Hispanic women have almost double the cervical cancer incidence and are twice as likely to die from cervical cancer compared with non-Hispanic White women. Cervical cancer is preventable with screening, and based on available data, multiple component screening interventions have been proposed as a strategy to maximize screening, but such studies are lacking. We sought to test the effectiveness of a multicomponent screening intervention for primary prevention and early detection of cervical cancer among underserved Hispanic women. We conducted a prospective community-based cervical cancer screening intervention utilizing a quasi-experimental design. The intervention was theory based, delivered by bilingual community health workers, combined education and reduction of noneconomic barriers, and addressed economic barriers. Components included outreach, education, provision of no-cost Papanicolaou and human papillomavirus screening, on-site diagnostic and treatment colposcopy, and patient navigation with tracking to facilitate screening, diagnosis, and treatment. The main outcome was self-reported screening. We recruited 300 intervention group and 299 control group participants. Mean age of the sample was 44.7 years. The majority were Hispanic (98%), born in Mexico (79%), and had a Spanish-language preference (86%). In intention-to-treat analyses, the intervention group had a relative risk of screening of 14.58 (95% confidence interval = 8.57-24.80, p < .001) compared with the control group. A multilevel, multiple component culturally tailored bilingual cervical cancer screening intervention combining education, navigation, and no-cost screening can significantly increase cervical cancer screening uptake in a high-risk, underscreened population and has the potential to affect cervical cancer health disparities.

Purpose: To determine whether group education is as effective as individual education in improving cervical cancer screening uptake along the US–Mexico border. Design: Cluster randomized controlled study. Setting: El Paso and Hudspeth Counties, Texas. Participants: Three hundred women aged 21 to 65 years, uninsured, due for a Pap test, no prior history of cervical cancer or hysterectomy. Intervention: Theory-based, culturally appropriate program comprised of outreach, educational session, navigation services, and no-cost cervical cancer testing. Measures: Baseline, immediate postintervention, and 4-month follow-up surveys measured knowledge and theoretical constructs from the Health Belief Model, Theory of Reasoned Action, and the Social Cognitive Theory. Analysis: Relative risk regression analyses to assess the effects of educational delivery mode on the uptake of screening. Mixed effect models to analyze changes in psychosocial variables. Results: One hundred and fifty women assigned to each educational group; 99% Hispanic. Of all, 85.7% completed the follow-up survey. Differences in screening rate at follow-up were analyzed by education type. Overall screening rate at follow-up was 73.2%, no significant difference by education type (individual: 77.6%, group: 68.9% P = .124). Significant increases among group education at follow-up for knowledge, perceived susceptibility, perceived seriousness, and subjective norms and significant decrease for perceived benefits. Conclusion: This study provides evidence to support the effectiveness of group education to promote cervical cancer screening among vulnerable Hispanic women and offers an additional method to address cervical cancer disparities.

Introduction : Hispanic women residing along the US-Mexico border have the highest cervical cancer incidence rates in the US. Genital human papillomavirus (HPV) is the major causative agent, but more information is needed about the prevalence and distribution of genital HPV subtypes in this high-risk population. Methods : A population-based cross-sectional study of uninsured Hispanic women along the US-Mexico border was conducted and participants had their cervical specimens undergo DNA extraction followed by HPV genotype testing using the Linear Assay from Roche® Diagnostics, to identify 37 genital HPV subtypes. Results : Among the 585 women aged 21-65 years, 584 self-identfied as Hispanic. Any HPV subtype prevalence was 53.2% (95% CI: 49.0%-57.3%) and of these 52% (i.e. 27.5% of the total) had single infections and 48% (i.e. 25.6% of the total) had multiple infections. High-risk HPV prevalence was 15.6% (95% CI: 24-31.3%). The mean number of subtypes among those testing positive was 2.1 (SD 1.6). The prevalence of any HPV and high-risk HPV showed a U shaped pattern with age; and prevalence of 16/18 and non-16/18 high-risk subtypes (e.g. 31, 33, 35, 39, 45, 51, 52, 58); also varied with age. Forty-one percent of high-risk HPV occurrences were of a subtype not covered by the current nonavalent HPV vaccine. Discussion : Our findings suggest a different high-risk HPV subtype pattern and age distribution among Hispanic women in the USA, which could have implications for future cervical cancer prevention strategies.

Highlights We observed a higher recall rate for diagnostic testing in this population. Breast density distribution was different to both Hispanic and other populations. We did not observe lower biopsy rates compared to other populations. Age, health status, and years in the US were associated with breast density.

