title: Multi-level Intervention to increase participation in mammography screening: ¡Fortaleza Latina! study design.
abstract: BACKGROUND
  Breast cancer is the most common cancer and the leading cause of death among Latinas in the United States. The Multi-level Intervention to Increase Participation in Mammography Screening study (¡Fortaleza Latina!) is a partnership among research institutions, a Latino-serving community-based primary care clinic organization, and a cancer treatment center. The study will assess the efficacy of a clinic- and patient-level program to increase breast cancer screening among Latinas in Western Washington.
  
  
  METHODS
  The intervention is a multi-level breast cancer screening program in four participating primary care clinics. The study is a parallel randomized controlled trial of 600 Latino women aged 42-74 who are non-compliant with breast cancer screening guidelines. Participants will be randomized within clinic using block randomization to: (1) a control arm (usual care); and (2) a theory-based counseling program consisting of a 'promotora' or community health worker-led home-based intervention to encourage breast cancer screening. At the clinic-level, two clinics will offer additional mammography services provided by a mobile mammography unit operated by the Seattle Cancer Care Alliance. The primary endpoint is the rate of mammography uptake over the 1-year follow-up period.
  
  
  CONCLUSIONS
  This multi-level intervention aims to raise rates of participation in breast cancer screening among Latino women. If effective, the program may improve rates of early detection of breast cancer in Latino women. Clinicaltrials.gov
  
  
  BACKGROUND
  NCT02010008.
authors: Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA. Electronic address: Gloria.d.coronado@kpchr.org.
authors: Gloria D
authors: GD
authors: Coronado
authors: Sea Mar Community Health Centers, 1040 S Henderson Street, Seattle, WA 98108, USA. Electronic address: RicardoJimenez@seamarchc.org.
authors: Ricardo
authors: R
authors: Jimenez
authors: Department of Family Medicine School of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña McKenna 4686 Macul, Santiago, Chile. Electronic address: jmarting@med.puc.cl.
authors: Javiera
authors: J
authors: Martinez-Gutierrez
authors: Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA. Electronic address: dmclerra@fhcrc.org.
authors: Dale
authors: D
authors: McLerran
authors: University of Washington School of Public Health, Box 357230, Seattle, WA 98195, USA. Electronic address: iornelas@u.washington.edu.
authors: India
authors: I
authors: Ornelas
authors: University of Washington School of Public Health, Box 357230, Seattle, WA 98195, USA. Electronic address: donald@u.washington.edu.
authors: Donald
authors: D
authors: Patrick
authors: Seattle Cancer Care Alliance, Radiology, 825 Eastlake Ave. E, P.O. Box 19023, Seattle, WA 98109, USA. Electronic address: rgut@u.washington.edu.
authors: Robert
authors: R
authors: Gutierrez
authors: Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA. Electronic address: sbishop@fhcrc.org.
authors: Sonia
authors: S
authors: Bishop
authors: Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Seattle, WA 98109, USA; University of Washington School of Public Health, Box 357230, Seattle, WA 98195, USA. Electronic address: beresfrd@u.washington.edu.
authors: Shirley A A
authors: SA
authors: Beresford
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006630:Hispanic or Latino; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration; D012107:Research Design; D012959:Socioeconomic Factors; D014481:United States
keywords: Breast cancer; Cancer disparities; Hispanic women; Latino women; Mammogram; Multi-level intervention