Can language-concordant prevention care managers improve cancer screening rates?
OBJECTIVE
There is evidence that non-English speakers in the United States receive lower quality health care and preventive services than English speakers. We tested the hypothesis that Spanish-speaking women would respond differently to an intervention to increase up-to-date status for cancer screening.


METHODS
A multisite randomized controlled trial showed that scripted telephone support, provided by a Prevention Care Manager (PCM), increased up-to-date rates for breast, cervical, and colorectal cancer screening. This subgroup analysis investigated the relative efficacy of the PCM among women who chose to communicate with the PCM in Spanish versus English.


RESULTS
Of 1,346 women in this analysis, 63% were Spanish speakers. Whereas the PCM intervention increased cancer screening rates generally, Spanish-speaking women seemed to benefit disproportionately more than English-speaking women for cervical cancer screening (unadjusted odds ratio, 1.77; 95% confidence interval, 1.03-3.05). In addition, in this exploratory analysis, there was a trend toward Spanish-speaking women receiving more benefit than English-speaking women from the intervention in increased breast and colorectal cancer screening rates.


CONCLUSIONS
Spanish-speaking women seemed to benefit more than did English-speaking women from a bilingual telephone support intervention aimed at increasing cancer screening rates.
Beach
Michael L
ML
Norris Cotton Cancer Center, Dartmouth Medical School, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, USA.
Flood
Ann Barry
AB
Robinson
Christina M
CM
Cassells
Andrea N
AN
Tobin
Jonathan N
JN
Greene
Mary Ann
MA
Dietrich
Allen J
AJ
D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D019303:Multilingualism; D009519:New York City; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017010:Reminder Systems; D012944:Social Support; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*; D014600:Utilization Review / Q000706:statistics & numerical data