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Using the Delphi Process in the Development of the Partnering to Build Understanding of Genomics Responsibly
Marie Smith1, Vickie Reed, Ashley Evans Knowell
1Author Affiliations: Center for Integrative Oncology and Survivorship, Cancer Institute, Prisma Health, Greenville, South Carolina (Smith); School of Health Professions, The University of Southern Mississippi, Hattiesburg, Mississippi (Reed, Anderson-Lewis, and Johnson); Health Equity Research and Training Center, South Carolina State University, Orangeburg, South Carolina (Knowell); Forsyth Technical Community College, Winston-Salem, North Carolina (Williams); Center for Community Health Alignment, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (Kolb and Green); Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina (Glenn); Tennessee Community Health Worker Association, Franklin, Tennessee (Burke and Hoffma); Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Jaeger, Grullon, Wagner, and Allen); Department of Medicine, Emory University School of Medicine, Atlanta, Georgia (Ramos); Ponderosa Public Health Consulting, Albuquerque, New Mexico (Menking); Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia (Guan); and Health Education Research and Training Center, South Carolina State University, Orangeburg, South Carolina (McCrary-Quarles).
Context:
Community Health Workers (CHWs) are increasingly involved in genomics-related communication and research engagement, yet few genomics training programs are tailored to their roles, learning needs, or community contexts.
Objective:
To refine and build consensus on the content, structure, and applicability of the PaRtnEring to build understanding oF gEnomics Responsibly (PREFER) CHW Genomics Research Education Program using a multiround Delphi process.
Design:
A 3-round Delphi study incorporating quantitative ratings and qualitative feedback to evaluate and revise curriculum modules and activities.
Setting:
Five CHW partner training sites across the Southeastern United States.
Participants:
Twenty-four individuals, including CHWs, CHW trainers, and genetics content experts. CHWs and CHW trainers comprised 83% of the panel.
Intervention:
An iterative refinement of a 10-module genomics education curriculum covering topics such as Genetics 101, Family History, Genetic Counseling and Testing, CHW Roles, Genetics Research, Ethical/Legal/Social Issues, and Communicating About Genomics.
Main Outcome Measures:
Clarity of learning objectives, use of adult learning theory, anticipated knowledge gain, and appropriateness of module-specific workbook activities, assessed using the Kirkpatrick Model and predefined consensus threshold of ≥75% agreement.
Results:
In Round 1, Genetics 101 and CHW Roles scored below the 75% consensus threshold. Round 2 focus groups identified needs for simplified scientific content, strengthened integration of CHW roles, and expanded real-world examples. In Round 3, 18 full assessments showed improved agreement across modules, although gaps remained in adult learning integration for selected modules. The final curriculum achieved consensus on clarity and anticipated knowledge gain across all modules.
Conclusions:
The Delphi process effectively refined the PREFER curriculum and ensured alignment with CHW needs. CHWs played a central role throughout development, directly shaping content, structure, and cultural relevance. The resulting curriculum offers a feasible, community-aligned approach to building CHW capacity in genomics communication and research engagement.
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