Screening Mammography and Latinas: A Multilevel Intervention
Condition: Breast Cancer
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      ¡Fortaleza Latina! is a multi-level randomized trial to increase participation in mammography
      screening among Latinas who seek care at a community health center in Western Washington.

      In partnership with the partnering community health center, we have obtained lists of women
      patients aged 42 to 74 years old who had not had a mammogram in the last two years and
      resided within defined radii of the four clinics. Baseline and one year follow-up surveys
      will be obtained by in person home interview. Participants are randomized within clinic to
      intervention or comparison group. The intervention consist of two motivational interviewing
      sessions, one in person in the home, and one telephone follow-up. The study hypothesis is
      that a higher proportion of participants in the motivational interviewing arm will obtain a
      screening mammogram within the study period than those in the comparison arm.
    

Detailed description: 
      Breast cancer is the most common cancer among Hispanic women in the United States (US) and
      five-year survival from breast cancer is lower in Hispanic than in non-Hispanic White women.
      This reduced survival has a number of potential causes, but differential screening rates may
      be a partial explanation, since Hispanic women have lower breast cancer screening rates than
      non-Hispanic White women. The overall purpose of the study is to develop and evaluate a
      culturally-appropriate intervention aimed at increasing screening mammography rates in a
      clinic-based sample of predominantly Mexican American women in Western Washington.

      The recruitment goal of the Fortaleza Latina study is approximately 500 Latina women aged
      40-74 who have had a clinic visit within the past 5 years, but no recent mammogram, from the
      four selected Community Health Center clinics. After providing informed consent and
      completing a baseline assessment, eligible women are randomly assigned to intervention or
      comparison group, within clinic. The individual-level intervention implements motivational
      interviewing (MI) in two participant encounters. MI is a direct counseling style, led by a
      promotora (lay health advisor), that elicits behavior change by helping participants explore
      and resolve ambivalence.

      Of the 2194 women contacted by field interviewers, a total of 710 surveys have been
      completed; of these, 542 were eligible and have been randomized and enrolled into the
      Fortaleza Latina study (279 intervention, 263 usual care).
    

Intervention name(s): Motivational Interviewing Intervention
Intervention type(s): Behavioral
Intervention description(s): An individual-level intervention that implements a motivational interviewing intervention led by a promotora
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: breast cancer; cancer disparities; Latino women; Hispanic women; mammography; multi-level intervention