A secondary analysis reveals sociodemographic factors affecting knowledge improvement in community health workers, suggesting tailored training approaches may enhance outcomes.
Background: Smoking is a key contributor to cancer disparities, particularly among adults with low socioeconomic status (SES), who smoke at nearly twice the national rate (24% vs. 15%) and experience elevated cancer morbidity and mortality. Community health workers (CHWs), as trusted frontline public health professionals embedded in underserved communities, are uniquely positioned to address tobacco use outside of traditional healthcare settings. Prior research has shown that training CHWs in brief tobacco interventions requires adaptation to their relational and community-based roles. However, little is known about which CHWs benefit most from cessation training—an equity gap that may hinder effective implementation and workforce development. Objective: To identify sociodemographic factors associated with improvement in tobacco-related knowledge and confidence in delivering cessation support among CHWs following a modified smoking cessation training. Methods: We conducted a secondary analysis of pre- and post-training data from 155 CHWs in Chicago, IL, recruited from a public health department, community-based organizations, and a CHW degree program. CHWs completed pre-tests prior to training and post-tests at its conclusion. Outcomes were the changes in tobacco-related knowledge and confidence scores from pre- to post- training. Independent variables were age, gender, race/ethnicity, education, prior tobacco training, and time in position. Multivariable linear regression was used to identify predictors of change. Results: We found that 155 CHWs completed the pre-training test, and 144 completed the post-training test. Post-training scores for tobacco-related knowledge and confidence were significantly higher than pre-training scores (p < 0.001). Greater increases in readiness to deliver cessation support were observed among CHWs with postgraduate education (p = 0.049), while older CHWs showed smaller improvements (p = 0.043). Black or African American CHWs also showed smaller improvements in confidence (p = 0.039). No consistent predictors were found for changes in knowledge, motivation, confidence, or MI-specific confidence. Conclusions: These findings highlight the effectiveness of the training, as it led to significant improvements in both tobacco-related knowledge and confidence among CHWs. The lack of consistent predictors suggests that the training is broadly applicable and equitable across diverse CHW populations. However, the smaller confidence gains among African American and older CHWs point to the need for future training to incorporate culturally responsive and age-sensitive approaches to ensure that all CHWs benefit fully. Addressing these disparities in training outcomes is critical for reducing broader health disparities, as CHWs play a key role in delivering cessation support in underserved communities. Tailoring training to meet the needs of diverse CHWs can strengthen their ability to promote equitable tobacco cessation outcomes and advance health equity. Citation Format: Andres Mauricio Garcia Sierra, Victoria Nassar Abuabara, Marcia Tan. Sociodemographic predictors of knowledge and confidence gains among community health workers following a modified smoking cessation training [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B012.
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