Multilevel Intervention Raises Latina Participation in Mammography Screening: Findings from ¡Fortaleza Latina!

Abstract

Background Breast cancer is the most commonly diagnosed cancer in women in the United States, and Latinas have relatively low rates of screening participation. The Multi-level Intervention to Increase Latina Participation in Mammography Screening study (¡Fortaleza Latina!) sought to assess the efficacy of a clinic- and patient-level program to increase breast cancer screening among Latinas in Western Washington who seek care at a safety net health center. Methods The study enrolled 536 Latinas ages 42-74 who had a primary care clinic visit in the previous 5 years and had not obtained a mammogram in the previous 2 years. Participants were block-randomized within clinic to either (1) a control arm (usual care) or (2) a promotora-led, motivational interviewing intervention that included a home visit and telephone follow-up. At the clinic level, two of four participating clinics were provided additional mammography services delivered by a mobile mammography unit. Results Rates of screening mammography 1 year post-randomization were 19.6% in the intervention group and 11.0% in the usual care group (p<0.01), based on medical record data. No significant differences in participants’ mammography screening were observed in clinics randomized to additional mammography services vs. usual care (15.8% vs. 14.4%, p=0.74). Conclusion This multi-level intervention of promotora-delivered motivational interviewing and free mammography services modestly raised rates of participation in breast cancer screening among Latinas. Impact Our findings can inform future efforts to boost mammography participation in safety net practices.

Systematic Review of Mammography Screening Educational Interventions for Hispanic Women in the United States

“…Using the inclusion criteria for this review, seven studies were initially identified; however, after full text review, two of these studies were removed because the samples did not include over 50% Hispanic participants or did not report results separately for Hispanic women, leaving a final sample of five studies [6,9,10,16,24]. Three studies employed experimental designs with random samples, and two studies used quasi-experimental designs, randomized by study site ( Table 1).…”

“…To calculate ORs for each study, 12-month follow-up periods were used for three studies [6,9,24]. For the Jandorf et al study, the 8-month follow-up period data were used, and for the Fernandez et al study, 6-month follow-up period data were used [10,16].…”

Breast Cancer Beliefs as Potential Targets for Breast Cancer Awareness Efforts to Decrease Late-Stage Presentation in Uganda

“… 34 These items were tested iteratively, modified with the guidance of cultural and survey experts, and cognitively tested in UWOCASO women. 35 The final Attitudes on Breast Cancer Surveillance and Knowledge survey was translated from English (primary language) to Luganda (common local language).…”

Change in Breast Cancer Screening Knowledge is Associated With Change in Mammogram Intention in Mexican-Origin Women After an Educational Intervention

“… 3 Nevertheless, interventions to increase mammogram utilization in Hispanic women have generally focused on increasing breast cancer screening knowledge, self-efficacy, or decreased real or perceived barriers to screening. 9 – 12 There continues to be a limited amount of information on what type of knowledge acquired through breast cancer screening interventions is important to affect behavioral change. 4 , 13 , 14 This is despite the consensus that having the correct screening knowledge on breast cancer risk is essential to making informed decisions to be screened.…”