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Esperanza y Vida: Training Lay Health Advisors and Cancer Survivors to Promote Breast and Cervical Cancer Screening in Latinas

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Abstract

The use of lay health advisors (LHAs) to promote community-based health education programs is well documented and is considered an effective way to reach underserved communities. Esperanza y Vida (Hope & Life) is an educational outreach program to increase breast and cervical cancer screening for diverse Latinas. It incorporates Latino LHAs (men and women) and cancer survivor role models, sobrevivientes, in the program delivery. An interactive training program, conducted by bilingual staff across three sites (Little Rock, Arkansas; Buffalo, New York and New York City) included 74 sobrevivientes and LHAs who were recruited and trained. All training attendees completed an initial application assessing socio-demographics, experience and availability as well as, true/false surveys at the beginning (pre-) and end of the training (post-) measuring knowledge levels of breast and cervical cancer health. Data analysis indicated a significant increase of both breast and cervical cancer knowledge for attendees trained as LHAs (pre = 60%; post = 80%; p = 0.000), whereas sobrevivientes had a higher baseline knowledge of breast health (74%), and therefore did not show a significant increase following training (79%). However, sobrevivientes did display a significant increase in cervical cancer knowledge (p = 0.003). These findings demonstrate the impact of training and how LHAs may be recruited at different levels of knowledge and experience and be successfully trained in key program elements. Moreover, results indicate that sobrevivientes may be impacted differently, or require variations in training approaches. This information can be useful in developing and customizing curriculum for future lay health training programs.

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References

  1. American Cancer Society. (2009). Cancer facts and figures for Hispanics/Latinos, 2009–2011. Atlanta, GA: American Cancer Society.

  2. Joslyn, S. A., Foote, M. L., Nasseri, K., Coughlin, S. S., & Howe, H. L. (2005). Racial and ethnic disparities in breast cancer rates by age: NAACCR breast cancer project. Breast Cancer Research and Treatment, 92, 97–105.

    Article  PubMed  Google Scholar 

  3. Li, C. I., Malone, K. E., & Daling, J. R. (2003). Differences in breast cancer stage, treatment, and survival by race and ethnicity. Archives of Internal Medicine, 163, 49–56.

    Article  PubMed  Google Scholar 

  4. Rodriguez, M. A., Ward, L. M., & Perez-Stable, E. S. (2005). Breast and cervical cancer screening: Impact of health insurance status, ethnicity and nativity of Latinas. Annals of Family Medicine, 3(3), 235–241.

    Article  PubMed  Google Scholar 

  5. Bazargan, M., Bazargan, S. H., Farooq, M., & Baker, R. S. (2004). Correlates of cervical cancer screening among underserved Hispanic and African–American women. Preventive Medicine, 39(3), 465–473.

    Article  PubMed  Google Scholar 

  6. Sullivan, S. G., Glasson, E. J., Hussain, R., et al. (2003). Breast cancer and the uptake of mammography screening services by women with intellectual disabilities. Preventive Medicine, 37(5), 507–512.

    Article  PubMed  CAS  Google Scholar 

  7. Centers for Disease Control and Prevention. (2008). Racial and ethnic approaches to community health (REACH US): Finding solutions to health disparities 2008. <www.cdc.gov/reach>.

  8. Fernández, M. E., Gonzales, A., Tortolero-Luna, G., et al. (2009). Effectiveness of cultivando la salud: A breast and cervical cancer screening promotion program for low-income Hispanic women. American Journal of Public Health, 99(5), 936–943.

    Article  PubMed  Google Scholar 

  9. Koval, A. E., Riganti, A. A., & Foley, K. L. (2006). CAPRELA (cancer prevention for latinas): Findings of a pilot study in winston-salem, forsyth county. North Carolina Medical Journal, 67(1), 9–15.

    PubMed  Google Scholar 

  10. Rhodes, S. D., Hergenrather, K. C., Montaño, J., et al. (2006). Using community-based participatory research to develop an intervention to reduce HIV and STD infections among Latino men. AIDS Education and Prevention, 18(5), 375–389.

    Article  PubMed  Google Scholar 

  11. Nies, M. A., Artinian, N. T., Schim, S. M., Vander Wal, J. S., & Sherrick-Escamilla, S. (2004). Effects of lay health educator interventions on activity, diet, and health risks in an urban Mexican American community. Journal of Primary Prevention, 25(4), 441–455.

    Article  Google Scholar 

  12. Darnell, J. S., Chang, C., & Calhoun, E. A. (2006). Knowledge about breast cancer and participation in a faith-based breast cancer program and other predictors of mammography screening among African American women and Latinas. Health Promotion Practice, 7(3_suppl), 201S–212S.

