Effectiveness of Cultivando La Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic Women

Autor:	Janet L. Williams, Alicia Gonzales, Monica Saavedra-Embesi, Wenyaw Chan, Guillermo Tortolero-Luna, Sally W. Vernon, Maria E. Fernandez
Rok vydání:	2009
Předmět:	medicine.medical_specialty Research and Practice Uterine Cervical Neoplasms Papanicolaou stain Breast Neoplasms Health Promotion Breast cancer Surveys and Questionnaires medicine Humans Mass Screening Mammography Pap test Program Development Poverty Cervix Vaginal Smears Cervical cancer Gynecology medicine.diagnostic_test business.industry Public health Public Health Environmental and Occupational Health Hispanic or Latino Middle Aged Patient Acceptance of Health Care medicine.disease United States medicine.anatomical_structure Health promotion Family medicine Female business Papanicolaou Test
Zdroj:	American Journal of Public Health. 99:936-943
ISSN:	1541-0048 0090-0036
DOI:	10.2105/ajph.2008.136713
Popis:	Objectives. We tested the effectiveness of a lay health worker intervention to increase breast and cervical cancer screening among low-income Hispanic women. Methods. Participants were women 50 years and older who were nonadherent to mammography (n = 464) or Papanicolaou (Pap) test (n = 243) screening guidelines. After the collection of baseline data, lay health workers implemented the Cultivando la Salud (CLS; Cultivating Health) intervention. Data collectors then interviewed the participants 6 months later. Results. At follow-up, screening completion was higher among women in the intervention group than in the control group for both mammography (40.8% vs 29.9%; P < .05) and Pap test (39.5% vs 23.6%; P < .05) screening. In an intent-to-treat analysis, these differences remained but were not significant. The intervention increased mammography self-efficacy, perceived susceptibility, perceived survivability, perceived benefits of mammography, subjective norms, and processes of change. The intervention also significantly increased Pap test self-efficacy, perceived benefits of having a Pap test, subjective norms, and perceived survivability of cancer. It did not change Pap test knowledge, perceived susceptibility, or perceptions about negative aspects of Pap test screening. Conclusions. Our results add to the evidence concerning the effectiveness of lay health worker interventions for increasing Pap test screening and mammography. Future research should explore the effectiveness of CLS in other Hispanic groups, the mechanisms through which interpersonal communication influences decisions about screening, and how effective interventions such as CLS can best be adopted and implemented in community-based organizations or other settings.
Databáze:	OpenAIRE
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