Evaluation of a cervical cancer lay health worker intervention for Vietnamese American women

Background: The cervical cancer incidence rate among Vietnamese women in the US is over twice the rate among non-Latina white women. Lay health worker-based interventions represent a promising approach to disease prevention. Objective: We conducted a randomized controlled trial to evaluate the effectiveness of a cervical cancer control lay health worker intervention for Vietnamese women. Methods: The study group included 234 women who had not received a Pap test in the last three years. Experimental group participants received a lay health worker home visit. Our trial end-point was Pap smear receipt within six months of randomization. Pap testing completion was ascertained through women's self-reports, as well as medical record reviews. We conducted stratified analyses and examined intervention effects among women who had ever and never received a Pap smear (prior to randomization). Results: Three-quarters (75%) of the experimental group women completed a home visit. Previously screened experimental arm participants were significantly more likely to self-report Pap testing at follow-up than previously screened control arm participants (p<0.02). Similarly, previously screened women randomized to the experimental arm were significantly more likely to have medical records verified Pap testing than previously screened women randomized to the control arm (p<0.04). There were no significant differences between the trial arms for women who had never been screened for cervical cancer. Discussion: Our findings indicate that lay health worker interventions for Vietnamese women are acceptable to the community, feasible to implement, and can positively impact levels of Pap testing use.