Background: There is limited information on physical activity in marginalized older populations like that on the U.S.-Mexico border. This study aims to understand physical activity engagement among older Hispanics residing in two U.S.-Mexico Border counties. Methods: The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity in El Paso and Cameron County, Texas. Physical activity levels were reported for vigorous, moderate, and walking met/mins. Adjusted and unadjusted modeling was conducted to determine county differences and sociodemographic covariates. Results: There were 784 participants and 92.9% were less than 65 years of age. El Paso participants reported a significantly greater natural log met/mins of vigorous (β = 1.34, p = 0.000) and walking (β = 0.331, p = 0.006). Significant sociodemographic covariates in El Paso for vigorous met/mins were gender (females β = −1.20, p = 0.003), having a regular doctor (β = −0.779, p = 0.029), and acculturation (β = 0.513, p = 0.019). Significant associations in Cameron County were having a regular doctor (β = −1.03, p = 0.000) and fair/poor health status (β = −0.475, p = 0.001). Conclusion: Level of physical activity may differ in older Hispanics by urban context on the U.S.-Mexico border. Future physical activity programs to promote physical activity should take context into consideration.

Objective To evaluate the impact of an online-delivered, theory-based narrative video on cervical cancer screening knowledge, attitudes, and beliefs in a predominantly Latino community. Methods The study design was a nonrandomized pretest–posttest evaluation. The eligibility criteria included men and women 18 years or older not previously enrolled in our community cervical cancer screening program who had internet access. Participants were recruited via in-person county-wide flyer distribution and social media dissemination. The intervention involved a narrative video designed for Latinas delivered via the internet. The 17-minute video is novella style, with a culturally tailored storyline and setting that covers cervical cancer risk factors and statistics, importance of screening, and addresses testing barriers. The measures were knowledge about cervical cancer and screening, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, subjective norms, and self-efficacy. Analysis was performed using change scores for knowledge and psychosocial variables and descriptive statistics for satisfaction and acceptability of the video. Results Data from 227 surveys were analyzed; respondent mean age: 37.6 years; 98.8% female, 88.8% Hispanic; 42.0% had an annual income of $20,000 or less; and 85.2% had at least a high school education. Knowledge and all psychosocial variables improved significantly. More than 90% of the participants rated all of the satisfaction items as good or excellent. Conclusions and Implications for Practice A culturally appropriate narrative video about cervical cancer and screening disseminated online effectively improved knowledge and psychosocial variables among Latinas. Our findings indicate that health promotion interventions online could be effective for improving desired health behavior through a new means of educational dissemination by way of websites and social media outlets.

Purpose:To determine the relationship between breast cancer screening knowledge and intent to receive a mammogram within 6 months in a sample of Mexican-origin women living in El Paso, Texas.Methods:A total of 489 uninsured Mexican-origin women were assigned to treatment or control and completed surveys at pre- and postintervention. Pre-post associations between breast cancer screening knowledge and intent were tested.Results:Participants were on average were 56.7 years of age and spoke primarily Spanish (92.6%). Most of the samples had not had a mammogram in 3 or more years (51.6%) and 14.6% had never had a mammogram. At baseline, the majority intended to be screened for breast cancer within the next 6 months (93.4%). At postintervention, half of the intervention group changed their 6-month intent to be screened for breast cancer from likely to unlikely. Change in intent was associated with a change in knowledge of risk of having a first child by the age of 30 and breast cancer being rare after the age of 70.Discussion:Intent to be screened for breast cancer in Mexican-origin women may be influenced by the type of knowledge.Conclusions:Change in screening knowledge may influence perceived risk that influences intention to be screened.

Background In the United States, breast cancer remains one of the most diagnosed cancers among females and remains the second leading cause of cancer death. In addition, breast cancer is most likely diagnosed at an advanced stage among Hispanic females in the United States due to lower mammogram utilization. Aims The objective of this study was to determine the effectiveness of a multilevel, multicomponent community-based breast cancer screening intervention called the Breast Cancer Education Screening and NavigaTion (BEST) program. The primary outcome was the completion of a screening mammogram 4 months post-intervention. Method We used a pragmatic approach for evaluation, utilizing a quasi-experimental delayed intervention design. We recruited women from the community aged between 50 and 75, uninsured or underinsured, and overdue for screening. Results Six hundred participants were recruited (300 intervention and 300 control). Among completers, the screening rate was 97% in the intervention group and 4.4% in the control group (RR = 22.2, 95% CI: 12.5–39.7, p < .001). In multivariable analysis, age ≥ 65 (RR = 1.29, p = .047), perceived benefits (RR = 1.04, p = .026), curability (RR = 1.24, p < .001), subjective norms (RR = 1.14, p = .014), and fatalism (RR = .96, p = .004) remained significantly associated with screening outcome. Conclusion A multicomponent, bilingual, and culturally tailored intervention effectively facilitated breast cancer screening completion in an underserved population of Hispanic women. Individuals with improved screening outcomes were more likely to have higher positive beliefs. Our study has important implications regarding using multicomponent interventions in increasing breast cancer screening completion in poorly screened populations. It also highlights differences in health belief motivation for breast cancer screening completion.