The impact of a promotora on increasing routine chronic disease prevention among women aged 40 and older at the U.S.-Mexico border.
A randomized controlled intervention tested the effectiveness of a community health worker (CHW) program in increasing compliance with annual preventive exams among uninsured Hispanic women living in a rural U.S.-Mexico border area. During 1999-2000, household surveys were administered to women aged 40 and older. Uninsured women not receiving routine comprehensive preventive care were invited to participate in a free comprehensive clinical exam. Participants in the initial exam were eligible to participate in the CHW (promotora) intervention. Women were randomized to one of two intervention arms. One arm received a post-card reminder for an annual preventive exam, the other a postcard reminder and follow-up visit by a promotora. Receiving the promotora intervention was associated with a 35% increase in rescreening over the postcard-only reminder (risk ratio [RR] = 1.35, 95% confidence interval 0.95-1.92). Using promotoras to increase compliance with routine screening exams is an effective strategy for reaching this female population.
Hunter
Jennifer B
JB
Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ 85721, USA. jhunter@coph.arizona.edu.
de Zapien
Jill Guernsey
JG
Papenfuss
Mary
M
Fernandez
Maria Lourdes
ML
Meister
Joel
J
Giuliano
Anna R
AR
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003153:Community Health Services / Q000458:organization & administration; D003150:Community Health Workers / Q000458:organization & administration*; D005260:Female; D006801:Humans; D017057:Medically Uninsured; D017058:Mexican Americans; D008875:Middle Aged; D010808:Physical Examination; D011322:Primary Prevention; D012959:Socioeconomic Factors; D016387:Women's Health