Online Program

A randomized trial of a community health worker led intervention using HPV self-sampling to increase cervical cancer screening among minority women: Preliminary findings

Monday, November 4, 2013

Brendaly Rodriguez, MA, CTSI- Community Engagement and Cultural Diversity, University of Miami, Miami, FL
Olveen Carrasquillo, MD, MPH, Division of General Medicine, Miller School of Medicine, University of Miami, Miami, FL
Erin Kobetz, Ph.D., MPH, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
Sainth Anthony Amofah, MD, MBA, Chief Medical Officer, Community Health of South Florida, Inc., Miami, FL
Shelia McCann, MEd, SM, GPC, Grants Management, Health Choice Network of Florida, Doral, FL
Tulay Koru-Sengul, MHS, PhD, Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Feng Miao, MSc, Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Minority and immigrant women face numerous barriers to Pap smear screening including lack of knowledge, limited access to care and cultural norms. Self-sampling for the human papilloma virus (HPV) holds great promise as a screening strategy among hard to reach populations. Our ongoing randomized trial is testing this approach in 3 minority communities in Miami. With various community partners, we are recruiting 600 minority women ages 30-65 who have not had a Pap smear in three years. Participants are randomized to one of three arms: 1) standard educational materials (control), 2) community health workers (CHW) led individualized health education and navigation to health centers for Pap smears 3) CHW education and HPV self-sampling. Using various community outreach strategies, CHWs have assessed 2,884 women for study inclusion. Of these, 604 were study eligible and under 5% have declined to participate in the study. Among the 318 already randomized, 51% are Hispanic, 31% Haitian, and 18% African American; with >50% are uninsured. Among women in group 2, 44% have been screened (via PAP). Among women in Group 3, 78% have been screened (Pap or HPV). In group 3, 84% of women preferred to have the HPV self-sampling versus a Pap smear. Our study suggests that culturally and linguistically competent CHWs are an efficient mechanism to recruit underserved populations into randomized trials. Preliminary data suggests that a CHW led HPV self-sampling strategy leads to high rates of cervical cancer screening among unscreened minority women.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education
Public health or related research

Learning Objectives:
Demonstrate the role of CHW/promotores as a cultural/linguistic intervention to increasing access to cervical cancer screening in vulnerable populations. Assess evidence on the value of community-based interventions in reaching women at risk for cervical cancer. Analyze our process of working with community health workers. Demonstrate our quantifiable screening outcomes in randomized clinical trial

Keyword(s): Cancer Screening, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the manager of this federally funded grant since January 2011 and previous presenter to APHA on this project. I have been working with CHWs/promotores de salud in many capacities since 1999 and currently am a member of regional, state and national steering committees on community health workers/promotores.
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.