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CHW 103: Health Across the Lifespan
103.5 Diabetes, Kidneys, Cancer Screening, Lungs and Asthma
Chronic conditions CHWs see most, and how we help people stay ahead
Your materials
Slides (PowerPoint) Handout (Word)
For instructors
Facilitator guide Printable pre and post tests Quiz (LMS import)
What you will learn
- Explain type 1, type 2 and prediabetes and the A1C ranges
- Recognize low and high blood sugar signs and respond safely
- Match recommended cancer screenings to a person's age
- Support people with asthma or COPD using action plans and quit help
Start here
Eight in ten adults with prediabetes do not know they have it. Who in your circle might be one of them?
Lesson
Type 1 and type 2 diabetes
Type 1
- The immune system attacks cells that make insulin
- The body makes little or no insulin
- Needs insulin every day
- Often found in children and young adults
- Cannot be prevented
Type 2
- The body does not use insulin well
- Develops slowly over many years
- Often has no signs at first
- Usually found in adults, now more in youth
- Can often be prevented or delayed
Reading A1C and fasting blood sugar
| Result | A1C test | Fasting blood sugar |
|---|---|---|
| Normal | Below 5.7% | 99 mg/dL or lower |
| Prediabetes | 5.7% to 6.4% | 100 to 125 mg/dL |
| Diabetes | 6.5% or higher | 126 mg/dL or higher |
Low and high blood sugar signs
Low (below 70 mg/dL)
- Shaking, sweating, fast heartbeat
- Hunger, dizziness, nervousness
- Confusion or acting strangely
- Severe: fainting or seizures, call 911
High
- Very thirsty, urinating often
- Blurry vision, very tired
- Slow-healing sores, tingling feet
- Nausea, vomiting or stomach pain: call the provider
Kidneys: diabetes and blood pressure connect
- 1 in 7 U.S. adults have chronic kidney disease (about 14%)
- 87% of adults with kidney disease do not know it
- 1 in 3 adults with diabetes have chronic kidney disease
Source: CDC Chronic Kidney Disease fact sheet, 2026
Cancer screenings by age
| Cancer | Who | Test and how often |
|---|---|---|
| Breast | Women 40 to 74 | Mammogram every 2 years |
| Colorectal | Adults 45 to 75 | Stool test or colonoscopy, schedule varies |
| Cervical | Women 21 to 29 | Pap test every 3 years |
| Cervical | Women 30 to 65 | HPV test every 5 years, or other options |
| Lung | Ages 50 to 80, heavy smoking history | Low-dose CT scan every year |
Asthma and COPD: breathing support
- Know the difference: Asthma narrows airways in flare-ups. COPD is lung damage that worsens over time, mainly from tobacco smoke.
- Find the triggers: Tobacco smoke, mold, dust mites, cockroaches, pet dander, pollen, cold air, strong smells and colds.
- Use the action plan: Green: doing well. Yellow: caution, use quick-relief medicine as planned. Red: emergency, get help now.
- Help people quit: The Ohio Tobacco Quit Line, 1-800-QUIT-NOW, is free for any Ohio resident and open 24 hours.
Why asthma clusters in old housing
- What we see: Jaylen, age 9, in Hough, goes to the emergency room for asthma three times this winter and misses a lot of school.
- Why it happens (upstream): Old rental housing with mold, pests and leaks, landlords who delay repairs, nearby traffic pollution, and secondhand smoke in shared buildings.
- What we can build on (assets): The school nurse, the family's pediatric clinic, tenant rights groups, block clubs, healthy homes programs, and Jaylen's grandmother who already tracks his symptoms.
Situation: shaky at the food pantry
Situation: At a Lorain food pantry, Mr. Luis Ortega, who has diabetes and takes insulin, says he skipped lunch. He is sweaty, shaky and a little confused, but awake and talking. His meter reads 58.
What should the CHW do?
- Help him follow his plan: 15 grams of fast sugar, like 4 ounces juice
- Stay with him and recheck in 15 minutes
- Call 911 if he passes out, has a seizure or cannot swallow
- Tell your supervisor and help him contact his provider
Study sheet
The big idea: Many chronic diseases start quietly, so screening, daily plans and community support catch them early and keep people well.
Key points
- Type 1 needs daily insulin; type 2 develops slowly and can often be prevented or delayed with lifestyle change.
- A1C below 5.7% is normal, 5.7% to 6.4% is prediabetes, and 6.5% or higher is diabetes.
- Low blood sugar is below 70: follow the person's plan and the 15-15 rule, and call 911 for fainting or seizures.
- Diabetes and high blood pressure are the main causes of kidney failure, and most people with kidney disease do not know.
- Screenings: mammogram from 40, colorectal from 45, cervical from 21, and yearly lung CT for eligible people 50 to 80.
