AMIGAS: building a cervical cancer screening intervention for public health practice.
BACKGROUND
Many barriers to cervical cancer screening for Hispanic women have been documented, but few effective interventions exist. The Community Preventive Services Task Force recommends increasing cervical cancer screening through various methods. Building on this evidence, the Centers for Disease Control and Prevention funded the research and testing phases for an evidence-based and theoretically grounded intervention designed to increase cervical cancer screening among never and rarely screened Hispanic women of Mexican descent. In this article, we describe the development process of the AMIGAS (Ayudando a las Mujeres con Información, Guía, y Amor para su Salud) intervention, highlight the integration of scientific evidence and community-based participatory research principles, and identify opportunities for dissemination, adaptation, and implementation of this intervention.


METHODS
The AMIGAS team was a collaboration among researchers, promotoras (community health workers), and program administrators. The multiyear, multiphase project was conducted in Houston, Texas; El Paso, Texas; and Yakima, Washington. The team completed several rounds of formative research, designed intervention materials and methodology, conducted a randomized controlled trial, created a guide for program administrators, and developed an intervention dissemination plan.


RESULTS
Trial results demonstrated that AMIGAS was successful in increasing cervical cancer screening among Hispanic women. Adaptation of AMIGAS showed minimal reduction of outcomes. Dissemination efforts are underway to make AMIGAS available in a downloadable format via the Internet.


CONCLUSIONS
Developing a community-based intervention that is evidence-based and theoretically grounded is challenging, time-intensive, and requires collaboration among multiple disciplines. Inclusion of key stakeholders-in particular program deliverers and administrators-and planning for dissemination and translation to practice are integral components of successful intervention design. By providing explicit directions for adaptation for program deliverers, relevant information for program administrators, and access to the intervention via the Internet, AMIGAS is available to help increase cervical cancer screening among Hispanic women and other women disproportionately affected by cervical cancer.
Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. JLeeSmith@cdc.gov
Judith Lee
JL
Smith
Katherine M
KM
Wilson
Carlyn E
CE
Orians
Theresa L
TL
Byrd
D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D003150:Community Health Workers; D055812:Community-Based Participatory Research; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D016730:Program Development; D015980:Public Health Practice; D016032:Randomized Controlled Trials as Topic; D013781:Texas; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D014626:Vaginal Smears; D014861:Washington