Skip to main content
Log in

Educating Latinas about cervical cancer and HPV: a pilot randomized study

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to assess effects of three different educational intervention arms on knowledge of and intention to receive Pap testing and HPV co-testing.

Methods

Three active educational intervention arms were developed: a fotonovela, a radionovela, and a digital story. A pilot randomized controlled trial of 160 Latinas was conducted to assess the effectiveness of the intervention arms in increasing knowledge of cervical cancer and HPV and intention to be screened for cervical cancer compared to an attention control group (flu vaccination).

Results

Women in all three treatment arms significantly increased knowledge about cervical cancer compared to control arm (p = 0.02). Knowledge about cervical cancer screening also increased in the active arms compared to control (p = 0.0003). Knowledge of HPV risk also increased relative to the control (p = 0.0001). There were no significant differences between the intervention arms in increased knowledge of cervical cancer or cervical cancer screening (p = 0.57 and 0.16, respectively).

Discussion

This study supported the use of small media interventions in narrative education form as effective in increasing knowledge and intention to be screened for cervical cancer. The three culturally relevant interventions, built on qualitative data, were all successful in increasing knowledge.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. National Cancer Institute Surveillance Epidermiology and End Results (SEER) Program (2016) Cancer statistics facts: cervix uteri cancer

  2. Centers for Disease Control and Prevention (CDC) (2015) Cancer screening test use. Morbidity and mortality weekly report, pp. 464–468

  3. National Cancer Institute (2016) NCI dictionary of cancer terms

  4. United States Preventive Services Task Force (2016) Final update summary: cervical cancer screening

  5. American Cancer Society (2017) HPV and HPV testing: human papilloma virus (HPV)

  6. Harper DM et al (2004) Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. The Lancet 364(9447):1757–1765

    Article  CAS  Google Scholar 

  7. Brown ML et al (2014) Peer reviewed: challenges in meeting healthy people 2020 objectives for cancer-related preventive services. National Health Interview Survey, 2008 and 2010. Prevent Chronic Dis 11:E29

    Google Scholar 

  8. CDC (2014) Behavioral risk factor surveillance system survey data. CDC, Atlanta

    Google Scholar 

  9. Goel MS et al (2003) Racial and ethnic disparities in cancer screening. J Gen Intern Med 18(12):1028–1035

    Article  Google Scholar 

  10. Singh GK, Hiatt RA (2006) Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. Int J Epidemiol 35(4):903–919

    Article  Google Scholar 

  11. Froment M-A et al (2014) Impact of socioeconomic status and ethnic enclave on cervical cancer incidence among Hispanics and Asians in California. Gynecol Oncol 133(3):409–415

    Article  Google Scholar 

  12. Vanslyke JG et al (2008) HPV and cervical cancer testing and prevention: knowledge, beliefs, and attitudes among Hispanic women. Qual Health Res 18(5):584–596

    Article  Google Scholar 

  13. Fernandez-Esquer ME et al (2003) A su salud: a quasi-experimental study among Mexican American women. Am J Health Behav 27(5):536–545

    Article  Google Scholar 

  14. Baezconde-Garbanati L et al (2013) Reducing the excess burden of cervical cancer among latinas: translating science into health promotion initiatives. Calif J Health Promot 11(1):45–57

    Article  Google Scholar 

  15. Fernandez ME et al (2014) Cervical cancer control for Hispanic women in Texas: strategies from research and practice. Gynecol Oncol 132(Suppl 1):S26–S32

    Article  Google Scholar 

  16. Mann L et al (2015) Increasing cervical cancer screening among US hispanics/latinas: a qualitative systematic review. J Cancer Educ 30(2):374–387

    Article  Google Scholar 

  17. Chen NN et al (2018) Understanding cervical cancer screening among latinas through the lens of structure, culture, psychology and communication. J Health Commun 23:1–9

    Article  Google Scholar 

  18. Guide to Community Preventive Services (2005) Cancer screening: small media targeting clients—cervical cancer. https://www.thecommunityguide.org/findings/cancer-screening-small-media-targeting-clients-cervical-cancer (cited 2019 Jan 7, 2019)

