Strategies for Strengthening the Role of Community Health Workers in Breast Cancer Prevention: A Qualitative Study

Breast cancer continues to be a major cause of illness and mortality for women. Delayed detection remains a significant barrier to better health outcomes in many settings. This study explored the critical role of community health workers (CHW) in breast cancer prevention and identified practical strategies to enhance their effectiveness.

This descriptive qualitative study, using an interpretivist paradigm, was conducted in the Kaliwates subdistrict, Jember, Indonesia, from May 2024 to January 2025. Purposive sampling was used, including 12 CHWs with ≥1 year of involvement in the cancer program and 5 Healthcare Professionals (HCPs) involved in community health worker programs. In-depth interviews, each lasting between 60 and 90 minutes within 2-3 sessions, were performed. Interviews were concluded once data saturation was reached. All sessions were audio-recorded, transcribed verbatim, and analyzed using the six steps of Braun and Clarke's thematic analysis with ATLAS.ti software. To ensure trustworthiness, member checking and triangulation were employed.

Analysis of data from all 17 participants generated three themes. Theme one positioned CHWs as catalysts for early breast cancer prevention through building community confidence in breast self-examination and guiding individuals to professional care. Theme two focused on capacity development, emphasizing skill and confidence building alongside trust-building communication strategies. Theme three highlighted health system support and collaboration, identifying the need for adequate resources and formal recognition of collaborative efforts.

CHWs have a pivotal role in early breast cancer prevention. Strengthening their capacity through targeted training and trust-based communication, supported by adequate resources and collaborative recognition within the health system, is essential for optimizing their impact. Future research should focus on designing targeted interventions grounded in empowerment models to enhance CHWs' early detection skills.