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A Promotora-administered group education intervention to promote breast and cervical cancer screening in a rural community along the U.S.–Mexico border: a randomized controlled trial

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Abstract

Background

Breast cancer is the most common neoplasm among Hispanic women. Cervical cancer has a higher incidence and mortality among Hispanic women compared with non-Hispanic White women.

Objective

To assess the effectiveness of a promotora-administered educational intervention to promote breast and cervical cancer screening among post-reproductive age, medically underserved Hispanic women residing along the U.S.–Mexico border.

Methods

Women age 50 or older were eligible to participate in this intervention study. A total of 381 subjects agreed to participate. Women were randomly assigned into one of two groups, educational intervention or usual care. The primary outcomes were self-reported mammogram and Pap smear screening. Logistic regression analysis was used to compute odds ratios for comparisons between intervention and control groups.

Results

Women in the intervention group were 2.0 times more likely to report having had a mammogram within the last year when compared with the usual care group (95% CI = 1.3–3.1). Likewise, women in the intervention group were 1.5 times more likely to report having a Pap smear within the last year when compared with the usual care group, although this was not statistically significant (95% CI = 0.9–2.6). In a secondary analysis, the intervention suggests a stronger effect on those that had not had a mammogram or Pap smear within the past year at baseline.

Conclusions

A promotora-based educational intervention can be used to increase breast and cervical cancer screening utilization among Hispanic women.

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References

  1. American Cancer Society (2006) Cancer facts & figures for Hispanics/Latinos 2006–2008. American Cancer Society, Atlanta

    Google Scholar 

  2. MMWR Morb Mortal Wkly (2002) Invasive cervical cancer among Hispanic and non-Hispanic women–United States, 1992–1999. 51:1067–1070

  3. Coughlin SS, Richards TB, Nasseri K, Weiss NS, Wiggins CL, Saraiya M et al (2008) Cervical cancer incidence in the United States in the US-Mexico border region, 1998–2003. Cancer 113(suppl 10):2964–2973

    Article  PubMed  Google Scholar 

  4. Healthy Border 2010 (2003) An agenda improving health on the United States-Mexico Border. U.S. Mexico Border Health Commission 2003

  5. Nuño T, Castle PE, Harris RB, Estrada AL, Garcia F (2011) Breast & cervical cancer screening utilization among hispanic women living near the U.S.-Mexico border. J Womens Health (in press)

  6. Suarez L, Nichols D, Brady C (1993) Use of peer role models to increase Pap smear and mammogram screening in Mexican-American and black women. Am J Prev Med 9(5):290–296

    CAS  PubMed  Google Scholar 

  7. Castro FG, Elder J, Coe K, Tafoya-Barraza H, Moratto S, Campbell N et al (1995) Mobilizing churches for health promotion in Latino communities: Companeros en la Salud. J Natl Cancer Inst 18:127–135

    Google Scholar 

  8. Navarro AM, Senn KL, McNicholas LJ, Kaplan RM, Roppe B, Campo MC (1998) Por La vida model intervention enhances use of cancer screening tests among Latinas. Am J Prev Med 15(1):32–41

    Article  CAS  PubMed  Google Scholar 

  9. Hiatt RA, Pasick RJ, Stewart S, Bloom J, Davis P, Gardiner P et al (2001) Community-based cancer screening for underserved women: design and baseline findings from the breast and cervical cancer intervention study. Prev Med 33(3):190–203

    Article  CAS  PubMed  Google Scholar 

  10. Fernandez-Esquer ME, Espinoza P, Torres I, Ramirez AG, McAlister AL (2003) A Su Salud: a quasi-experimental study among Mexican American Women. Am J Health Behav 27(5):536–545

    PubMed  Google Scholar 

  11. Mayo RM, Sherrill WW, Crew L, Watt P, Mayo WW (2004) Connecting rural African American and Hispanic women to cancer education and screening: the Avon Health Connector Project. J Cancer Educ 19(2):123–126

    Article  PubMed  Google Scholar 

  12. Giarratano G, Bustamante-Forest R, Carter C (2005) A multicultural and multilingual outreach program for cervical and breast cancer screening. J Obstet Gynecol Neonatal Nurs 34(3):395–402

    Article  PubMed  Google Scholar 

  13. Hansen LK, Feigl P, Modiano MR, Lopez JA, Escobedo Sluder S, Moinpour CM et al (2005) An educational program to increase cervical and breast cancer screening in Hispanic women: a Southwest Oncology Group study. Cancer Nurs 28(1):47–53

