Using a Culturally Tailored Narrative to Increase Cervical Cancer Detection Among Spanish-Speaking Mexican-American Women (original) (raw)
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Journal of cancer education : the official journal of the American Association for Cancer Education, 2016
US Latina women experience disproportionately high cervical cancer incidence and mortality rates. These health disparities are largely preventable with routine pap tests and human papillomavirus (HPV) screening. This study tested the efficacy of a cervical cancer education intervention to improve risk factor knowledge, attitudes, self-efficacy, and self-reported behavior related to cervical cancer screening among low-income Latinas who had not been screened in the past 2 years, compared to a usual care control group. Low-income Latinas who had not had a pap test in the prior 2 years were recruited from three Federally Qualified Health Centers and randomly assigned to intervention and control groups, with in-person assessment at baseline and 6-month follow-up. Women in the intervention group received a one-time low-literacy cervical cancer education program through an interactive, multimedia kiosk in either English or Spanish based on their language preference. Compared to the contro...
American journal of public health, 2015
We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were signific...
International Journal of Communication, 2017
This study investigated the role played by level of acculturation in the effect of narrative persuasion on health-related outcomes. A random sample of 186 Mexican American females watched either a narrative designed to increase human papillomavirus (HPV) vaccine uptake or an equivalent nonnarrative film. While message format failed to exert a direct effect on vaccination norms and behavioral intent, participants’ level of acculturation played an important role in the processing of the message. Specifically, when treating acculturation as a moderator, consistent effects emerged for less acculturated Latinas on various research outcomes, including descriptive and injunctive norms regarding HPV vaccine uptake. These findings extend the discussion on health communication through storytelling by calling attention to the importance of cultural factors in the framework of narrative persuasion.
Journal of Cancer Education, 2015
Despite declining cervical cancer rates, ethnic minorities continue to bear an unequal burden in morbidity and mortality. While access to screening is a major barrier, low levels of knowledge and cultural influences have been found to play a part in underutilization of preventive services. The aim of our study was to evaluate the effect of a promontora-led educational intervention on cervical cancer and human papillomavirus knowledge in mainly Hispanic females attending a primary care clinic. One hundred ten females were recruited from the waiting room of a busy primary care clinic and invited to attend individual or small group educational sessions. Participants completed knowledge surveys pre-and post-intervention. An overall evaluation of the educational session was also completed. Following the educational intervention, participants showed an improvement in knowledge scores from a mean score of 10.8 (SD 3.43) out of a possible score of 18 to a mean score of 16.0 (SD1.51) (p<0.001). 94.5 % of participants rated as excellent, the presentation of information in a way that was easy to understand, most reported that it was a good use of their time and that it lowered their anxiety about testing for early detection of cervical cancer. An educational intervention delivered by well-trained Promotora/Lay health care worker significantly improves patient's cervical cancer and HPV knowledge and can be a useful tool in patient education in the clinical setting especially with high risk populations.
Purpose: Although deaths from cervical cancer are declining, Latinas are not benefiting equally in this decline. Incidence of invasive cervical cancer among Los Angeles', California Latinas is much higher than among non-Latina Whites (14.7 versus 8.02 per 100,000). This paper examines cervical cancer screening among Latinas. Methods: Ninety-seven women of Mexican origin participated in 12 focus groups exploring barriers to screening. Saturation was reached. Results: All participants knew what a Pap test was and most knew its purpose. More acculturated participants understood the link between HPV and cervical cancer. More recent immigrants did not. There was confusion whether women who were not sexually active need to be screened. Most frequently mentioned barriers were lack of time and concern over missing work. Lower income and less acculturated women were less likely to be aware of free/lowcost clinics. Older and less acculturated participants held more fatalistic beliefs, were more embarrassed about getting a Pap test, were more fearful of being perceived as sexually promiscuous, and were more fearful of receiving disapproval from their husbands. Conclusions: Latinas are informed regarding cervical cancer screening; rather they encounter barriers such as a lack of time, money and support. Health promotion interventions can be enhanced via peer-to-peer education, by addressing barriers to cervical cancer screening with in-language, culturally tailored interventions, and working with clinics on systemic changes, such as extended clinic hours.
