title: A cancer screening intervention for underserved Latina women by lay educators.
abstract: OBJECTIVE
  Inadequate screening adherence for breast, cervical, and colorectal cancer among Latinas places them at greater risk for poor survival rates, once diagnosed. The purpose of this study was to examine two delivery methods of lay health educators (promotoras de salud) to increase screening behavior and evaluate costs.
  
  
  METHODS
  This community-based group randomized trial assigned Latinas due for breast, cervical, or colorectal cancer screening (n=1006) to promotora-taught cancer screening/prevention classes delivered individually (IND) or in social support groups (SSG) over 8 weeks. Screening behaviors were assessed immediately after and 3 and 15 months after intervention. Intervention costs per study arm were compared.
  
  
  RESULTS
  Screening and maintenance behaviors were not significantly different between SSG and IND for any one type of cancer screening, but with a study entry requirement that participants were either never screened or due for screening, postintervention screening rates (that is, completing a screening that was due) were notable (39.4% and 45.5%, respectively). The cost of achieving any one screening was much higher for IND participants.
  
  
  CONCLUSIONS
  SSG vs. IND delivery did not significantly affect cancer screening behaviors, but both interventions produced robust achievement of screenings for previously nonadherent participants. Group-based promotora-led interventions supporting social involvement are recommended as a more cost-effective approach to achieving cancer screening among Latina women.
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona 85004, USA. larkeylite@msn.com
authors.forename: Linda K
authors.initials: LK
authors.lastname: Larkey
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Herman
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Roe
authors.forename: Francisco
authors.initials: F
authors.lastname: Garcia
authors.forename: A M
authors.initials: AM
authors.lastname: Lopez
authors.forename: J
authors.initials: J
authors.lastname: Gonzalez
authors.forename: Prasadini N
authors.initials: PN
authors.lastname: Perera
authors.forename: Kathylynn
authors.initials: K
authors.lastname: Saboda
mesh_terms: D000069:Acculturation; D000328:Adult; D001130:Arizona; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D003150:Community Health Workers; D055088:Early Detection of Cancer / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology; D011320:Primary Health Care / Q000706:statistics & numerical data; D012657:Self-Help Groups / Q000706:statistics & numerical data; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control