    Article  PubMed  Google Scholar 

  13. Hansen, L. K., Feigl, P., Modiano, M. R., et al. (2005). An educational program to increase cervical and breast cancer screening in Hispanic women: A southwest oncology group study. Cancer Nursing, 28(1), 47–53.

    Article  PubMed  Google Scholar 

  14. Rhodes, S. D., Foley, K. L., Zometa, C. S., & Bloom, F. R. (2007). Lay health advisor interventions among Hispanics/Latinos. A qualitative systematic review. American Journal of Preventive Medicine, 33(5), 418–427.

    Article  PubMed  Google Scholar 

  15. US Department of Health and Human Services. (2007). Community health worker national workforce study. US Department of Health and Human Services Health Resources and Services Administration (HRSA).

  16. Swider, S. M. (2002). Outcome effectiveness of community health workers: An integrative literature review. Public Health Nursing, 19(1), 11–20.

    Article  PubMed  Google Scholar 

  17. Rosenthal, E. L., deHeer, H., Rush, C. H., & Holderby, L. (2010). Focus on the future: A community health worker agenda by and for the field. Progress in Community Health Partnerships: Research, Education, and Action, 2(3), 183–184.

    Article  Google Scholar 

  18. Love, M., Gardner, K., & Legion, V. (1997). Community health workers: Who they are and what they do. Health Education & Behavior, 24(4), 510–522.

    Article  CAS  Google Scholar 

  19. Eng, E., & Parker, E. A. (2002). Natural helper models to enhance a community’s health & competence. In R. J. DiClemente, R. A. Crosby, & M. C. Kegler (Eds.), Emerging theories in health promotion practice and research: Strategies for improving public health. San Francisco, CA: Joessey-Bass.

    Google Scholar 

  20. Eng, E., Parker, E., & Harlan, C. (1997). Lay health advisor intervention strategies: A continuum from natural helping to paraprofessional helping. Health Education and Behavior, 24(4), 413–417.

    Article  PubMed  CAS  Google Scholar 

  21. Perez, M., Findley, S. E., Mejia, M., & Martinez, J. (2006). The impact of community health worker training and programs in New York City. Journal of Health Care for the Poor and Underserved, 17, S26–S43.

    Google Scholar 

  22. Ramirez, A., McAlister, A., & Gallion, K. (1995). Community level cancer control in a Texas barrio: Part I. Theoretical basis, implementation, and process evaluation. Journal National Cancer Institute Monograph, 18, 117–122.

    Google Scholar 

  23. Castro, F., Elder, J., & Coe, K. (1995). Mobilizing churches for health promotion in Latino communities: Companeros en la salud. Journal National Cancer Institute Monogram, 18, 127–356.

    Google Scholar 

  24. Navarro, A. M., Senn, K. L., McNicholas, L. J., Kaplan, R. M., Roppé, B., & Campo, M. C. (1998). Por la vida model intervention enhances use of cancer screening tests among Latinas. American Journal of Preventive Medicine, 15(1), 32–41.

    Article  PubMed  CAS  Google Scholar 

  25. Navarro, A. M., Senn, K. L., & Kaplan, R. M. (Eds.) (1995). Por la vida intervention model for cancer prevention in latinas. Journal National Cancer Institute Monograph, 18, 137–145.

    Google Scholar 

  26. Davis, R. E., & Flannery, D. D. (2001). Designing health information delivery systems for Puerto Rican women. Health Education & Behavior, 28, 680–695.

    Article  CAS  Google Scholar 

  27. Erwin, D. O., Johnson, V. A., Trevino, M., Duke, K., Feliciano, L., & Jandorf, L. (2007). A comparison of African American and Latina social networks as indicators for culturally tailoring a breast and cervical cancer education intervention. American Cancer Society CANCER Supplement, 109(2), 368–377.

    Google Scholar 

  28. Katapodi, M., Facione, N., Miaskowski, C., Dodd, M., & Waters, C. (2002). The influence of social support on breast cancer screening in a multicultural community sample. Oncology Nursing Forum, 29(5), 845–852.

    Article  PubMed  Google Scholar 

  29. Meade, C. D., Calvo, A., & Cuthbertson, D. (2002). Impact of culturally, linguistically, and literacy relevant cancer information among Hispanic farmworker women. Journal of Cancer Education, 17(1), 50–54.

    PubMed  Google Scholar 

  30. Erwin, D. O., Ivory, J., Stayton, C., et al. (2003). Replication and dissemination of a cancer education model for African American women. Cancer Control, 10(5 Suppl), 13–21.