NAPA Bulletin, 2010
Latinas have higher cervical cancer age-adjusted incidence and mortality rates, and present with more advanced disease compared to non-Latino whites. This study used a cross-sectional mixed methods survey design, exploring knowledge, attitudes, and beliefs regarding the human papillomavirus (HPV), the HPV vaccine, and cervical cancer screening with four groups of women (Mexican, Honduran, Puerto-Rican, Anglo American; n=80) attending low-income health clinics along with one group of Latina health care workers (n=17). Data analyses included univariate frequency distributions and one-way ANOVA tests for quantitative data, thematic and content analysis of qualitative data, and cultural consensus analysis using the covariance method to compare groups. Results indicate overall cultural consensus for the five subgroups for both the agree/disagree questions and rankings on cervical cancer risk factors. However, differences were found between Latina women compared to Anglo American patients and health care clinic workers around birth control practices as possible causal factors for cervical cancer. Other findings suggested greater awareness of HPV and the HPV vaccine among Anglo American and Puerto Rican women compared to Mexican and Honduran women. Mexican and Honduran women were less likely to be aware of HPV and the HPV vaccine, and more likely to be uninsured and without a regular health care provider. Results point to the need to assess knowledge, attitudes, and beliefs in specific subgroups experiencing cervical cancer disparities to identify target areas for health education. Study findings will be used to inform the development and pilot testing of health education curriculum modules for cervical cancer prevention. While cervical cancer screening using the Papanicolaou (Pap) smear has resulted in dramatic reductions in cervical cancer incidence and mortality for women in the United States, its benefits have not been equitably distributed through all sociodemographic groups, based on age, socioeconomic and insured/uninsured status, and cultural and racial/ethnic categories (
Journal of Health Communication, 2012
Breast cancer is the most common cause of cancer and the leading cause of cancer death among Latinas in the United States. In addition, Latinas experience a disproportionate burden of cervical cancer incidence, morbidity, and mortality compared with non-Hispanic White women. Lower use of breast and cervical cancer screening services may contribute to these disparities. To address the underutilization of breast and cervical cancer screening among diverse subgroups of Latinas, a peer-led education program called Esperanza y Vida ("Hope and Life") was developed and administered at 3 sites (2 in New York and 1 in Arkansas). Immigrant Latina women and their partners were educated about the importance of breast and cervical cancer screening, with the goals of increasing their knowledge about these cancers and their screening behavior. An analysis of the intervention's findings at baseline among female participants demonstrated significant sociodemographic, interpersonal, cultural, health care system, and program variability in 3 distinct geographic regions in the United States. These data indicate the need for and feasibility of customizing cancer outreach and educational programs for diverse Latina subgroups living in various U.S. regions, with implications for informing the expansion and replication of the program in other regions of the country.
Health beliefs and socio cultural factors predicting cervical cancer screening dissertation
Health beliefs and socio cultural factors predicting cervical cancer screening -UMI Number: 3491199, 2012
ABSTRACT Cervical cancer is one of the most common reproductive cancers among women in the United States. The incidence and mortality rates of cervical cancer among Hispanic women in the U.S. are almost two times higher than non-Hispanic Whites. Cervical cancer screening is associated with early cervical cancer detection and, thus, with reductions in cancer morbidity and mortality. In Hispanic populations, where cancer rates are disproportionately high, it is important to conduct research that accounts for the influence of culture in health-seeking behaviors. The purpose of this study was to use the Health Belief Model (HBM) as a theoretical framework to explore the culturally determined beliefs and attitudes influencing Hispanic women’s decisions about cervical cancer and screening. A cross-sectional survey was conducted among self-identified Hispanic women, of various countries of origin, who were 18 to 65 years of age and who lived in seven cities in the Upstate of South Carolina. Generalized Linear Modeling was used to explore the effects of the hypothesized predictors. Results found evidence to support the hypothesized relationships between cervical cancer screening and health beliefs. Perceived threats (susceptibility and severity) and self-efficacy were the strongest predictors. The results also indicated that perceived benefits and barriers acted together to determine the women’s likelihood of getting screened. The importance of familism demonstrated the need to incorporate relevant cultural concepts when examining screening behaviors in minority groups. Knowledge about cervical cancer and the Pap test, age, marital status, income, access to regular medical care, familism, and cues to iii cervical cancer screening were determining factors that influenced S.C. Upstate Hispanic women’s perceptions of cervical cancer and the Pap test and their cervical cancer screening behaviors. The HBM can be used as a framework to design culturally appropriate cervical cancer screening interventions. Comprehensive approaches combining access to regular care and screening at a medical home and providing clear, accurate and culturally adapted information about cervical cancer, HPV, and screening will support the right of Hispanic women to access to cancer preventive care.
Cues to Cervical Cancer Screening Among U.S. Hispanic Women
Introduction: Hispanic women's cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening. Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old (n ¼ 220). Generalized linear modeling was used. Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed cues to action modified significantly the predictive effect of Perceived Threats (i.e., Susceptibility, Severity), benefits, barriers, and self-efficacy on Hispanic women's cervical cancer screening behavior. ''Mother told me'' and Spanish media messages were significant covariates. Conclusion: Cues to Action influenced Hispanic's women participation in cervical cancer screening. Cues to Action increased the strength of the health belief model as an explanatory model, and must be considered in designing culturally appropriate cervical cancer screening interventions.