Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.
Breast cancer is the most common cause of cancer and the leading cause of cancer death among Latinas in the United States. In addition, Latinas experience a disproportionate burden of cervical cancer incidence, morbidity, and mortality compared with non-Hispanic White women. Lower use of breast and cervical cancer screening services may contribute to these disparities. To address the underutilization of breast and cervical cancer screening among diverse subgroups of Latinas, a peer-led education program called Esperanza y Vida (“Hope and Life”) was developed and administered at 3 sites (2 in New York and 1 in Arkansas). Immigrant Latina women and their partners were educated about the importance of breast and cervical cancer screening, with the goals of increasing their knowledge about these cancers and their screening behavior. An analysis of the intervention’s findings at baseline among female participants demonstrated significant sociodemographic, interpersonal, cultural, health care system, and program variability in 3 distinct geographic regions in the United States. These data indicate the need for and feasibility of customizing cancer outreach and educational programs for diverse Latina subgroups living in various U.S. regions, with implications for informing the expansion and replication of the program in other regions of the country.
The use of lay health advisors (LHAs) to promote community-based health education programs is well documented and is considered an effective way to reach underserved communities. Esperanza y Vida (Hope & Life) is an educational outreach program to increase breast and cervical cancer screening for diverse Latinas. It incorporates Latino LHAs (men and women) and cancer survivor role models, sobrevivientes, in the program delivery. An interactive training program, conducted by bilingual staff across three sites (Little Rock, Arkansas; Buffalo, New York and New York City) included 74 sobrevivientes and LHAs who were recruited and trained. All training attendees completed an initial application assessing socio-demographics, experience and availability as well as, true/false surveys at the beginning (pre-) and end of the training (post-) measuring knowledge levels of breast and cervical cancer health. Data analysis indicated a significant increase of both breast and cervical cancer knowledge for attendees trained as LHAs (pre = 60%; post = 80%; p = 0.000), whereas sobrevivientes had a higher baseline knowledge of breast health (74%), and therefore did not show a significant increase following training (79%). However, sobrevivientes did display a significant increase in cervical cancer knowledge (p = 0.003). These findings demonstrate the impact of training and how LHAs may be recruited at different levels of knowledge and experience and be successfully trained in key program elements. Moreover, results indicate that sobrevivientes may be impacted differently, or require variations in training approaches. This information can be useful in developing and customizing curriculum for future lay health training programs.
As similar cancer health disparities have been documented for African American (AA) women and Latinas, it would be important to determine whether comparable interventions could be used to increase screening among these 2 culturally different populations. This paper reports research findings comparing cultural dimensions of breast and cervical cancer as they impact Latino and AA social networks and explore the feasibility of creating outreach models that may serve both groups.An existing intervention that integrates the social roles and relationships of AA women, The Witness Project 1 , is used as a framework for tailoring an intervention for Latino communities. Findings and data from focus groups and key informant interviews were collected from more than 120 Latinos in Arkansas and New York City. These findings are analyzed using the Pen-3 Model, categorized, and com-
The purpose of this qualitative study was to understand influential factors associated with decisions to obtain breast or cervical cancer screening by diverse Latinas after attending a community-based educational program. Forty-five interviews were conducted in Arkansas, New York City and Buffalo, New York. Thematic data analyses were conducted to understand influential factors following from the intervention. Four major themes emerged from the interviews: Social Capital, Screening Utilization, Health Care Provider (HCP) Communication and Social Networks. Social Capital included resources, access or screening knowledge women had prior to participation in the program and new resources and contacts gained through the program that influenced care seeking. Screening Utilization factors included past health experiences and participation in the program. HCP Communication included perceptions of quality of care and communication issues with HCPs that positively and negatively impacted screening. Social Networks included women's networks regarding emotional support, encouragement to discuss health issues, overall family network and how these may influence health-seeking behaviors. These findings suggest that participating in group-based health outreach programs empowered women by increasing their knowledge and awareness about the health care system and enabled them, with the tools provided, to become proactive in their health care-seeking behaviors.
The purpose of this article is to determine, through a community-based breast and cervical cancer intervention program, the impact Latino males may have on Latinas and their cancer screening behaviors. This report includes data collected from 163 Latino males recruited throughout rural Arkansas and four New York City boroughs for the Esperanza y Vida program, designed to evaluate cancer screening outcomes among Latinas and address their health care needs and cancer control challenges. Basic demographics and identical pre- and post-program knowledge surveys were collected and analyzed using SPSS 15.0 and SAS 9.2. Results from this study suggest Latino men have little knowledge about breast or cervical cancer screening and are unfamiliar with their partners' screening histories. Male participants were also less likely to complete program assessment forms (pre, post, demographic questionnaires) and more likely to commit response errors (i.e. multiple answers, illegible responses). These findings suggest that including males in education programs for Latinas may be a crucial component in decreasing cancers among this segment of the population. The further development of programs such as Esperanza y Vida, that empowers Latino males, will be important in reducing the unequal burden of breast and cervical cancers for Latinas. It is important to continue including Latino men in these types of studies because the impact of their role on Latina's health remains understudied, unknown, and misunderstood.
Abstract. Renewable energies and power quality have increasingly become a big concern over the last decade, being preferential subjects in research, development and innovation projects world wide. University's academic programs are being adapted to this need, in order to have more qualified engineers in the future. This paper analyzes how these subjects have been integrated into the power engineer's curricula at the University of Seville.
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