Online Program

A case study on differences on cervical cancer screening knowledge and prevention practices among Latinas at two sites in a community-based participatory randomized control trial in south Florida

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
Martha Gonzalez, MA, Jay Weiss Institute for Health Equity, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL
Erin Kobetz, Ph.D., MPH, Department of Medicine, University of Miami Miller School of Medicine, Miami, 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
Shelia McCann, MEd, SM, GPC, Grants Management, Health Choice Network of Florida, Doral, FL
Sainth Anthony Amofah, MD, MBA, Chief Medical Officer, Community Health of South Florida, Inc., Miami, FL
Immigrant Latinas are less likely to be screened for cervical cancer. With NCI support, we are examining the effectiveness of community health workers (CHWs) at increasing cervical cancer screening using self-sampling for the Human Papilloma virus (HPV, done free) versus clinic referral for traditional Pap Smear screening (nominal co-payments). One site (Hialeah) serves mostly Cuban women (n=106) and the other site (Southern Miami-Dade County, SMD) serves a predominantly non-Cuban Latino population (n=55). Using a mixed methods quantitative/qualitative approach, we examined differences in demographics, cervical cancer knowledge and prevention practices among participants at these sites. Latino participants in Hialeah were younger, more recent immigrants, more educated, insured, higher literacy (SAHLSA), and higher cervical cancer knowledge that those in SMD. Most participants in Hialeah (95%) preferred HPV self-sampling citing familiarity with home based vaginal screening in Cuba and preferences for health services that were free as main reason for choosing HPV self-sampling. In SMD only half the participants chose the HPV self-sampler. Cultural discomfort with vaginal self-sampling, preference for a doctor to perform a vaginal exam, and greater willingness to pay for health care services (despite lower SES) were found be major reasons why many women in SMD preferred being referred to a clinic for a traditional Pap smear. This study again highlights major differences in health knowledge and behaviors among different Latino subgroups. It also emphasizes the need for community based health programs to be tailored to the specific needs and practices of distinct Latino communities.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Describe differences among Hispanic/Latina groups in relation to perception of body/women's health, knowledge of HPV and cervical cancer and cervical cancer screening methhods. Describe the CHW/promotores as a cultural/linguistic intervention to increasing access to cervical cancer screening in different Hispanic/Latino communities. Provide evidence on the value of community-based interventions in reaching women at risk for cervical cancer.

Keyword(s): Cancer Screening, Latinas

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have managed this cervical cancer randomized control trial since funding on 2010, and have worked with promotoras/CHWs in Latino/Hispanic groups for over 12 yrs. Of those I also managed the outreach and recruitment activities of the Miami Field Center of the Hispanic Community Health Study-Study of Latinos for 4 years. I am also a certified translator English/Spanish with experience providing technical assistance to local, state, and national groups working with US Hispanics/Latino health disparities.
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.