Impact of community health workers facilitating Irish Travellers’ awareness of cancer and screening

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Abstract Background Irish Travellers, population circa 45,000, were formally recognised as a minority ethnic community in 2017. Data from the All-Ireland Traveller Health Study confirms reduced life expectancy and poorer health outcomes underpinned by the social determinants of health. While health services for this population remain underdeveloped, Traveller-led community health projects exist in providing targeted services. The American Public Health Association acknowledges the role of community health workers (CHW) in supporting public health and improving the health of minority populations as trusted community members, acting as liaisons and links to facilitate culturally competent services. Limited data exists on the impact of the Irish Traveller CHW (TCHW) role supporting cancer knowledge, awareness and access to health services. Methods Following ethical approval, 22 qualitative interviews were undertaken with Irish Travellers [November 2023 to February 2024] as part of a larger multi-methods study. Irish Primary Health Care Traveller Project peer researchers led recruitment to the study. All interviews were digitally recorded [with consent] and transcribed verbatim. Thematic methods were used to code, analyse, and map barriers and facilitators. Results Participants reported persistent systematic racism and discrimination experienced by Travellers, creating a significant barrier to accessing health services. Social determinants of health were critical in explaining barriers, including lack of education, unemployment, and poor housing. Traveller advocacy groups and TCHWs, supporting informed conversations and improving cancer health literacy through adopting culturally and gender appropriate methods, were highlighted mechanisms improving knowledge, awareness and engagement with health services. Conclusions The role of TCHW is pivotal in enabling cancer knowledge and awareness through the adoption of teachable moments and navigation of health systems. Key messages • The experiences of discrimination highlighted in this study may be similar for other communities and indicate an urgent need for mandatory and ongoing anti-racism training in health services. • Opportunity and willingness to co-design targeted approaches and ensure inclusivity in building trust and creating systematic change exists among minority ethnic groups to improve health access.