- Asthma action plans use green, yellow and red zones, and the Ohio Tobacco Quit Line is 1-800-QUIT-NOW.
Remember
- A1C: under 5.7 normal, 5.7 to 6.4 prediabetes, 6.5 or higher diabetes
- 15-15 rule: 15 grams fast sugar, recheck in 15 minutes
- Lung screening: ages 50 to 80, 20 pack-years, smoke now or quit within 15 years
- Ohio Tobacco Quit Line: 1-800-QUIT-NOW (1-800-784-8669)
Ask yourself
- Which screenings are due for me and the people I love?
- What housing or food conditions in my neighborhood make these diseases harder to manage?
- How can I explain the asthma zones in plain words to a parent?
Vocabulary
| Word | What it means |
|---|---|
| Insulin | A hormone that moves sugar from the blood into the body's cells for energy. |
| Prediabetes | Blood sugar higher than normal but not high enough to be type 2 diabetes. |
| A1C | A blood test that shows average blood sugar over the past two to three months. |
| Hypoglycemia | Low blood sugar, below 70 mg/dL. |
| Hyperglycemia | High blood sugar. |
| Chronic kidney disease (CKD) | Kidney damage that makes the kidneys filter blood less well over time. |
| Screening | A test to find a disease early, before a person has symptoms. |
| Mammogram | An X-ray of the breast used to screen for breast cancer. |
| Pack-year | A way to measure smoking: one pack a day for one year equals one pack-year. |
| COPD | Chronic obstructive pulmonary disease: lung diseases like emphysema and chronic bronchitis that block airflow and worsen. |
| Asthma action plan | A written plan from the provider that shows what to do in the green, yellow and red zones. |
| Trigger | Something that sets off asthma symptoms, such as smoke, mold, pests or cold air. |
Real-life situations
The screening he keeps putting off
Mr. Terrence Hill, 48, in Glenville, says colon screening is only for older men and he is scared of the prep.
What to do
- Listen to his worries without pushing
- Share that screening is now recommended starting at 45
- Explain there are different test options, and help him ask his provider which fits him
- Help with scheduling, a ride or a reminder call
Why: The USPSTF recommends colorectal screening from 45 to 75, and fear and logistics are common barriers CHWs can lower.
The yellow zone
Ms. Aisha Coleman in Fairfax calls to say her daughter is coughing and wheezing and woke up twice last night. She has an asthma action plan on the fridge.
What to do
- Ask her to read the yellow zone steps aloud and follow them
- Remind her: call 911 if her daughter has trouble walking or talking, or blue or gray lips
- Help her call the child's provider as the plan says
- Follow up later and ask about triggers at home
Why: The plan comes from the provider. The CHW helps the family use it and acts fast on danger signs.
Ready to quit
Mr. Frank Kowalski, 63, in Slavic Village, smoked a pack a day for 40 years. He says he wants to quit and asks if there is anything free.
What to do
- Praise his decision and ask what has worked or not worked before
- Give him the Ohio Tobacco Quit Line, 1-800-QUIT-NOW, and offer to call with him
- Encourage him to ask his provider about lung cancer screening
- Plan a follow-up call in one week
Why: The Quit Line offers free coaching to any Ohio resident, and his age and smoking history may make him eligible for yearly lung screening.
Activity: Screening navigator card
About 25 minutes.
- Make a one-page card that lists breast, colorectal, cervical and lung screening by age, in plain words.
- Add three local places in Greater Cleveland where people can get screened. Check that each one is current.
- Add one barrier for each screening (fear, cost, time, rides) and how a CHW could help.
- Practice explaining the card to a partner using teach-back.
- Upload your card to the course.
Post-test
Ten questions. You need 75% to pass, with one retake. Your result is saved in this browser.
Sources
- CDC, About Diabetes
- CDC, Diabetes Testing
- CDC, Diabetes Symptoms
- CDC, Diabetes Risk Factors
- CDC, A Report Card: Diabetes in the United States
- CDC, Low Blood Sugar (Hypoglycemia)
- CDC, Treatment of Low Blood Sugar
- CDC, Diabetes and Chronic Kidney Disease
- CDC, Chronic Kidney Disease fact sheet
- USPSTF, Breast Cancer Screening Clinician Summary (2024)
- USPSTF, Colorectal Cancer Screening Final Recommendation Bulletin (2021)
- USPSTF, Lung Cancer Screening Final Recommendation (2021)
- CDC, About COPD
- CDC, Asthma Action Plan
- North American Quitline Consortium, Ohio quitline profile
- USPSTF, Cervical Cancer Screening Final Recommendation (2018; update in progress)
- CDC, Common Asthma Triggers
- Warren County Health District (Ohio), Smoking Cessation: Ohio Tobacco Quit Line 1-800-QUIT-NOW (784-8669)