Abstract A21: Changes in healthcare utilization following community cancer education programs
Authors: Murray Kate , Navarro Ana , Barnack-Tavlaris Jessica , Minero Lupe , Sanchez Olga 
Published: December 2010

Abstract
Introduction: The Por la Vida community health advisor intervention programs target low-income and low-acculturation Latinos in a border region of the United States. These underserved individuals are less likely to have a usual source of healthcare and receive preventive services as there are numerous linguistic, cultural, and financial barriers that contribute to health disparities (Flores & Vega, 1998; Rivers & Patino, 2006). An important goal of these health education programs is to encourage the regular use of preventive and treatment-oriented health services. The current analyses examine whether there are differences in having a usual source of healthcare preand postintervention, as well as changes in the identified barriers to engaging in healthcare services. The natural differences across the Por la Vida programs provide the opportunity to examine differences in change depending on the focus of the health programs.
Method: Participants include 744 adult Latina women, predominantly first generation Mexican-American (95%), who participated in a 12-session nutrition education, tobacco-free communities program, or a women and cancer program that focused on the importance of preventive screening services and a range of other lifestyle factors. Chi-squared analyses of group differences in having a usual source of care in pre-and posttest assessments (6 months postintervention) were compared across groups. For the two programs which assessed barriers to healthcare, pre-and posttest reports on the experience of nine different barriers (e.g., cost, lack of Spanish-speaking staff, lack of childcare, and losing pay from work to go to an appointment) to accessing healthcare also were compared.
Results: Three of the four groups reported significant increases in having a usual source of care at post-assessment. Only the tobacco-free communities program showed no change in having a usual source of care at post-assessment. For the two programs assessed for changes in barriers, there were also reductions in the reports of barriers which prevented them from accessing care, such as cost and having to wait too long for an appointment. All nine of the identified barriers decreased from pre-to post-assessment.
Discussion: While the topic-specific gains for these programs have been reported elsewhere, the current analyses indicate there were positive changes to increase regular utilization of healthcare services for the nutrition and cancer-specific programs. The tobacco-free communities program did not evidence the same changes in regular healthcare use, which is consistent with the focus and content of the program. While many of the barriers examined in this study cannot be modified through the health education program content, there were reported reductions in all nine of the barriers in preventing participants from accessing care at post-assessment. This suggests additional gains for the health education programs beyond the targeted content and intervention goals.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A21.