Advancing Health Equity Knowledge, Attitudes, and Beliefs Within a National Health Nonprofit Organization

Objective: This study presents survey results assessing the impact of the American Cancer Society (ACS) health equity (HE) training on staff knowledge, attitudes, and beliefs about HE and social determinants of health (SDOH). Design: This study is a quasi-experimental design examining survey responses over time and comparing responses from staff who participated in ACS HE training sessions and education opportunities and those who did not. Setting: An electronic Web survey was distributed to all ACS and American Cancer Society Cancer Action Network (ACS CAN) staff in each of the 3 years that the training was held (2018-2020). Participants: ACS and ACS CAN staff who chose to take the survey were included in the study. Intervention: Engagement with training hosted by the ACS HE team was examined. Training sessions were intended to introduce staff to HE and SDOH in the context of cancer outcomes and provide staff with the skills to become HE champions in the organization. Main Outcome Measures: This study examines whether participation in training sessions hosted by the HE team had an impact on knowledge of HE terms, attitudes, and beliefs about HE and engagement with HE. Results: Trained respondents had a significantly higher HE knowledge summary score (98%) than those who were not trained (79%, SD = 0.26100, P < .001). Respondents who participated in training were more likely to believe that they could advance HE through their work at ACS and ACS CAN (88% compared with 66% of those who were not trained, SD = 0.47300, P < .001). Respondents who participated in training scored an average of 4.7 out of 6 on HE engagement compared with 3.8 among the untrained (SD = 1.425, P < .001). Conclusions: These findings demonstrate that participation in HE training is associated with higher levels of knowledge about HE and stronger personal attitudes and beliefs about the importance of addressing SDOH. This is a foundational step in staff taking action to integrate HE concepts into their day-to-day work toward reducing inequities in access to cancer treatment and health outcomes.