AMIGAS: Designing a culturally and linguistically relevant cervical cancer intervention with the participation of the priority community

Background: AMIGAS (Ayudando a Las Mujeres con Información, Guía y Amor para su Salud) is a culturally and linguistically relevant, theory-based intervention. It was developed with the participation of the priority community to support the goal that Latinas aged 18 and over will have a Pap test at least every three years. Methods: Formative research (focus groups, surveys) coupled with theory (Health Belief Model, the Theory of Planned Behavior, Social Cognitive Theory, and the Transtheoretical Model) provided detailed information about predisposing, enabling and reinforcing factors associated with cervical cancer screening among Latinas in El Paso, Texas. Using Intervention Mapping techniques, a Community Advisory Board helped translate these findings into specific performance objectives and intervention strategies. Subsequent evaluations in individual educational sessions with a sample of 200 women and 24 focus groups in urban and rural communities in Texas and California provided further insights into the needs, barriers, and beliefs related to screening among the intended population. Results: The final materials developed (flipchart, movie, informational handout) were informed by an extensive research and participatory process. A Lay Health Worker Advisory Committee comprised of Promotoras and Program Administrators helped refine and expand AMIGAS based on this new research and their own experiences in this broader set of communities. Half-day workshops in Spanish with Promotoras in Washington and California provided additional ideas and experiences to improve the materials and lesson plans. Discussion: This extensive participatory development process was critical to creating an evidence-based intervention that meets Latina and Promotora needs.