  19. Jandorf L et al (2008) Breast and cervical cancer screening among Latinas attending culturally specific educational programs. Prog Community Health Partnersh 2(3):195–204

    Article  Google Scholar 

  20. Fernández ME et al (2009) Effectiveness of Cultivando La Salud: a breast and cervical cancer screening promotion program for low-income hispanic women. Am J Public Health 99(5):936–943

    Article  Google Scholar 

  21. O’Brien MJ et al (2010) Community health worker intervention to decrease cervical cancer disparities in Hispanic women. J Gen Intern Med 25(11):1186–1192

    Article  Google Scholar 

  22. Luque JS et al (2011) Salud es vida: development of a cervical cancer education curriculum for promotora outreach with Latina farmworkers in rural Southern Georgia. Am J Public Health 101(12):2233–2235

    Article  Google Scholar 

  23. Saad-Harfouche FG et al (2011) Esperanza y Vida: training Lay health advisors and cancer survivors to promote breast and cervical cancer screening in latinas. J Community Health 36(2):219–227

    Article  Google Scholar 

  24. Thompson B et al (2014) Increasing cervical cancer screening in the United States-Mexico border region. J Rural Health 30(2):196–205

    Article  Google Scholar 

  25. Molokwu J et al (2016) Evaluation of the effect of a promotora-led educational intervention on cervical cancer and human papillomavirus knowledge among predominantly hispanic primary care patients on the US-mexico border. J Cancer Educ 31(4):742–748

    Article  Google Scholar 

  26. Thompson B et al (2017) Results of a randomized controlled trial to increase cervical cancer screening among rural latinas. Cancer 123(4):666–674

    Article  Google Scholar 

  27. Fleming K et al (2018) Educating hispanic women about cervical cancer prevention: feasibility of a promotora-led charla intervention in a farmworker community. Ethn Dis 28(3):169–176

    Article  Google Scholar 

  28. Nuno T et al (2011) A Promotora-administered group education intervention to promote breast and cervical cancer screening in a rural community along the U.S.-Mexico border: a randomized controlled trial. Cancer Causes Control 22(3):367–374

    Article  Google Scholar 

  29. Cheun ASA, Loomis J (2018) A culturally sensitive approach to cervical cancer prevention in the latina population using the promotora model. Nurs Womens Health 22(4):338–345

    Article  Google Scholar 

  30. Sabatino SA et al (2012) Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the guide to community preventive services. Am J Prev Med 43(1):97–118

    Article  Google Scholar 

  31. Task Force on Community Preventive Services (2008) Recommendations for client-and provider-directed interventions to increase breast, cervical, and colorectal cancer screening. Am J Prev Med 35(1 Suppl):S21

    Google Scholar 

  32. Byrd TL et al (2013) AMIGAS: a multicity, multicomponent cervical cancer prevention trial among Mexican American women. Cancer 119(7):1365–1372

    Article  Google Scholar 

  33. American FactFinder Community Facts (2017) Poverty status in the past 12 months; Yakima County 2013–2017 American community survey 5-year estimates. U.S. Census Bureau, Washington, DC

    Google Scholar 

  34. American FactFinder Community Facts (2017) Language spoken at home; Yakima County 2013–2017 American community survey 5-year estimates. U.S. Census Bureau, Washington, DC

    Google Scholar 

  35. Washington State Department of Health (2017) Chronic disease profiles by county. Washington State Department of Health, Olympia

    Google Scholar 

  36. Truven Health Analytics (2018) Community need index methodology and source notes, p. 2

  37. Hinojosa MS et al (2010) Salud de la mujer: using fotonovelas to increase health literacy among Latinas. Prog Commun Health Partnersh 4(1):25–30

    Article  Google Scholar 

  38. Houston C (2012) Fotonovelas and historietas. Library services for multicultural patrons: strategies to encourage library use, p 149

