Jandorf Lina, Bursac Zoran, Pulley Leavonne, Trevino Michelle, Castillo Anabella, Erwin Deborah O
Mount Sinai School of Medicine.
Prog Community Health Partnersh. 2008 Fall;2(3):195-204. doi: 10.1353/cpr.0.0034.
Latinas in the United States have higher morbidity and mortality rates for breast and cervical cancers (compared with non-Latina Whites), often due to lower screening rates. A community-based participatory research (CBPR) approach could help to improve screening rates by creating a culturally customized educational program for Latino men and women addressing low knowledge, gender roles, and spirituality.
This study was designed to assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location.
Participants were recruited to attend either a breast and cervical (intervention) or diabetes (control) education program, within a randomized plan. Sixty-nine programs (44 intervention; 25 control) were conducted in Arkansas (AR; n = 39) and New York City (NYC; n = 30) with a total of 847 Latino men and women. Telephone follow-up data were collected on 49% of the women who consented to being contacted 2 months postintervention.
At the 2-month follow-up call, screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6). The aORs accounted for the significant effects of study site (AR vs. NYC) and marital status.
Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.
在美国，拉丁裔女性患乳腺癌和宫颈癌的发病率和死亡率更高（与非拉丁裔白人相比），这通常是由于筛查率较低。基于社区的参与性研究（CBPR）方法可以通过为拉丁裔男性和女性创建一个针对知识水平低、性别角色和精神信仰的文化定制教育项目，来帮助提高筛查率。
本研究旨在评估一个文化定制项目（希望与生活）在提高拉丁裔女性乳腺癌和宫颈癌筛查率方面的有效性，并研究筛查率与癌症知识变化、种族起源差异和地理位置之间的关系。
按照随机计划，招募参与者参加乳腺癌和宫颈癌（干预）或糖尿病（对照）教育项目。在阿肯色州（AR；n = 39）和纽约市（NYC；n = 30）开展了69个项目（44个干预项目；25个对照项目），共有847名拉丁裔男性和女性参与。对49%同意在干预后2个月接受联系的女性收集了电话随访数据。
在2个月的随访电话中，干预组的临床乳腺检查（CBE；48%对31%；调整优势比[aOR]，2.2；95%置信区间[CI]，1.1 - 4.2）、乳腺自我检查（45%对27%；aOR，2.3；95% CI，1.1 - 5.0）和巴氏试验（51%对30%；aOR，3.9；95% CI，1.1 - 14.1）的筛查率显著高于对照组，但乳腺钼靶检查（67%对58%；aOR，0.7；95% CI，0.1 - 3.6）并非如此。优势比考虑了研究地点（AR与NYC）和婚姻状况的显著影响。
希望与生活项目有潜力通过增加癌症筛查从而提高早期发现率，来减少乳腺癌和宫颈癌发病率及死亡率方面的健康差距。
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