Abstract PR-9: Engaging immigrant Latinas in community-based interventions: Methods may be more important than messages for increasing screening
Authors: Erwin Deborah O. , Jandorf Lina , Shelton Rachel 
Published: December 2010

Background: Many Latina subgroups in the U.S. continue to be less likely to be screened with mammograms, clinical breast examinations (CBE), and Pap tests than non-Hispanic white women. These lower screening rates result in 20% higher breast and 50% higher cervical cancer death rates for Latinas. (ACS 2010; Reynolds 2004) The goal of this study was to investigate the effectiveness of Esperanza y Vida (Hope and Life) for reaching community-based groups of Latino immigrants to increase breast and cervical cancer knowledge and screening behaviors.

Methods: The randomized control design compared the effectiveness of a cancer education intervention to increase breast and cervical cancer screening compared to a similar educational intervention that focused on diabetes education (control condition). The programs and methods were comparable, incorporating survivor/patient narratives, followed by telephone assessments at 2-and 8-months. The educational programs were conducted in community settings in New York and Arkansas for diverse Latino women and men, and data collection was enhanced through the use of an electronic audience response system. We hypothesized that women participating in the cancer intervention would increase screening significantly more than those in the diabetes programs.

Results: This study recruited 2,339 participants, with response rates of 76% at 2-months and 66% at 8-months. Eighty-eight percent of the women attending the programs were immigrants, coming from four primary regions (Mexico, Puerto Rico, Central/South American and the Dominican Republic). Two-month results demonstrated no significant differences in breast and cervical screening outcomes among women attending the intervention compared to the control programs. More importantly, however, as it relates to the public health impact of our intervention, we found that an average of 43% of non-adherent women at all sites who participated in either the intervention or the control program obtained breast and cervical screening tests within 2 months. Negatively associated with mammogram adherence was being married or living with a partner (OR 0.48, p= 0.04), believing that “US doctors do not know what is best for me” (OR 0.42, p= 0.01), and “not knowing where to go for a mammogram” (OR 0.38, p= 0.02). Other positive and negative associations are available to be discussed.

Conclusion: This study is a significant contribution to the field of behavioral sciences involving diverse Latino subgroups and cancer control. These results suggest that: 1) local outreach and health education that is conducted in a culturally and linguistically appropriate way with interactive opportunities to discuss health concerns with knowledgeable and approachable staff and volunteers is effective in increasing cancer screening; and 2) the development of relationships and trust with Latina immigrants through outreach may be a more important pathway to screening than simply improving cancer knowledge. Regardless of the specific health message, important social capital resources were “deployed” that resulted in women's ability to obtain screenings. (Burke et al. 2009)

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):PR-9.