Improved access to women's health services for Alaska natives through community health aide training

This project demonstrates the effect of increasing the skills of Community Health Aides (CHAs) on the use of specific preventive health services by wo men in remote Alaska villages. Eight CHAs were trained in specimen collecti on for Pap and sexually transmitted disease testing, and in clinical breast examination. Skill competency was monitored. Computerized medical records of all women between the ages of 18 and 75 in the four villages with traine d CHAs and in four comparison villages (n = 1093) were checked for Pap stat us prior to CHA training and again 12 months later. All eight CHAs achieved competency and provided services in their village clinics with telephone s upport from an experienced clinician. The post-training year Pap test rate of women who were overdue for a Pap test was 0.44 in the villages with trai ned CHAs; the rate among the women in the comparison villages was 0.32 (p = .079).