Equitable Learning Outcomes Among Community Health Workers Following a Modified Smoking Cessation Training: A...

PurposeTo examine whether sociodemographic or professional characteristics predicted learning gains among community health workers (CHWs) immediately after completing a modified World Health Organization (WHO) smoking cessation training.DesignSecondary analysis of pre-post educational intervention conducted between October 2022 and June 2025 in Chicago, Illinois and San Joaquin Valley, California.Sample149 CHWs employed or in training, recruited through community-based organizations, public health agencies, and CHW certification programs in Chicago and San Joaquin Valley.InterventionA three-hour culturally adapted WHO 5A's/5R's training emphasizing motivational interviewing, structural determinants of health, and community-centered cessation support.MeasuresPre-post self-administered surveys assessed tobacco-related knowledge (10-item test), motivation, readiness, and confidence (10-point scales). Independent variables included age, gender, race/ethnicity, education, prior tobacco training/coursework, and time in position.AnalysisPaired-sample t-tests evaluated pre-post differences; multivariable linear regressions examined predictors of change using STATA 19.ResultsSignificant improvements were observed in knowledge (ΔM = 3.02, P < .001), motivation (ΔM = 0.90, P < .001), readiness (ΔM = 2.16, P < .001), and confidence (ΔM = 2.09, P < .001). Regression models showed no consistent sociodemographic predictors of change. Younger age (P = .024) and postgraduate education (P = .033) predicted greater readiness gains.ConclusionThe training produced substantial, equitable improvements across learning domains, indicating that culturally adapted, practice-oriented curricula can enhance CHW competence regardless of background. Findings support inclusive, community-responsive training as a mechanism of workforce equity.