title: Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women.
abstract: OBJECTIVE
  We tested the effectiveness of a lay health worker intervention to increase breast and cervical cancer screening among low-income Hispanic women.
  
  
  METHODS
  Participants were women 50 years and older who were nonadherent to mammography (n = 464) or Papanicolaou (Pap) test (n = 243) screening guidelines. After the collection of baseline data, lay health workers implemented the Cultivando la Salud (CLS; Cultivating Health) intervention. Data collectors then interviewed the participants 6 months later.
  
  
  RESULTS
  At follow-up, screening completion was higher among women in the intervention group than in the control group for both mammography (40.8% vs 29.9%; P < .05) and Pap test (39.5% vs 23.6%; P < .05) screening. In an intent-to-treat analysis, these differences remained but were not significant. The intervention increased mammography self-efficacy, perceived susceptibility, perceived survivability, perceived benefits of mammography, subjective norms, and processes of change. The intervention also significantly increased Pap test self-efficacy, perceived benefits of having a Pap test, subjective norms, and perceived survivability of cancer. It did not change Pap test knowledge, perceived susceptibility, or perceptions about negative aspects of Pap test screening.
  
  
  CONCLUSIONS
  Our results add to the evidence concerning the effectiveness of lay health worker interventions for increasing Pap test screening and mammography. Future research should explore the effectiveness of CLS in other Hispanic groups, the mechanisms through which interpersonal communication influences decisions about screening, and how effective interventions such as CLS can best be adopted and implemented in community-based organizations or other settings.
authors.affiliation: Center for Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, 7000 Fannin St, Suite 2558, Houston, TX 77030, USA. Maria.E.Fernandez@uth.tmc.edu
authors.forename: María E
authors.initials: ME
authors.lastname: Fernández
authors.forename: Alicia
authors.initials: A
authors.lastname: Gonzales
authors.forename: Guillermo
authors.initials: G
authors.lastname: Tortolero-Luna
authors.forename: Janet
authors.initials: J
authors.lastname: Williams
authors.forename: Monica
authors.initials: M
authors.lastname: Saavedra-Embesi
authors.forename: Wenyaw
authors.initials: W
authors.lastname: Chan
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D016730:Program Development / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000208:ethnology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data