A collectivist approach to cervical cancer screening among Latinas: The Sisters in Health Study

Purpose:  Latinas experience significantly greater incidence and mortality due to cervical cancer. Activating the natural social network can be a culturally-competent way to encourage cervical cancer screening for Latinas, who as a group tend to be collectivistic. We developed the Sisters in Health Study to test the feasibility of group visits, and identify the characteristics of participants who are more likely to benefit from this approach.            

Methods: Trained lay women recruited participants 21 years and older to attend a group visit for an HPV screening appointment in a partner health center. In group visits, participants stayed in the waiting room while they entered the exam room one-by-one. Participants completed survey interviews at baseline. 

Results: 105 participants consented to the study. Of these, 17 participants never scheduled a group visit or obtained individual screening prior to the scheduled visit. 13 women missed their scheduled visit because of unforeseen time conflicts or changes in screening guidelines in 2012. A total of 75 participants (71%) were screened in 35 group visits. Compared to those who did not attend a group visit, participants who did were significantly more likely to score higher on collectivism, be Mexican, and have had their last Pap test abroad. Health centers expressed difficulty opening slots for groups, especially after no-shows.

Conclusions: Group visits are a promising strategy to reach Latinas who are collectivistic and/or unfamiliar with the U.S. health system. However, strategies to improve appointment adherence and facilitate the integration of group visits in routine medical practice are necessary.