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

Abstract

Background This study examined the feasibility and efficacy of Salud Es Vida – a promotora-led, Spanish-language educational group session on cervical cancer screening (Pap tests), self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. Methods The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014–15. Hispanic/Latina immigrant women aged 21–65 years and overdue for a Pap test were included as intervention (N = 38) and control (N=52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Results Twelve (32%) intervention group participants received the Pap test compared to 10 (19%) control group participants (p = .178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < .001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. Conclusion The group intervention approach was associated with increased cervical cancer knowledge, but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

The Influence of Personal Factor, Husband’s support, Health Workers and Peers toward the Use of IVA Screening among Women of Reproductive Age in the Regency of Karanganyar

“…The results of the study are in accordance to a study by Lugue et al (2016) which concluded that self-efficacy is not related significantly to the behavior of using IVA screening. 5.…”

Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review

“…Skilled healthcare workers to intervene with different cultural backgrounds to better meet the migrants needs and encouraging medical doctors to promote CCS in appointments with migrant women may also play a role in increasing CCS participation. However, interventions aiming only to increase knowledge may be insufficient [64]. A multi-factor-oriented strategy can be a more effective approach to increase participation in CCS besides targeting individual-level factors or barriers.…”

Utilization of Cervical Cancer Screening Among Hispanic Immigrant Women in Coastal South Carolina

“…While only 16% of participants were insured, many women knew they could receive low cost or free Pap tests at a local health department or free clinic and were also informed of these resources through our educational brochure. Moreover, because our study was in an urban area, there are more options for low-cost screening options and follow-up care than rural areas, where transportation barriers are more cumbersome and affordable healthcare options are more limited [6, 26].…”

“…Our study also identified other factors besides insurance which were associated with not being up to date with screening such as not knowing where to go for screening, not having a regular provider, and psychosocial factors (e.g., attitudes toward screening results and self-efficacy)[31]. Self-efficacy is an important variable for intervention programs to target and measure changes to improve cervical cancer screening adherence [20, 6]. The participants in our study were able to identify free and low-cost providers to receive their Pap exams through family planning services at the health department for example.…”

“…Lower screening rates are associated with cancer health disparities for Hispanic women [5]. Clinician recommendations for screening and providing culturally appropriate cancer education can impact screening adherence but do not address system level barriers such as inadequate insurance coverage, high costs of health services, or challenges related to availability of Spanish language translation services [6–8].…”