Increasing Cervical Cancer Screening in the United States‐Mexico Border Region

Abstract

Purpose Hispanic women living on the US-México border experience health disparities, are less likely to access cervical cancer screening services, and have a higher rate of cervical cancer incidence compared to women living in non-border areas. Here we investigate the effects of an intervention delivered by community health workers (CHWs, known as lay health educators or Promotores de Salud in Spanish) on rates of cervical cancer screening in Hispanic women who were out of compliance with recommended screening guidelines. Methods Hispanic women out of compliance with screening guidelines, attending clinics in southern New México (NM), were identified using medical record review. All eligible women were offered the intervention. The study was conducted between 2009 and 2011, and data were analyzed in 2012. Setting/participants - 162 Hispanic women, resident in NM border counties, aged 29-80 years, who had not had a Pap test within the past 3 years. Intervention - A CHW-led, culturally appropriate, computerized education intervention. Main outcome measures - The percentage of women who underwent cervical cancer screening within 12 months of receiving the intervention. Change in knowledge of, and attitudes towards cervical cancer and screening as assessed by a baseline and follow-up questionnaire. Results 76.5% of women had a Pap test after the intervention. Women displayed increased knowledge about cervical cancer screening and about HPV. Conclusions A culturally appropriate promotora-led intervention is successful in increasing cervical cancer screening in at-risk Hispanic women on the US-México border.

Participation in Cervical Screening by Self-collection, Pap, or a Choice of Either in Brazil

“…The capacity building equipped them with behavior change strategies as evidenced by the significant pre-and post-training changes in perceived skills to promote behavior change and motivate women to be screened (21). This supports our work and others' that CHWs can be actively involved in behavior change if provided with appropriate training and supervision (29)(30)(31)(32)(33)(34).…”

Implementation of HPV vaccination guidelines in a diverse population in Los Angeles: Results from an environmental scan of local HPV resources and needs

“…Promoteres de salud have increased cervical cancer screening in Hispanic women in the United States-Mexico border region [18], which suggests this could be an effective method to increase HPV vaccination among similar vulnerable populations. Further, there is a need to encourage outreach to the LBGTQ community to address unique issues and challenges regarding access to care and vaccinations for this population.…”

Salud es Vida: a Cervical Cancer Screening Intervention for Rural Latina Immigrant Women

“…Since Hispanics/Latinos represent the largest ethnic minority group in the U.S., efforts to improve cervical cancer prevention among this population will have a significant public health impact on incidence and mortality rates [28]. There exists variability in cervical cancer incidence and mortality rates among Hispanic/Latino subgroups, with higher rates as well as greater barriers to screening among newer immigrant Hispanic/Latina women in the Midwest, Southeast, and those living near the United States-Mexico border region, all of whom are primarily of Mexican origin [36, 32, 21]. Research has shown that some Hispanic/Latino groups such as Puerto Ricans and Cubans have higher screening rates than Mexican Americans [1].…”