Predictors of pap screening among immigrant Spanish-speaking Latinas following attendance at an educational program Free

B24

Esperanza y Vida, a peer-led culturally targeted and community-based breast and cervical education program was tailored from a proven interventional model (the Witness Project), to increase breast and cervical knowledge and screening among immigrant Latinas from diverse countries of origin. To test the program’s effectiveness, women were randomly assigned to attend programs focusing on breast and cervical cancer (intervention) or diabetes education (control). This report will focus on the findings related to cervical cancer knowledge and screening rates (Pap tests). The incidence of cervical cancer for Latinas is nearly twice that of non-Latinas (14.2 per 100,000 compared to 7.3) and mortality rates are 3.4 versus 2.3, respectively. However, cervical cancer is highly curable, if detected and treated early, leading to a need to improve cervical cancer screening rates for Latina women. For example, increased morbidity and mortality is linked with lower Pap screening rates, particularly among uninsured Latina women (64.4% screened compared with 80.2% for White women). Examining the findings from the 2-month follow up data, we report the success of the program in increasing cervical cancer screening (Pap testing) among diverse, Spanish-speaking Latinas. We conducted 69 educational programs (44 intervention and 25 control programs) reaching over 800 Latina men and women in Arkansas and New York City. As access to care is a major barrier to screening among this population, women were also offered navigation assistance for screening tests. This report will focus on the 23.8% of the women who reported not having had a Pap test within the past three years (Screening interval recommended by the American Cancer Society at the time of the educational programs). Two months following the educational programs, women who agreed to be contacted were called and current screening rates were assessed. At that time, 60.9% (of the previously non-adherent) had completed a Pap test. Significant differences were detected among the newly adherent, based on which program type they had attended (74.1% of the women attending the intervention program became adherent, versus 42.0% of those attending the control program). In addition, there was a trend for Mexican women to be both less adherent before the educational program as well as to obtain screening following the educational program and navigation services, as compared to Latinas from other countries. However, although cervical cancer knowledge, tested immediately before and immediately following the education program increased significantly, these increases in knowledge did not significantly predict subsequent cervical screening. These findings demonstrate that cancer specific, culturally competent education programs together with navigation can significantly improve screening rates for cervical cancer in diverse Latina populations, and may serve to decrease the disparity of both the incidence and mortality of the disease among Latinas. Future research will explore these findings and other potential factors (e.g. level of acculturation, insurance status, knowledge) in a larger group of Latinas to further tailor our intervention.