title: Why a peer intervention program for Mexican-American women failed to modify the secular trend in cancer screening.
abstract: BACKGROUND
  We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening.
  
  
  METHODS
  The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older.
  
  
  RESULTS
  Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical.
  
  
  CONCLUSIONS
  Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.
authors.affiliation: Texas Cancer Registry, Texas Department of Health, Austin 78756-3199, USA. lsuarez@discon.tdh.state.tx.us
authors.forename: L
authors.initials: L
authors.lastname: Suarez
authors.forename: R A
authors.initials: RA
authors.lastname: Roche
authors.forename: L V
authors.initials: LV
authors.lastname: Pulley
authors.forename: N S
authors.initials: NS
authors.lastname: Weiss
authors.forename: D
authors.initials: D
authors.lastname: Goldman
authors.forename: D M
authors.initials: DM
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D017058:Mexican Americans; D008875:Middle Aged; D065006:Papanicolaou Test; D010379:Peer Group; D011203:Poverty; D013781:Texas; D014626:Vaginal Smears / Q000706:statistics & numerical data*