Effectiveness of Cultivando Los Angeles Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic ladies

Contributors

M. E FernГЎndez, A. Gonzales, and G. Tortolero-Luna originated the scholarly research, created the dimension instruments and research protocols, and oversaw research implementation. A. Gonzales and M. Saavedra-Embesi, our community lovers through the National Center for Farmworker Health, drafted the explanations associated with the program and in addition took part in the implementation of the research. J. Williams drafted the dimension parts of this article as well as the tables. W. Chan assisted within the analysis associated with information when it comes to article that is revised contributed into the analysis and outcomes chapters of this article. All writers took part in conceptualization of ideas, interpretation of outcomes, and article editing and review.

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Abstract

Goals. We tested the potency of a lay wellness worker intervention to boost breast and cervical cancer tumors assessment among low-income Hispanic ladies.

Techniques. Participants had been ladies 50 years and older who have been nonadherent to mammography (letter = 464) or Papanicolaou (Pap) test (n = 243) testing guidelines. Following the number of standard information, lay wellness workers implemented the Cultivando la Salud (CLS; Cultivating Health) intervention. Information enthusiasts then interviewed the individuals six months later on.

Outcomes. At follow-up, assessment conclusion had been greater among ladies in the intervention team compared to the control team both for mammography (40.8% vs 29.9%; P 1–6 Cervical cancer tumors incidence and mortality prices are almost two times as high for Hispanic ladies since they are for non-Hispanic White women; in addition, Hispanic women can be diagnosed at later on phases and now have poorer survival prices. 1,6

Reduced quantities of cancer tumors assessment among Hispanic ladies are caused by psychosocial factors fear that is including of, invasive procedures, and discomfort; lack of understanding of cancer tumors and its own assessment practices; attitudes of fatalism; spiritual or religious thinking; issues over privacy; language obstacles and identified discrimination; embarrassment; and partner disapproval. 1,7–24 External factors also influence testing, such as for example deficiencies in medical health insurance, regular sourced elements of medical care, and doctor referral; transport obstacles; price; and work that is restrictive.

Effective cancer-control programs for Hispanic females used (1) Spanish-language media; (2) part models showing up in advertising (papers, tv) with social reinforcement by community volunteers; (3) “small media,” such as videos delivered in team settings or kiosks; (4) multimethod approaches; and (5) lay wellness workers or promotoras. 38–47 The lay health worker or promotora model, that has been first developed in Latin America, is really a peer health education model whereby respected community people educate peers in a culturally appropriate manner. 48,49

A current Cochrane review reported the potency of lay wellness worker programs for increasing immunization uptake, marketing nursing, enhancing tuberculosis results, and reducing morbidity and mortality because of youth ailments. 50,51 an additional systematic review, the usa Preventive Services Task Force identified 1-on-1 training as a highly effective technique for increasing both breast and cervical cancer assessment. 52 the job force had been struggling to create a recommendation in regards to the utilization of lay health worker programs especially because there had been inadequate variety of posted studies assessing their effectiveness.

Although proof shows that lay health worker programs can enhance some wellness actions, the potency of this model for increasing cancer tumors testing has yet to be completely explored. To fill this space within the literature, we applied and evaluated Cultivando los angeles Salud (Cultivating wellness), a lay health worker–delivered academic intervention for breast and cancer screening that is cervical. We expected the intervention would increase mammography and Papanicolaou (Pap) test testing among low-income farmworker that is hispanic who did perhaps perhaps not stick to recommended assessment directions.

We developed an intervention that is educationalCultivando la Salud) in 2004 to improve breast and cervical cancer tumors testing among low-income, low-literacy, Hispanic feminine farmworkers aged 50 years and older. And even though Pap test testing is preferred for more youthful females, we decided to add only women 50 years and older because proof implies that rates of invasive cervical cancer tumors are greater, prices of assessment are reduced, and obstacles to assessment vary among older Hispanic females than among more youthful ladies. 13,18,53–57 We developed the intervention making use of maxims of community-based participatory research 58 and intervention mapping, an approach that is systematic intervention planning and execution. 14,59 We opted lay health workers to provide the intervention system due to their unique capacity to reach, through individual contact in the neighborhood, ladies who seldom or never ever access health care bills. Lay health workers were anticipated not just to teach ladies and motivate them to acquire testing but additionally to provide practical support that would facilitate the ladies’s use of screening services.

This system materials contains an application manual, an exercise curriculum, and a collection of teaching tools for the health that is lay (“tool box”). This program manual ended up being made to increase use for the system also to offer instructions for system execution and sustainability. It included a description of this system, proof of its effectiveness, and details about how exactly to develop and manage a lay wellness worker program. Working out curriculum contained course plans, learning tasks, and artistic helps for lay health worker training by hospital staff. The “tool box” included bilingual breast and cervical cancer tumors academic materials including a movie, flipchart, breast models, pamphlets, and a training guide. The lay health workers utilized these materials to supply screening information to feamales in the city. 60 A pilot research carried out in 2 farmworker communities in south Texas (Brownsville and Pharr) supplied information on the appropriateness and acceptability for the academic materials and the feasibility of applying this program. 14,61

Acknowledgments

This research had been supported by a cooperative contract from the Centers for infection Control and Prevention, A nationwide Cancer Institute Preventive Oncology Academic Award, a nationwide zoosk promo code Cancer Institute research grant tion analysis Center Special Interest Project ). This book has also been authorized because of the nationwide Cancer Institute .

We gratefully acknowledge the help of this farmworker ladies and lay wellness workers whom took part in this task as well as the known people of the nationwide Center for Farmworker Health nationwide Cancer Coalition. We also acknowledge Vincent Chen and Patricia Dolan Mullen for support in the analysis and Edward W. Fernandez and Karyn Popham for editorial assistance.

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