D
- Dublin City Community Co-op
- HSE Community Healthcare West
- HSE Dublin South, Kildare, West Wicklow Community Healthcare.
These included peer support workers, community health workers, migrant support workers, Roma support workers and health promotion staff.
Evaluation
The evaluation included focus groups and an online survey. It aimed to identify what worked well and what we could improve by:
- evaluating the training and resources to see if they meet the needs of community champions
- assessing the types of interventions used by community champions
- reviewing the collaboration between community champions and the National Screening Service.
Main findings
The report shows that our community champions reached people in many communities including migrants, Roma, Travellers, disabled people, homeless people, the LGBTQI+ community, refugees, people who live in deprivation, and people in addiction.
- Training and resources: The training helped to build the confidence of our community champions. Most participants found the online training platform adaptable and user-friendly. The presentations, animated videos, infographics and easy-to-read materials were cited as the most useful for interventions. Some participants expressed a need for guidance and support materials on managing fear of screening results and post-diagnosis information.
- Interventions: Screening interventions such as information sharing, group education and literacy support resulted in people going for screening and registering for screening. Barriers to screening identified by community champions included fear of diagnosis, relocation issues, language barriers, logistical challenges and cultural factors. Transport and overburdened GP practices were significant concerns. Challenges for community champions included addressing sensitive health issues and explaining abnormal results, highlighting the need for more training materials and support in this area.
- Collaboration and support: Participants viewed their roles as community champions positively and appreciated the support and collaborative approach of the National Screening Service.
Recommendations
Based on the findings of the evaluation, some of the recommended actions include:
- expanding and making improvements to our community champions training content and resources
- exploring ways for community champions to gather and record the outcome of their interventions
- maintaining and expanding our support to community champions.
Feedback from participants
“The training was absolutely essential. After some training sessions, I had already built up the knowledge into how we deploy and how we deliver the interventions.”
“The translation of the video was very helpful for me to use. It was much easier for the Roma women to understand in their own language.”
“I think they [the NSS] listen to everything we have to feedback, and they are really interested and really supportive of small changes and understand how much they matter."
Next steps
We will continue to provide training and support to our community champions, while also building our network and training additional people in 2025. We will regularly assess the impact of the work being carried out by our community champions, identify and respond to areas for improvement and ensure that the project is continually meeting its objectives.
- We’ve complemented our Community Champions pilot project by also completing a literature review on the use of community champions in improving screening access at a community level.
- Our equity projects aim to address the barriers to screening and to make screening more accessible to everyone. Find out more about the work we're doing to improve equity in screening at hse.ie/equityinscreening.