The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72555

Vickie D. Krenz, PhD, MSPH¹, Helda Lucia Pinzon-Perez, PhD, CHES¹, Eric W. Krenz, PhD¹, and Paul Haugan, BS². (1) Department of Health Science, California State University, Fresno, 2345 East San Ramon Ave, Fresno, CA 93740, 559-278-4014, vickik@csufresno.edu, (2) Fresno County Workforce Connection, California State University, Fresno, 3302 N. Blackston #155, Fresno, CA 93726

Cervical Cancer is the third leading cancer diagnosed in Hispanic/Latino women, with a rate 7.3 times that of White women. Papanicolau (Pap) smears are highly effective in detecting cervical cancer at the earliest stages. However, pap smear rates have been 15 - 30% lower among Latinas as compared to whites. This study utilized Geographical Information System mapping to measure differences in immigrant Latinas enrolled in managed Medicaid and 3-year rates of pap smear screenings. Participants were recruited from four large community health centers (urban vs. rural) that serve predominately Hispanics in the Central Valley and the Blue Cross Managed Medicaid system. A total of 266 of the women had evidence of a pap smear and 104 had no record of the screening within the past three years. Geocoded addresses were used to identify Pap smear status by residence and distance to medical clinics. Structured interviews were conducted with the participants to identify factors for pap smear screening. Potential barriers of rural residential locations and transportation did not affect pap smear rates between Latinas who had obtained a screening and those who had not. The data was then presented to focus groups of rural community health professionals, including community outreach workers, clinical medical practitioners, and MPH students. Alternative strategies were identified that would increase pap smear screening rates among Hispanic/Latino women in rural locations, including “promotora” programs, “pap ladies” (i.e., female OB/GYN practictioners, nurse practitioners, etc.) at rural clinic sites to perform screenings, and a mobile screening (“pap-mobile”) to access Hispanic/Latinas.

Learning Objectives:

• To identify geographical and transportation barriers among immigrant Latinas for pap smear screening in rural areas.
• To identify strategies to improve pap smear screening among rural immigrant Latinas.
• To demonstrate GIS technologies in planning for community health interventions.

Keywords: Community-Based Health Promotion, Cervical Cancer

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: ESRI Arcview was used to graphically display and analysze access to pap smear screening.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Grant from CMS (Project No. 25-P-91150/9-01)