A community-based intervention to increase mammography among Latinas with disabilities

Latinas with disabilities are doubly underserved in obtaining preventive healthcare screenings. In a pilot community-based research project, Central Coast Center for Independent Living and researchers from the University of California San Francisco developed and implemented a culturally appropriate intervention to teach such women about breast cancer, mammography, and strategies for healthcare self-advocacy. About 100 Latina women over 40 with physical or sensory disabilities who had not received a recent mammogram were recruited from the agricultural Salinas Valley area of California to participate in the study; most were monolingual Spanish speakers and many had low literacy levels. Participants attended an innovative, two-and-a-half-hour class that included a game of “breast cancer bingo,” creation of an individual mammography action plan, and pre- and post-tests on knowledge and attitudes; they were later interviewed to find out whether they had gotten a mammogram. Recruitment of women for the study posed a much greater challenge than anticipated, due in part to cultural taboos related to both breasts and cancer, as well as stigma and misconceptions regarding disability. Other difficulties included limited participation by promotoras from a partner organization who had been trained to co-teach the class, the need to greatly limit the pre- and post-intervention data collection due to poor test-taking skills, and challenges posed in trying to re-contact participants lacking answering machines or cell phones. Preliminary results suggest that, despite these difficulties, the intervention was a qualified success in increasing awareness and self-efficacy, and in motivating many of the participants to obtain needed screenings.