Esperanza y Vida: Training Lay Health Advisors and Cancer Survivors to Promote Breast and Cervical Cancer Screening in Latinas
- 449 Downloads
The use of lay health advisors (LHAs) to promote community-based health education programs is well documented and is considered an effective way to reach underserved communities. Esperanza y Vida (Hope & Life) is an educational outreach program to increase breast and cervical cancer screening for diverse Latinas. It incorporates Latino LHAs (men and women) and cancer survivor role models, sobrevivientes, in the program delivery. An interactive training program, conducted by bilingual staff across three sites (Little Rock, Arkansas; Buffalo, New York and New York City) included 74 sobrevivientes and LHAs who were recruited and trained. All training attendees completed an initial application assessing socio-demographics, experience and availability as well as, true/false surveys at the beginning (pre-) and end of the training (post-) measuring knowledge levels of breast and cervical cancer health. Data analysis indicated a significant increase of both breast and cervical cancer knowledge for attendees trained as LHAs (pre = 60%; post = 80%; p = 0.000), whereas sobrevivientes had a higher baseline knowledge of breast health (74%), and therefore did not show a significant increase following training (79%). However, sobrevivientes did display a significant increase in cervical cancer knowledge (p = 0.003). These findings demonstrate the impact of training and how LHAs may be recruited at different levels of knowledge and experience and be successfully trained in key program elements. Moreover, results indicate that sobrevivientes may be impacted differently, or require variations in training approaches. This information can be useful in developing and customizing curriculum for future lay health training programs.
KeywordsLatinas Cancer screening Lay health advisor Health disparities Cancer survivors
Formative research was supported by Susan G. Komen Race for the Cure Foundation Grants #: POP0201290 and POP0503950. The intervention effectiveness study is currently supported by American Cancer Society grant: RSGT-07-021-01-CPPB and funding from the John R. Oishei Foundation of Western New York. The authors acknowledge the assistance of Paula Jones.
- 1.American Cancer Society. (2009). Cancer facts and figures for Hispanics/Latinos, 2009–2011. Atlanta, GA: American Cancer Society.Google Scholar
- 7.Centers for Disease Control and Prevention. (2008). Racial and ethnic approaches to community health (REACH US): Finding solutions to health disparities 2008. <www.cdc.gov/reach>.
- 12.Darnell, J. S., Chang, C., & Calhoun, E. A. (2006). Knowledge about breast cancer and participation in a faith-based breast cancer program and other predictors of mammography screening among African American women and Latinas. Health Promotion Practice, 7(3_suppl), 201S–212S.PubMedCrossRefGoogle Scholar
- 15.US Department of Health and Human Services. (2007). Community health worker national workforce study. US Department of Health and Human Services Health Resources and Services Administration (HRSA).Google Scholar
- 19.Eng, E., & Parker, E. A. (2002). Natural helper models to enhance a community’s health & competence. In R. J. DiClemente, R. A. Crosby, & M. C. Kegler (Eds.), Emerging theories in health promotion practice and research: Strategies for improving public health. San Francisco, CA: Joessey-Bass.Google Scholar
- 21.Perez, M., Findley, S. E., Mejia, M., & Martinez, J. (2006). The impact of community health worker training and programs in New York City. Journal of Health Care for the Poor and Underserved, 17, S26–S43.Google Scholar
- 22.Ramirez, A., McAlister, A., & Gallion, K. (1995). Community level cancer control in a Texas barrio: Part I. Theoretical basis, implementation, and process evaluation. Journal National Cancer Institute Monograph, 18, 117–122.Google Scholar
- 23.Castro, F., Elder, J., & Coe, K. (1995). Mobilizing churches for health promotion in Latino communities: Companeros en la salud. Journal National Cancer Institute Monogram, 18, 127–356.Google Scholar
- 25.Navarro, A. M., Senn, K. L., & Kaplan, R. M. (Eds.) (1995). Por la vida intervention model for cancer prevention in latinas. Journal National Cancer Institute Monograph, 18, 137–145.Google Scholar
- 27.Erwin, D. O., Johnson, V. A., Trevino, M., Duke, K., Feliciano, L., & Jandorf, L. (2007). A comparison of African American and Latina social networks as indicators for culturally tailoring a breast and cervical cancer education intervention. American Cancer Society CANCER Supplement, 109(2), 368–377.Google Scholar
- 36.Sudarson, N. R., Jandorf, L., & Erwin, D. O. (2010). Multi-site implementation of health education programs for Latinas. Journal of Community Health (in press).Google Scholar
- 37.Jandorf, L., Ellison, J. L., Shelton, R. C., et al. (2010). Esperanza y vida: A culturally and linguistically customized breast and cervical education program for diverse Latinas: At three different US sites. Journal of Health Communication (in review).Google Scholar
- 39.Erwin, D. O., Johnson, V. A., Feliciano-Libid, L., Zamora, D., & Jandorf, L. (2005). Incorporating cultural constructs and demographic diversity in the research and development of a Latina breast and cervical cancer education program. Journal of Cancer Education, 20(1), 39–44.PubMedCrossRefGoogle Scholar
- 40.Jandorf, L., Bursac, Z., Pulley, L., Trevino, M., Castillo, A., & Erwin, D. O. (2008). Breast and cervical cancer screening among Latinas attending culturally specific educational programs. Progress in Community Health Partnerships: Research, Education and Action, 2(3), 195–204.CrossRefGoogle Scholar