ArticlePloS one2016
From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews.BMC cancer · 2020Pooled it
- Clinical breast examination screening by trained laywomen in Malawi integrated with other health services.The Journal of surgical research · 2016Trial
- Breast Health Training Program for Traditional Healers: A Pathway to Early Breast Cancer Detection in Tanzania.Cancer reports (Hoboken, N.J.) · 2026Article
- A multi-phase structured cascade model for mass training of community healthcare workers in performing clinical breast exams in remote regions.Journal of global health · 2024Article
- Implementation of a clinical breast exam and referral program in a rural district of Pakistan.BMC health services research · 2024Article
- Breast Cancer Early Detection in Eswatini: Evaluation of a Training Curriculum and Patient Receipt of Recommended Follow-Up Care.JCO global oncology · 2021Article
- Capacity building for cancer prevention and early detection in the Ugandan primary healthcare facilities: Working toward reducing the unmet needs of cancer control services.Cancer medicine · 2021Article
- Dynamics of Breast Cancer under Different Rates of Chemoradiotherapy.Computational and mathematical methods in medicine · 2019Article
- Impact of Breast Cancer Early Detection Training on Rwandan Health Workers' Knowledge and Skills.Journal of global oncology · 2018Article
- Promoting Clinical Breast Evaluations in a Lower Middle-Income Country Setting: An Approach Toward Achieving a Sustainable Breast Health Program.Journal of global oncology · 2018Article
- Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-ExaminationAsian Pacific journal of cancer prevention : APJCP · 2017Article
- Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi.Cancer causes & control : CCC · 2017Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBreast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi's first clinical breast exam (CBE) screening effort.
methodsLaywomen were recruited as Breast Health Workers (BHWs) with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges.
resultsWe interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (p<0.0001). Clinician and BHW CBE had 88% concordance (kappa 0.43). The mean rating of BHW educational talks was 4.4 (standard deviation 0.7).
conclusionsMalawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.