  39. Clayman ML et al (2010) Providing health messages to Hispanics/Latinos: understanding the importance of language, trust in health information sources, and media use. J Health Commun 15(sup3):252–263

    Article  Google Scholar 

  40. Ramirez AS et al (2015) Seeking Information on behalf of others: an analysis of calls to a Spanish-language radio health program. Health Promot Pract 16(4):501–509

    Article  Google Scholar 

  41. Briant KJ et al (2016) The power of digital storytelling as a culturally relevant health promotion tool. Health Promot Pract 17(6):793–801

    Article  Google Scholar 

  42. Kepka D et al (2011) Evaluation of a radionovela to promote HPV vaccine awareness and knowledge among Hispanic parents. J Community Health 36(6):957–965

    Article  Google Scholar 

  43. Kepka DL et al (2012) Development of a radionovela to promote HPV vaccine awareness and knowledge among latino parents. Public Health Rep 127(1):130–138

    Article  Google Scholar 

  44. Centers for Disease Control and Prevention (2016) Seasonal influenza. Centers for Disease Control and Prevention, Atlanta

    Google Scholar 

  45. Robinson D (2012) Becoming a translator: an introduction to the theory and practice of translation. Routledge, London

    Book  Google Scholar 

  46. Harris PA et al (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  Google Scholar 

  47. Sabogal F et al (1996) Printed health education materials for diverse communities: suggestions learned from the field. Health Educ Q 23(1_suppl):123–141

    Article  Google Scholar 

  48. Dixon-Gray LA et al (2013) Amor y Salud (love and health): a preconception health campaign for second-generation Latinas in Oregon. Am J Health Promot 27(3_suppl):S74–S76

    Article  Google Scholar 

  49. Murphy ST et al (2013) Narrative versus nonnarrative: the role of identification, transportation, and emotion in reducing health disparities. J Commun 63(1):116–137

    Article  Google Scholar 

  50. Moran MB et al (2016) A pilot test of the acceptability and efficacy of narrative and non-narrative health education materials in a low health literacy population. J Commun Healthc 9(1):40–48

    Article  Google Scholar 

  51. Hinyard LJ, Kreuter MW (2007) Using narrative communication as a tool for health behavior change: a conceptual, theoretical, and empirical overview. Health Educ Behav 34(5):777–792

    Article  Google Scholar 

  52. Kilanowski JF (2013) Anticipatory guidance preferences of Latina migrant farmworker mothers. J Pediatr Health Care 27(3):164–171

    Article  Google Scholar 

  53. Kochhar R (2000) The occupational status and mobility of Hispanics. Pew Hispanic Center, Washington, p. 7

    Google Scholar 

Download references

Acknowledgments

We are grateful to all the providers and community women who participated in this research project. We would also like to thank all the staff at the Center for Community Health Promotion. This project was supported by Grant Numbers 3U54CA153502, 3U54CA153502-05S1, U54 CA132381, and U54 CA132383 from the National Cancer Institute (NCI) and the Institute of Translational Health Science Grant (UL1 RR025014) from the National Center for Research Resources (NCRR) at the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCI, NCRR, or the NIH.

Author information

Authors and Affiliations

Authors

Contributions

BT was responsible for the overall conceptualization, funding acquisition, methodology, and writing of the manuscript. WEB contributed to the formal analysis, supervision, and writing of the manuscript. KJB contributed to conceptualization, funding acquisition, methodology, and writing of the manuscript. EK contributed to the formal analysis, the visualization, and the writing of the manuscript. EC contributed to the conceptualization, methodology, project administration, and supervision of the manuscript. NEG and VJG involved with conceptualization, data curation, validation, and investigation of the manuscript.

Corresponding author

Correspondence to Beti Thompson.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thompson, B., Barrington, W.E., Briant, K.J. et al. Educating Latinas about cervical cancer and HPV: a pilot randomized study. Cancer Causes Control 30, 375–384 (2019). https://doi.org/10.1007/s10552-019-01150-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-019-01150-w

Keywords

Navigation