Protocol for the development of a culturally tailored cancer prevention workshop for community health workers: ORBIT phase I study in Somali and Oromo communities

Cancer disparities disproportionately affect Somali and Oromo communities in the USA due to systemic inequities, cultural barriers, and migration-related challenges. These two communities face low participation in cancer screening, due in part, to mistrust of healthcare systems, language barriers, and cancer-related stigma. Lifestyle changes, such as dietary shifts to calorie-dense foods and reduced physical activity, further exacerbate risks such as obesity—a well-documented risk factor for cancer. Community Health Workers (CHWs) embedded within the community can serve as important bridges between cultural and systemic gaps among underrepresented populations, but few tailored CHW interventions address the specific needs of East African communities. In partnership with Metro Youth Diversion Center in Minneapolis, MN, this study uses qualitative methods guided by Community-Based Participatory Research (CBPR) principles and the Theory of Planned Behavior (TPB) to inform the development of a culturally tailored cancer prevention workshop for CHWs serving Somali and Oromo communities. The study aims to (1) identify cultural, structural, and knowledge-based barriers to cancer prevention through focus groups with Somali and Oromo adults; (2) explore CHWs’ perspectives, roles, and training needs through in-depth interviews; and (3) use findings to co-develop a culturally sensitive and appropriate workshop guided by the Consolidated Framework for Implementation Research (CFIR). CHWs’ perceptions of the workshop's acceptability, relevance, and feasibility are also assessed to inform further refinement and prepare for future pilot testing. This formative study applies CBPR principles to engage community stakeholders and increase cultural relevance, TPB to identify determinants of cancer prevention behavior, and the ORBIT model to guide the structured development of a CHW-led workshop prior to feasibility testing. Findings will directly inform the design of a future ORBIT Phase II feasibility study to assess implementation potential and preliminary behavioral impact based on formative input from this study. By integrating community perspectives and implementation considerations early, this study aims to align the intervention with the lived experiences and structural barriers faced by Somali and Oromo communities.