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.
Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ 85721, USA. jhunter@coph.arizona.edu.
Jennifer B
JB
Hunter
Jill Guernsey
JG
de Zapien
Mary
M
Papenfuss
Maria Lourdes
ML
Fernandez
Joel
J
Meister
Anna R
AR
Giuliano
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