title: Increasing Breast and Cervical Cancer Screening in Rural and Border Texas with Friend to Friend Plus Patient Navigation.
abstract: The Friend to Friend plus Patient Navigation Program (FTF+PN) aims to build an effective, sustainable infrastructure to increase breast and cervical screening rates for underserved women in rural Texas. The objective of this paper is to identify factors that (1) distinguish participants who chose patient navigation (PN) services from those who did not (non-PN) and (2) were associated with receiving a mammogram or Papanicolaou (Pap) test. This prospective study analyzed data collected from 2689 FTF+PN participants aged 18-99 years from March 1, 2012 to February 28, 2015 who self-identified as African American (AA), Latina, and non-Hispanic white (NHW). Women who were younger, AA or Latina, had less than some college education, attended a FTF+PN event because of the cost of screening or were told they needed a screening, and who reported a barrier to screening had higher odds of being a PN participant. Women who were PN participants and had more contacts with program staff had greater odds of receiving a mammogram and a Pap compared with their reference groups. Latina English-speaking women had lower odds of receiving a mammogram and a Pap compared with NHW women and Latina Spanish-speaking women had higher odds of receiving a Pap test compared with NHW women. Women with greater need chose PN services, and PN participants had higher odds of getting a screening compared with women who did not choose PN services. These results demonstrate the success of PN in screening women in rural Texas but also that racial/ethnic disparities in screening remain.
authors.affiliation: School of Social Work, The University of Texas at Austin, 1 University Station D3500, Austin, TX, 78712, USA. dereksfalk@utexas.edu.
authors.forename: Derek
authors.identifier: 0000-0001-5929-8874
authors.initials: D
authors.lastname: Falk
authors.affiliation: School of Social Work, The University of Texas at Austin, 1 University Station D3500, Austin, TX, 78712, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cubbin
authors.affiliation: School of Social Work, The University of Texas at Austin, 1 University Station D3500, Austin, TX, 78712, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jones
authors.affiliation: School of Social Work, The University of Texas at Austin, 1 University Station D3500, Austin, TX, 78712, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Carrillo-Kappus
authors.affiliation: Texas A&M AgriLife Extension Service, The Texas A&M University System, Agriculture and Life Sciences Building, 600 John Kimbrough Boulevard, Suite 509, 7101 TAMU, College Station, TX, 77843-7101, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Crocker
authors.affiliation: Texas A&M AgriLife Extension Service, The Texas A&M University System, Agriculture and Life Sciences Building, 600 John Kimbrough Boulevard, Suite 509, 7101 TAMU, College Station, TX, 77843-7101, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Rice
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D055088:Early Detection of Cancer; D005006:Ethnicity; D005260:Female; D033062:Friends; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D062526:Patient Navigation; D011446:Prospective Studies; D012424:Rural Population; D013781:Texas; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data; D044465:White People; D055815:Young Adult
keywords: Disparities; Patient navigation; Prevention; Screening