228053 Promotora intervention to reduce cervical cancer disparities in Latinas

Monday, November 8, 2010 : 9:30 AM - 9:45 AM

Matthew James O'Brien, MD , Robert Wood Johnson Clinical Scholar's Program, University of Pennsylvania, Philadelphia, PA
Rebecca Bixby, RN , Puentes de Salud, Philadelphia, PA
Chanita Hughes-Halbert, PhD , Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
Susana Pimentel , Puentes de Salud, Philadelphia, PA
Judy Shea, PhD , Division of General Internal Medicine, University of Pennsyvania School of Medicine, Philadelphia, PA
Cervical cancer disproportionately affects U.S. Latina women, with incidence and mortality rates almost twice that of white women. Community health workers (CHWs), often called promotoras in Latino communities, provide one potential model for reducing cervical cancer disparities. We recruited 4 promotoras to lead 2, 180-minute workshops with community members about cervical cancer. This study is a randomized trial of this educational intervention, with 60 participants in each arm. Cervical cancer risk, previous screening history, baseline cervical cancer knowledge, and self-efficacy were measured by a pre-intervention questionnaire. The post-intervention questionnaire measured the following outcomes: cervical cancer knowledge, self-efficacy, and receipt of Pap smear screening during the previous 6 months. Univariate analyses were performed using chi square, t-test, and the Mann-Whitney test. There were no statistically significant differences between the 2 experimental groups at baseline, including the proportion of women who received Pap smear screening, cervical cancer knowledge (on a 0-6 scale), and self-efficacy (on a 0-6 scale). Follow-up data revealed significant improvements in all outcome measures: Pap smear screening (65% vs. 36%, p-value 0.02), knowledge (5.4 vs. 3.5, p-value 0.02), and self-efficacy (4.7 vs. 4.0, p-value 0.01). Many healthcare stakeholders have advocated for CHWs to reduce health disparities and lower healthcare costs. However, there is a paucity of rigorous data to support such recommendations. Our randomized trial of a promotora-led educational intervention demonstrated potential for reducing disparities. Future research should evaluate such programs on a larger scale, and explore factors that predict cervical cancer screening to identify novel targets for intervention.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related education
Public health or related research

Learning Objectives:
1) Describe the implementation of a randomized promotora intervention focused on cervical cancer prevention 2) Discuss the effectiveness of this intervention in increasing women’s self-efficacy, in addition to improving Pap smear screening rates 3) Describe the potential for replication of the current intervention

Keywords: Cervical Cancer, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the study and am responsible for all of the content presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.