A randomized controlled trial to evaluate an adapted community health worker-delivered breast and cervical cancer screening education and navigation intervention for underserved Latina adults.

INTRODUCTION

We evaluated the effectiveness of an adapted community-based breast and cervical screening behavioral intervention. Community health workers (CHW) delivered group education and optional telephone-based health coaching and navigation on mammography and Papanicolaou (Pap) test screening among low-income Latinas in the Greater Houston area.

METHODS

CHWs recruited women (40 years and older) who were non-adherent to mammography screening guidelines (n=797), as well as women 21 years and over who were non-adherent to cervical cancer screening guidelines (n=501). Data collectors completed baseline surveys, randomized women to the CHW-delivered intervention and comparison (delayed intervention) arms, and completed 6-month follow-up surveys.

RESULTS

At follow-up, 39.9% in the mammography intervention arm and 20.3% of women in the comparison arm completed mammograms (P < .001). For cervical cancer screening, 55.8% of women in the intervention arm and 27.4% of women in the comparison arm completed cervical screening (P < .001). Adjusting for socio-economic, demographic, and cancer screening history factors significant in bivariate analysis (P <.25), women in the mammography intervention had a significantly increased odds of receiving a mammogram based on adjusted intention-to-treat (aOR: 2.00, 95% CI: 1.40-2.84) and per-protocol analyses (aOR: 2.53, 95% CI: 1.74-3.68). Similarly, women in the Pap test screening intervention arm had a significantly increased odds of Pap test screening in intention-to-treat (aOR: 1.95, 95% CI: 1.29-2.95) and per-protocol analyses (aOR: 3.51, 95% CI: 2.18-5.65).

CONCLUSION

This study provides strong evidence that community-based group education and navigation increase breast and cervical screening among low-income Latinas in urban settings. Future research to scale up this evidence-based CHW-delivered program is needed.