A lay health worker intervention to improve breast and cervical cancer screening among Latinas in El Paso, Texas: A randomized control trial.

INTRODUCTION: We examined the effectiveness of a lay health worker (promotora)-delivered intervention on increasing breast and cervical cancer screening among low-income, primarily uninsured Latinas living in El Paso, Texas. METHODS: In 2015, Breast and Cervical Cancer Screening (BCCS) program promotoras recruited Latinas overdue for breast and/or cervical cancer screening in community settings. Promotoras consented eligible women and conducted baseline surveys before individually randomizing women into control (n = 313) or intervention (n = 314) groups. Control participants received printed material providing basic information about breast and cervical cancer screening.Intervention participants received promotora-delivered one-on-one breast and cervical cancer screening education followed by navigation calls, providing assistance to address personal and logistic barriers to accessing clinical services. We assessed breast and cervical cancer screening outcomes using a 6-month follow-up survey. Per protocol (PP) and intent to treat (ITT) analyses are reported. RESULTS: At follow-up, among women in need of breast cancer screening, those in the intervention group were significantly more likely to complete a mammogram than those in the control group (PP: 53.4% vs. 40.1%, p = .013; ITT: 47.9% vs. 35.2%, p = .011). Among women in need of Pap screening, only intervention group women 50 years and older were more likely to complete a Pap screening compared with control group women (PP: 64.5% vs. 43.5%, p = .019). CONCLUSIONS: A promotora-delivered behavioral intervention, embedded in a community-based organization, increased mammography uptake in all women and Pap uptake among women 50 years and older in a sample of low-income Latinas. NCT04397744.

A community-based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT.

OBJECTIVE: We assessed the short-term effects of a community-based intervention for Hispanic men to encourage informed decision making (IDM) about prostate cancer screening with prostate specific antigen (PSA). METHODS: All senior social and housing centers in El Paso, TX were randomized to intervention, a group-based Spanish language educational program facilitated by promotores (12 centers; 161 men) [I's], or to control, promotores-facilitated diabetes video and discussion (13 centers; 160 men) [C's]. RESULTS: Participants had low levels of schooling and baseline knowledge; 44% reported previous PSA testing. At post-test, the I's made large knowledge gains, increased their understanding that experts disagree about testing, shifted toward more active decision making roles, were more likely to believe that it is important to weigh the advantages and disadvantages of screening and to anticipate potential screening outcomes in making a decision, and were less likely to consider the screening decision easy. The I's did not change in their screening intention or the belief that choosing not to be screened could be a responsible choice. CONCLUSIONS: A community-based intervention to support IDM for prostate cancer screening can increase knowledge and may promote more active involvement in decision making about prostate cancer screening. Such an approach can increase knowledge and may promote more active involvement in decision making about prostate cancer screening. PRACTICE IMPLICATIONS: It is feasible to develop and implement a community-based intervention program to promote IDM for prostate cancer screening.

What is needed for informed decisions about prostate cancer screening: perspectives of African-American and Hispanic men.

Professional guidelines suggest that men should learn about risks and benefits of screening to make informed decisions consistent with their preferences. We used concept mapping to investigate views of informed decision making (IDM) of minority men. Statements about what men need for IDM about prostate cancer screening were sorted by similarity and rated for importance by 16 Hispanic and 15 African-American men. Multidimensional scaling and cluster analysis were used to develop a concept map for IDM. The 10-cluster solution was selected. The clusters rated most important were labeled Future Considerations, What to Know and Decision to Make. Clusters labeled Social Support and Sharing Perspectives depicted social aspects of the decision and were intermediate in importance. There was strong correlation in relative importance ratings of clusters by African-American and Hispanic men. However, African-American men gave higher importance ratings than Hispanic men. Concept mapping, a method with strong participatory elements, was useful in identifying conceptual frameworks for IDM of African-American and Hispanic men. Health education to support IDM requires some shifts in focus and strategy. It is important that interventions with minority men build upon a strong conceptual framework.

Comparison of factors affecting repeat mammography screening of low-income Mexican American women.

PURPOSE/OBJECTIVES: To examine the level of cancer fatalism and other sociocognitive behavioral determinants in Mexican American women categorized as regular mammography screeners and infrequent mammography screeners. DESIGN: Cross-sectional, descriptive. SETTING: A southwestern American city on the U. S.-Mexico border. SAMPLE: 68 Mexican American women with low incomes recruited from a cancer consortium database. METHODS: Women who had been identified as regular or infrequent screeners based on screening history were contacted and invited to participate in a telephone survey. Participation consisted of completing the Powe Fatalism Inventory (PFI) and the Mammography Beliefs and Attitudes Questionnaire (MBAQ) in English or Spanish. MAIN RESEARCH VARIABLES: Total scores on the PFI and total scores on each of the MBAQ subscales. FINDINGS: Differences between the two groups were noted in cancer fatalism, perceived control over their participation in screening activities, and family history of cancer. No significant differences were noted in demographic characteristics. CONCLUSIONS: Cancer fatalism, generally believed to be highly related to socioeconomic status, may be mediated by women's perceptions of control over screening behavior or choices and by family history of cancer. IMPLICATIONS FOR NURSING: Further research is needed to explore cancer fatalism among Hispanic women, including other factors that can affect the level of cancer fatalism and perceived control over mammography screening participation. With this knowledge, culturally sensitive interventions may be developed to increase self-efficacy and facilitate perceived control.