Abstract B27: Developing promotora curriculum modules for cervical cancer prevention and control
Authors: Luque John S. , Mason Mondi , Garcia Claudia Reyes , Hinojosa Andrea , Meade Cathy D. 
Published: December 2010

Aim: Cervical cancer is a disease characterized by health disparities in incidence and mortality, disproportionately affecting Hispanic women compared to whites. This research presents the initial findings of the second phase of a two-phase, multi-year study to gain a better understanding of knowledge, risk perceptions, and cultural attitudes among different Hispanic subethnicities in order to develop pilot curriculum modules on HPV and cervical cancer for promotora (lay health advisor) programs. The aim of phase 2 is to develop and evaluate pilot curriculum modules on cervical cancer and HPV using feedback from a group of promotoras in southern Georgia. The development of the pilot modules was designed and conceptualized by a multidisciplinary team with expertise in health literacy, health communication, and Spanish/English translation. The curriculum will be further modified after pilot testing and analysis of the evaluation findings.

Methods: In partnership with a Hispanic-serving nonprofit agency in southern Georgia, the team developed pilot curriculum modules, guided by promotora curricula developed for Hispanic populations in Texas, as well as survey results from phase 1 with Mexican and Honduran farm worker women in Florida, and added the most recent information on cervical cancer, HPV, and the HPV vaccine. Six Spanish-speaking promotoras have been recruited to pilot test curriculum modules to ensure comprehensibility, and cultural and literacy-level appropriateness. The curriculum will be evaluated both quantitatively through a pretest/posttest instrument and qualitatively through a post-training focus group and written evaluations.

Results: Survey results from phase 1 found that Mexican and Honduran farm worker women were less likely to have heard of HPV or the HPV vaccine than Puerto Rican or Anglo American women recruited from similar low-income clinic settings. Based on this finding, when designing the curriculum for Mexican farm worker women in Georgia, a separate module was developed on HPV and the HPV vaccine. The curriculum is divided into two lessons of three hours instruction each. The curriculum is delivered by a female, native Spanish speaker trained in pedagogical techniques. The first lesson covers cervical cancer screening, and the second lesson covers HPV and the HPV vaccine. Each lesson contain five topics, with accompanying slide presentations, vocabulary cards, problem cards for discussion, and list of local and national resources to facilitate access to cervical cancer screening. The curriculum modules are designed with a Popular Education framework and coded throughout with cues for listening, dialogue, and action. Each lesson begins with icebreakers and includes interactive exercises to facilitate co-learning. The curriculum is also coded by constructs from Social Cognitive Theory, with activities and lessons linked to the appropriate construct.

Conclusion: Future cervical cancer educational interventions should address distinct cultural belief factors about cervical cancer in order to target materials to Hispanic farm worker women. This project is distinguished for its focus on community collaboration with the goal of building sustainable outreach programs to reduce barriers to cervical cancer screening, while addressing both culture and literacy in the development of educational materials to reduce cancer disparities.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B27.