    PubMed  Google Scholar 

  31. Erwin, D. O., Spatz, T. S., & Stotts, R. C. (1996). Increasing mammography and breast self-examination in African American women using the witness project model. Journal of Cancer Education, 11, 210–215.

    PubMed  CAS  Google Scholar 

  32. Kreuter, M. W., Buskirk, T. D., Holmes, K., et al. (2008). What makes cancer survivor stories work? An empirical study among African American women. Journal of Cancer Survivorship, 2, 33–44.

    Article  PubMed  Google Scholar 

  33. Kreuter, M. W., Green, M. C., Cappella, J. N., et al. (2007). Narrative communication in cancer prevention and control: A framework to guide research and application. Annals of Behavioral Medicine, 33(3), 221–235.

    Article  PubMed  Google Scholar 

  34. Erwin, D. O., Spatz, T. S., & Stotts, R. C. (1999). Increasing mammography practice by African American women. Cancer Practice, 7, 78–85.

    Article  PubMed  CAS  Google Scholar 

  35. Erwin, D. O., Spatz, T. S., & Turturro, C. L. (1992). Development of an African–American role model intervention to increase breast self-examination and mammography. Journal of Cancer Education, 7(4), 311–319.

    Article  PubMed  CAS  Google Scholar 

  36. Sudarson, N. R., Jandorf, L., & Erwin, D. O. (2010). Multi-site implementation of health education programs for Latinas. Journal of Community Health (in press).

  37. Jandorf, L., Ellison, J. L., Shelton, R. C., et al. (2010). Esperanza y vida: A culturally and linguistically customized breast and cervical education program for diverse Latinas: At three different US sites. Journal of Health Communication (in review).

  38. Erwin, D. O., Trevino, M., Feliciano, L., et al. (2010). Contextualizing diversity and culture within cancer control interventions for Latinas: Changing interventions, not cultures. Social Science and Medicine, 71, 693–701.

    Article  PubMed  Google Scholar 

  39. Erwin, D. O., Johnson, V. A., Feliciano-Libid, L., Zamora, D., & Jandorf, L. (2005). Incorporating cultural constructs and demographic diversity in the research and development of a Latina breast and cervical cancer education program. Journal of Cancer Education, 20(1), 39–44.

    Article  PubMed  Google Scholar 

  40. Jandorf, L., Bursac, Z., Pulley, L., Trevino, M., Castillo, A., & Erwin, D. O. (2008). Breast and cervical cancer screening among Latinas attending culturally specific educational programs. Progress in Community Health Partnerships: Research, Education and Action, 2(3), 195–204.

    Article  Google Scholar 

  41. Larkey, L. K., & Gonzalez, J. (2007). Storytelling for promoting colorectal cancer prevention and early detection among Latinos. Patient Education and Counseling, 67, 272–278.

    Article  PubMed  Google Scholar 

  42. Booker, V. K., Robinson, J. G., Kay, B. J., Najera, L. G., & Stewart, G. (1997). Changes in empowerment: Effects of participation in a lay health promotion program. Health Education & Behavior, 24(4), 452–464.

    Article  CAS  Google Scholar 

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Acknowledgments

Formative research was supported by Susan G. Komen Race for the Cure Foundation Grants #: POP0201290 and POP0503950. The intervention effectiveness study is currently supported by American Cancer Society grant: RSGT-07-021-01-CPPB and funding from the John R. Oishei Foundation of Western New York. The authors acknowledge the assistance of Paula Jones.

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Authors and Affiliations

  1. Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA

    Frances G. Saad-Harfouche, Jomary Colón & Deborah O. Erwin

  2. Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY, 10029-6574, USA

    Lina Jandorf, Linda D. Thélémaque & Anabella G. Castillo

  3. Department of Health Behavior, School of Public Health and Health Professionals, The State University of New York at Buffalo, 305 Kimball Tower, 3435 Main Street, Buffalo, NY, 14214, USA

    Elizabeth Gage

  4. Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St, Slot 820, Little Rock, AR, 72205, USA

    Michelle Treviño

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  1. Frances G. Saad-Harfouche
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  2. Lina Jandorf
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Correspondence to Frances G. Saad-Harfouche.

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Saad-Harfouche, F.G., Jandorf, L., Gage, E. et al. Esperanza y Vida: Training Lay Health Advisors and Cancer Survivors to Promote Breast and Cervical Cancer Screening in Latinas. J Community Health 36, 219–227 (2011). https://doi.org/10.1007/s10900-010-9300-3

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