A pilot test of a church-based intervention to promote multiple cancer-screening behaviors among Latinas.

We assessed the feasibility, acceptability, and initial impact of a church-based educational program to promote breast, cervical, and colorectal cancer screening among Latinas ages 18 years and over. We used a one-group pre-/post-evaluation within a low-income, Latino Baptist church in Boston, MA. Participants completed interviewer-administered assessments at baseline and at the end of the 6-month intervention. Under the guidance of a patient navigator (PN), women from the church (peer health advisors, or PHAs) were trained to deliver evidence-based screening interventions, including one-to-one outreach, small group education, client reminders, and reduction of structural barriers to screening. The PN and PHAs also implemented a health fair, and the pastor integrated health information into regular sermons. At pre-intervention, nearly half of the sample did not meet screening guidelines. The majority (97%, n = 35) of those who completed the post-intervention assessment participated in intervention activities. Two thirds (67%) reported talking with the PN or PHAs about health issues. Participation in small group education sessions was highest (72%), with health fairs (61%) and goal setting (50%) also being popular activities. Fourteen percent also reported receiving help from the PN in finding a primary care provider. This study supports the feasibility and acceptability of churches as a setting to promote cancer screening among Latinas.

Culturally responsive health promotion in puerto rican communities: a structuralist approach.

This literature review discusses the value of the structuralist approach as an integrated theoretical and methodological framework for participatory cultural assessments designed to capture the cultural dynamics of those affected by health disparities. Drawing from principles of the Lévi-Straussian strand of structural anthropology found in contemporary cultural studies, and using the Puerto Rican cultural experience as an example, the authors present the distinction between deep and surface structures of cultural knowledge and meaning and highlight information-processing and behavioral systems influenced by the complexity of cognitive and social representations of cultural structures. To understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses, the authors show the need for ethnographic narrative inquiry beyond surface manifestations of culture. Finally, the authors discuss the implications of the structuralist approach for culturally responsive health education and other health promotion interventions.