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Using technology for improving population health: comparing classroom vs. online training for peer community health advisors in African American churches


Technology is increasingly used in health promotion interventions. Project HEAL (Health Through Early Awareness and Learning) compared two methods of training lay community health advisors (CHAs): 1) the traditional/classroom approach vs. 2) a new online training system.


Fourteen African American churches located throughout Prince George's County, MD were randomized to receive the traditional/classroom (N = 8 churches) or the online (N = 6 churches) training approach. The CHAs received Project HEAL workshop intervention materials and led a 3-part workshop series in his/her church encouraging breast, prostate, and colorectal cancer early detection. Study participants completed surveys at workshops 1 and 3 and another at 12 months post-baseline, which were used to evaluate the intervention impact on Health Belief Model-based outcomes and self-reported cancer screening.


CHAs recruited 385 African Americans age 40 -75 (122 men and 261 women) with an average age of 54.75 (SD = 9.16), and 229 (60%) completed the 3-month follow-up survey. The intervention resulted in significant overall pre-post increases in colorectal cancer knowledge (p < 0.05), and prostate cancer knowledge (p < 0.001), yet knowledge specific to the prostate cancer "controversy" decreased (p < 0.05). In addition, participants expressed significantly greater satisfaction (e.g., interest; personal relevance; importance; trust) with the workshops from the online approach than in the classroom approach (p < 0.01). Finally, the men taught by online-trained CHAs had marginally greater increases in prostate cancer knowledge as compared to those taught by the classroom-trained CHAs (p < 0.07), and this effect became significant at 12 months (p < 0.05). Additional analyses examine change in baseline to 12-month follow in study outcomes.


Use of an online approach is a novel way to train peer community health advisors and has implications for wider scalability and reach. We discuss lessons learned and implications for dissemination/implementation research in this context.

This research is funded by the National Cancer Institute (#R01CA147313). None of the authors have any commercial interests.

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Correspondence to Cheryl L Holt.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Holt, C.L., Zara Santos, S.L., Tagai, E.K. et al. Using technology for improving population health: comparing classroom vs. online training for peer community health advisors in African American churches. Implementation Sci 10 (Suppl 1), A60 (2015).

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