Effectiveness of Cultivando Los Angeles Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic ladies


M. E FernГЎndez, A. Gonzales, and G. Tortolero-Luna originated the scholarly research, created the dimension instruments and research protocols, and oversaw research implementation. A. Gonzales and M. Saavedra-Embesi, our community lovers through the nationwide Center for Farmworker Health, drafted the descriptions regarding the scheduled system and in addition took part in the utilization of the analysis. J. Williams drafted the dimension parts of this article while the tables. W. Chan assisted into the analysis regarding the information for the article that is revised contributed towards the analysis and outcomes chapters of this article. All writers took part in conceptualization of a few ideas, interpretation of outcomes, and article editing and review.


Goals. We tested the potency of a health that is lay intervention to boost breast and cervical cancer assessment among low-income Hispanic females.

Techniques. individuals had been ladies 50 years and older have been nonadherent to mammography (n = 464) or Papanicolaou (Pap) test (letter = 243) assessment instructions. Following the assortment of standard information, lay wellness workers applied the Cultivando la Salud (CLS; Cultivating Health) intervention. Information enthusiasts then interviewed the individuals a few months later on.

Outcomes. At follow-up, assessment conclusion ended up being greater among feamales in the intervention team compared to the control team both for mammography (40.8% vs 29.9%; P 1–6 Cervical cancer incidence and mortality prices are almost two times as high for Hispanic ladies since they are for non-Hispanic White women; in addition, Hispanic women can be identified at later on phases and now have poorer survival prices. 1,6

Reduced quantities of cancer tumors testing among Hispanic women can be caused by psychosocial facets fear that is including of, invasive procedures, and discomfort; not enough understanding of cancer tumors and its assessment practices; attitudes of fatalism; religious or religious opinions; concerns over privacy; language obstacles and sensed discrimination; embarrassment; and partner disapproval. 1,7–24 External factors also influence screening, such as for example a not enough medical health insurance, regular resources of medical care, and doctor referral; transport obstacles; expense; and restrictive work policies.

Effective cancer-control programs for Hispanic ladies used (1) Spanish-language news; (2) part models showing up in media (magazines, tv) with social reinforcement by community volunteers; (3) “small media,” such as videos delivered in team settings or kiosks; (4) multimethod approaches; and (5) lay health workers or promotoras. 38–47 The lay wellness worker or promotora model, that has been first developed in Latin America, is a peer wellness education model whereby respected community people educate peers in a manner that is culturally appropriate. 48,49

A recently available Cochrane review reported the potency of lay health worker programs for increasing immunization uptake, marketing nursing, enhancing tuberculosis results, and reducing morbidity and mortality because of youth ailments. 50,51 an additional systematic review, the US Preventive Services Task Force identified 1-on-1 education as a successful technique for increasing both breast and cervical cancer tumors testing. 52 the duty force ended up being struggling to make a suggestion in regards to the usage of lay wellness worker programs especially since there had been inadequate variety of posted studies evaluating their effectiveness.

Although proof suggests that lay health worker programs can enhance some wellness actions, the potency of this model for increasing cancer tumors assessment has yet become completely explored. To fill this space into the literary works, we applied and evaluated Cultivando los angeles Salud (Cultivating Health), a lay health worker–delivered academic intervention for breast and cervical cancer tumors testing. We expected the intervention would increase mammography and Papanicolaou (Pap) test testing among low-income farmworker that is hispanic whom did perhaps not stick to recommended testing tips.

We developed a academic intervention (Cultivando la Salud) in 2004 to boost breast and cervical cancer tumors assessment among low-income, low-literacy, Hispanic feminine farmworkers aged 50 years and older. Despite the fact that Pap test assessment is preferred for more youthful ladies, we made a decision to consist of only women 50 years and older because proof shows that prices of invasive cervical cancer tumors are greater, prices of assessment are reduced, and obstacles to assessment vary among older Hispanic ladies than among younger females. 13,18,53–57 We developed the intervention making use of axioms of community-based participatory research 58 and intervention mapping, a systematic approach for intervention preparation and implementation. 14,59 We opted for lay health workers to produce the intervention system due to their unique capability to achieve, through personal contact in the neighborhood, ladies who hardly ever or never ever access care that is medical. Lay health workers had been expected not just to educate ladies and motivate them to have assessment but additionally to provide assistance that is practical would facilitate the ladies’s use of assessment services.

This system materials contained a course manual, an exercise curriculum, and a collection of training tools for the lay wellness employees (“tool box”). This program manual had been built to increase use associated with the system also to offer directions for program implementation and sustainability. It included a description associated with the system, proof of its effectiveness, and information regarding just how to develop and manage a lay wellness worker system. working out curriculum contained class plans, learning tasks, and artistic aids for lay health worker training by hospital staff. The “tool box” included bilingual breast and cervical cancer academic materials including a video, flipchart, breast models, pamphlets, and a training guide. The lay health workers utilized these materials to provide assessment information to feamales in the city. 60 A pilot research carried out in 2 farmworker communities in south Texas (Brownsville and Pharr) supplied home elevators the appropriateness and acceptability of this academic materials and the feasibility of applying this system. 14,61


This research had been sustained by an agreement that is cooperative the Centers for Disease Control and Prevention, A national Cancer Institute Preventive Oncology Academic Award, A nationwide Cancer Institute research grant tion Research Center Special Interest Project ). This book has also been authorized by the nationwide Cancer Institute .

We gratefully acknowledge the help associated with farmworker females and lay wellness workers swinglifestyle review whom took part in this task plus the people in the nationwide Center for Farmworker wellness nationwide Cancer Coalition. We additionally acknowledge Vincent Chen and Patricia Dolan Mullen for support in the analysis and Edward W. Fernandez and Karyn Popham for editorial assistance.

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