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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.136713v1 99/5/936    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fernández, M. E. Articles by Vernon, S. W. Search for Related Content PubMed PubMed Citation Articles by Fernández, M. E. Articles by Vernon, S. W. Related Collections Hispanics/Latinos Rural Health Screening Cancer

María E. Fernández, PhD, Alicia Gonzales, MSW, Guillermo Tortolero-Luna, MD, PhD, Janet Williams, MPH, Monica Saavedra-Embesi, MPH, Wenyaw Chan, PhD and Sally W. Vernon, PhD

María E. Fernández, Janet Williams, and Sally W. Vernon are with the Center for Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, Houston. Alicia Gonzales and Monica Saavedra-Embesi are with the National Center for Farmworker Health, Buda, TX. Guillermo Tortolero-Luna is with the Comprehensive Cancer Center, University of Puerto Rico, San Juan. Wenyaw Chan is with the Department of Biostatistics, School of Public Health, University of Texas Health Science Center, Houston.

Correspondence: Requests for reprints should be sent to María E. Fernández, PhD, University of Texas–Houston School of Public Health, Division of Health Promotion and Behavioral Sciences, 7000 Fannin St, Suite 2558, Houston, TX 77030 (e-mail: Maria.E.Fernandez{at}uth.tmc.edu).

Objectives. 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.