Effectiveness of Cultivando La Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic Females


M. E FernГЎndez, A. Gonzales, and G. Tortolero-Luna originated the scholarly research, created the dimension instruments and research protocols, and oversaw research implementation. A. Gonzales and M. Saavedra-Embesi, our community lovers from the National Center for Farmworker Health, drafted the explanations associated with the scheduled program and in addition took part in the utilization of the research. J. Williams drafted the dimension chapters of the content together with tables. W. Chan assisted within the analysis regarding the information when it comes to article that is revised contributed towards the analysis and outcomes chapters of this article. All writers participated in conceptualization of tips, interpretation of outcomes https://hookupdate.net/gleeden-review/, and article review and editing.

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Goals. We tested the potency of a lay wellness worker intervention to boost breast and cervical cancer tumors assessment among low-income Hispanic ladies.

Practices. Individuals had been females 50 years and older who had been nonadherent to mammography (letter = 464) or Papanicolaou (Pap) test (letter = 243) testing directions. Following the assortment of standard information, lay wellness workers applied the Cultivando la Salud (CLS; Cultivating Health) intervention. Information enthusiasts then interviewed the individuals six months later on.

Outcomes. At follow-up, assessment conclusion ended up being greater among ladies in the intervention team compared to the control team for both mammography (40.8% vs 29.9%; P 1–6 Cervical cancer tumors incidence and mortality prices are almost two times as high for Hispanic females since they are for non-Hispanic White women; in addition, Hispanic women can be identified at later on phases and also have poorer survival prices. 1,6

Reduced quantities of cancer tumors assessment among Hispanic ladies are the consequence of psychosocial facets fear that is including of, invasive procedures, and discomfort; not enough information about cancer and its own assessment practices; attitudes of fatalism; spiritual or religious thinking; issues over privacy; language obstacles and sensed discrimination; embarrassment; and partner disapproval. 1,7–24 outside factors also influence assessment, such as for instance deficiencies in medical health insurance, regular types of medical care, and doctor referral; transport obstacles; price; and restrictive work policies.

Effective cancer-control programs for Hispanic females purchased (1) Spanish-language news; (2) role models showing up in advertising (papers, television) with social reinforcement by community volunteers; (3) “small media,” such as videos delivered in team settings or kiosks; (4) multimethod approaches; and (5) lay wellness workers or promotoras. 38–47 The lay wellness worker or promotora model, that has been first developed in Latin America, is really a peer wellness education model whereby respected community people educate peers in a culturally appropriate way. 48,49

A current Cochrane review reported the potency of lay wellness worker programs for increasing immunization uptake, marketing nursing, enhancing tuberculosis results, and reducing morbidity and mortality because of youth diseases. 50,51 an additional systematic review, the usa Preventive Services Task Force identified 1-on-1 training as a fruitful technique for increasing both breast and cancer screening that is cervical. 52 the job force ended up being not able to make a recommendation concerning the usage of lay wellness worker programs especially because there had been inadequate amounts of posted studies assessing their effectiveness.

Although proof shows that lay health worker programs can enhance some health actions, the potency of this model for increasing cancer tumors testing has yet to be completely explored. To fill this space into the literary works, we applied and evaluated Cultivando la Salud (Cultivating wellness), a lay health worker–delivered academic intervention for breast and cervical cancer tumors assessment. We expected the intervention would increase mammography and Papanicolaou (Pap) test testing among low-income Hispanic farmworker females whom did maybe maybe not adhere to recommended assessment instructions.

We developed an intervention that is educationalCultivando la Salud) in 2004 to improve breast and cervical cancer tumors testing among low-income, low-literacy, Hispanic feminine farmworkers aged 50 years and older. Despite the fact that Pap test assessment is advised for more youthful ladies, we decided to consist of only women 50 years and older because proof implies that prices of invasive cervical cancer are greater, prices of assessment are reduced, and obstacles to assessment vary among older Hispanic females than among more youthful ladies. 13,18,53–57 We developed the intervention through the use of maxims of community-based participatory research 58 and intervention mapping, an approach that is systematic intervention preparation and execution. 14,59 We decided on lay health workers to produce the intervention system for their unique capacity to achieve, through individual contact in the neighborhood, women that hardly ever or never ever access care that is medical. Lay health workers had been anticipated not just to teach females and motivate them to get testing but in addition to supply assistance that is practical would facilitate the ladies’s use of assessment services.

This system materials contained a course manual, an exercise curriculum, and a collection of teaching tools for the health that is lay (“tool box”). This system manual had been built to increase use regarding the scheduled system also to offer tips for system execution and sustainability. It included a description associated with scheduled system, proof of its effectiveness, and details about simple tips to develop and manage a lay health worker system. Working out curriculum contained training plans, learning tasks, and artistic helps for lay health worker training by hospital staff. The “tool box” included bilingual breast and cervical cancer tumors academic materials including a movie, flipchart, breast models, pamphlets, and a training guide. The health that is lay utilized these materials to supply assessment information to ladies in the city. 60 A pilot research carried out in 2 farmworker communities in south Texas (Brownsville and Pharr) supplied home elevators the appropriateness and acceptability regarding the academic materials and the feasibility of applying this program. 14,61


This research ended up being supported by an agreement that is cooperative the Centers for infection Control and Prevention, a nationwide Cancer Institute Preventive Oncology Academic Award, a nationwide Cancer Institute research grant tion analysis Center Special Interest Project ). This book had been additionally authorized because of the nationwide Cancer Institute .

We gratefully acknowledge the help associated with farmworker females and lay health workers whom took part in this task while the people of the nationwide Center for Farmworker wellness National Cancer Coalition. We additionally acknowledge Vincent Chen and Patricia Dolan Mullen for help from the analysis and Edward W. Fernandez and Karyn Popham for editorial assistance.