    Article  PubMed  Google Scholar 

  14. Larkey L (2006) Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening. J Community Health 31(1):69–77

    Article  PubMed  Google Scholar 

  15. Ell K, Vourlekis B, Lee P-J, Xie B (2007) Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med 44:26–33

    Article  PubMed  Google Scholar 

  16. Ferrante JM, Chen P-H, Kim S (2007) The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health 85(1):114–124

    Article  PubMed  Google Scholar 

  17. Sauaia A, Min S-j, Lack D, Apodaca C, Osuna D, Stowe A, et al. (2007) Church-based breast cancer screening education: impact of two approaches on Latinas enrolled in public and private health insurance plans. Prev Chronic Dis 4(4): http://www.cdc.gov/pcd/issues/2007/oct/06_0150.htm

  18. Martinez-Donate AP (2009) Using lay health advisors to promote breast and cervical cancer screening among Latinas: a review. Wis Med J 108(5):259–262

    Google Scholar 

  19. U.S. Census Bureau (2000) Summary file 1 (SF 1) and summary file 3 (SF 3)

  20. Bandura A (1986) Social foundations of thought and action: a social cognitive theory. Prentice-Hall, Englewood Cliffs, NJ

    Google Scholar 

  21. Bandura A (2004) Health promotion by social cognitive means. Health Edu Behav 31(2):143–164

    Article  Google Scholar 

  22. Baranowski T, Perry CL, Parcel GS (2002) How individuals, environments, and health behavior interact: social cognitive theory. In: Glanz K, Rimer BK, Lewis FM (eds) Health behavior and health education: theory, research, and practice, 3rd edn. Jossey-Bass, San Francisco, CA, pp 165–184

    Google Scholar 

  23. Saslow D, Castle PE, Cox JT, Davey DD, Einstein MH, Ferris DG et al (2007) American Cancer Society guidelines for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA Cancer J Clin 57(1):7–28

    Article  PubMed  Google Scholar 

  24. Suarez L, Goldman D, Weiss N (1995) Validity of Pap smear and mammogram self-reports in a low-income Hispanic population. Am J Prev Med 1:94–98

    Google Scholar 

  25. Paskett E, Tatum C, Mack D, Hoen H, Case L, Velez R (1996) Validation of self-reported breast and cervical cancer screening tests among low-income minority women. Cancer Epidemiol Biomark Prev 5:721–726

    CAS  Google Scholar 

  26. Caplan LS, McQueen DV, Qualters JR, Leff M, Garrett C, Calonge N (2003) Validity of women’s self-reports of cancer screening test utilization in a managed care population. Cancer Epidem Biom Prev 12:1182–1187

    Google Scholar 

  27. Hunter JB, De Zapien JG, Denman C, Moncada E, Papenfuss M, Wallace D et al (2003) Healthcare access and utilization among women 40 and older at the U.S.-Mexico border: predictors of a routine check-up. J Commun Health 28(5):317–333

    Article  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge the enthusiastic participation of the many women in Yuma County who took part in the baseline survey and follow-up study activities. We also recognize the invaluable contributions of the lay community health workers (promotoras) who were primarily responsible for administering the survey and performing all the outreach work. We are indebted to the community of women’s health care practitioners in Yuma County who provided access to their patients and their clinics for the purposes of this study. We are also indebted to Dr. Richard Bragg at the Centers for Medicare & Medicaid Services (CMS) who provided broad guidance and input on this project. This manuscript was completed as part of dissertation work for the Epidemiology Graduate Program at the Mel and Enid Zuckerman College of Public Health. This work was partially funded by the Center for Medicaid and Medicare Services under contract number 25-P-91062.

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Authors and Affiliations

  1. The Mel and Enid Zuckerman College of Public Health, Division of Epidemiology & Biostatistics, University of Arizona, 1295 N. Martin A250, P.O. Box 245209, Tucson, AZ, 85724-5209, USA

    Tomas Nuño, Maria Elena Martinez, Robin Harris & Francisco García

  2. The Arizona Cancer Center, University of Arizona, Tucson, AZ, USA

    Maria Elena Martinez, Robin Harris & Francisco García

  3. The Center of Excellence in Women’s Health at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    Francisco García

Authors
  1. Tomas Nuño
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  2. Maria Elena Martinez
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  3. Robin Harris
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  4. Francisco García
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Corresponding author

Correspondence to Francisco García.

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Nuño, T., Martinez, M.E., Harris, R. et al. A Promotora-administered group education intervention to promote breast and cervical cancer screening in a rural community along the U.S.–Mexico border: a randomized controlled trial. Cancer Causes Control 22, 367–374 (2011). https://doi.org/10.1007/s10552-010-9705-4

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  • DOI: https://doi.org/10.1007/s10552-010-9705-4

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