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

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.