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

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


M. E FernГЎndez, A. Gonzales, and G https://datingstreet.net/okcupid-review/. Tortolero-Luna originated the research, created the dimension instruments and research protocols, and oversaw research implementation. A. Gonzales and M. Saavedra-Embesi, our community lovers through the nationwide Center for Farmworker Health, drafted the information associated with the scheduled system and in addition took part in the utilization of the analysis. J. Williams drafted the dimension parts of this article as well as the tables. W. Chan assisted within the analysis associated with the information for the revised article and contributed into the analysis and outcomes chapters of the content. All writers took part in conceptualization of tips, interpretation of results, and article review and modifying.

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Goals. We tested the potency of a lay health worker intervention to improve breast and cervical cancer tumors testing among low-income Hispanic ladies.

Practices. Individuals had been ladies 50 years and older who have been nonadherent to mammography (letter = 464) or Papanicolaou (Pap) test (n = 243) assessment instructions. Following the number of standard information, lay wellness workers applied the Cultivando la Salud (CLS; Cultivating Health) intervention. Information enthusiasts then interviewed the individuals half a year later on.

Outcomes. At follow-up, assessment conclusion had been greater among feamales 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 nearly doubly high for Hispanic females because they are for non-Hispanic White women; in addition, Hispanic women can be identified at later on phases and also have poorer survival prices. 1,6

Reduced levels of cancer tumors testing among Hispanic ladies are caused by psychosocial factors including concern about cancer tumors, invasive procedures, and discomfort; not enough information about cancer tumors as well as its assessment techniques; attitudes of fatalism; spiritual or religious opinions; issues over privacy; language barriers and recognized discrimination; embarrassment; and partner disapproval. 1,7–24 External factors also influence assessment, such as for instance a not enough medical insurance, regular sourced elements of medical care, and doctor referral; transport obstacles; price; and restrictive work policies.

Effective cancer-control programs for Hispanic ladies purchased (1) Spanish-language news; (2) part models showing up in media (magazines, 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 wellness worker or promotora model, that has been first developed in Latin America, is really a peer wellness education model whereby respected community people educate peers in a manner that is culturally appropriate. 48,49

A recently available Cochrane review reported the potency of lay wellness worker programs for increasing immunization uptake, advertising nursing, enhancing tuberculosis outcomes, 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 powerful technique for increasing both breast and cervical cancer testing. 52 the duty force ended up being not able to make a suggestion concerning the usage of lay wellness worker programs especially since there had been inadequate amounts of posted studies evaluating their effectiveness.

The effectiveness of this model for increasing cancer screening has yet to be fully explored although evidence suggests that lay health worker programs can improve some health behaviors. To fill this space within the literary works, we applied and evaluated Cultivando los angeles Salud (Cultivating wellness), a lay health worker–delivered academic intervention for breast and cervical cancer tumors assessment. We expected the intervention would increase mammography and Papanicolaou (Pap) test assessment among low-income Hispanic farmworker females whom did maybe not stick to recommended testing instructions.

We developed an intervention that is educationalCultivando la Salud) in 2004 to improve breast and cervical cancer assessment among low-income, low-literacy, Hispanic feminine farmworkers aged 50 years and older. Despite the fact that Pap test testing is preferred for more youthful women, we made a decision to consist of only women 50 years and older because proof implies that prices of invasive cancer that is cervical greater, prices of assessment are reduced, and barriers to assessment differ among older Hispanic females than among more youthful females. 13,18,53–57 We developed the intervention by making use of concepts of community-based participatory research 58 and intervention mapping, an approach that is systematic intervention preparation and execution. 14,59 We decided on lay health workers to supply the intervention system due to their unique power to achieve, through individual contact in the neighborhood, women that seldom or never ever access care that is medical. Lay health workers had been anticipated not just to teach ladies and motivate them to acquire testing but additionally to supply practical help that would facilitate the ladies’s usage of assessment services.

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


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 Cancer Institute research grant tion analysis Center Special Interest Project ). This book ended up being additionally made possible by the nationwide Cancer Institute .

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


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