AMIGAS: Testing a Linguistically and Culturally Relevant Cervical Cancer Screening Intervention

Background: Latinas in the United States have higher rates of cervical cancer morbidity and mortality, and lower rates of cervical cancer screening than non-Latina whites. AMIGAS is a promotora-led intervention developed with the community to increase cervical cancer screening in Latinas. The study was to test the effectiveness of AMIGAS for increasing cervical cancer screening in three populations of women of Mexican origin (US/Mexico border, urban, and rural) using a controlled randomized design. Methods: In this multi-site (El Paso, Houston and Yakima Valley) study, 600 women were randomly assigned to one of four study arms: the full AMIGAS program delivered in the home by a trained promotora (150); AMIGAS without the video delivered in the home by a trained promotora (150); AMIGAS without the flipchart delivered in the home by a trained promotora (150); and the usual care control group (150). Women in the control group received the usual education about cervical cancer screening delivered by clinics and media. Results: Overall, 29% of women in the control group and 62% of women in the full AMIGAS group received cervical cancer screening 6 months after entry into the study (p<0.001). AMIGAS minus the video and minus the flipchart were also significantly different from the controls (51% and 56% respectively; p<0.001). Discussion: This intervention was found to be very effective. We believe that involving the community in the development of the materials and using trained promotores de salud to deliver the intervention helped to assure effectiveness and may be useful to others.