Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
J Womens Health (Larchmt). 2013 Sep;22(9):718-23. doi: 10.1089/jwh.2013.4467. Epub 2013 Aug 9.
Many barriers to cervical cancer screening for Hispanic women have been documented, but few effective interventions exist. The Community Preventive Services Task Force recommends increasing cervical cancer screening through various methods. Building on this evidence, the Centers for Disease Control and Prevention funded the research and testing phases for an evidence-based and theoretically grounded intervention designed to increase cervical cancer screening among never and rarely screened Hispanic women of Mexican descent. In this article, we describe the development process of the AMIGAS (Ayudando a las Mujeres con Información, Guía, y Amor para su Salud) intervention, highlight the integration of scientific evidence and community-based participatory research principles, and identify opportunities for dissemination, adaptation, and implementation of this intervention.
The AMIGAS team was a collaboration among researchers, promotoras (community health workers), and program administrators. The multiyear, multiphase project was conducted in Houston, Texas; El Paso, Texas; and Yakima, Washington. The team completed several rounds of formative research, designed intervention materials and methodology, conducted a randomized controlled trial, created a guide for program administrators, and developed an intervention dissemination plan.
Trial results demonstrated that AMIGAS was successful in increasing cervical cancer screening among Hispanic women. Adaptation of AMIGAS showed minimal reduction of outcomes. Dissemination efforts are underway to make AMIGAS available in a downloadable format via the Internet.
Developing a community-based intervention that is evidence-based and theoretically grounded is challenging, time-intensive, and requires collaboration among multiple disciplines. Inclusion of key stakeholders-in particular program deliverers and administrators-and planning for dissemination and translation to practice are integral components of successful intervention design. By providing explicit directions for adaptation for program deliverers, relevant information for program administrators, and access to the intervention via the Internet, AMIGAS is available to help increase cervical cancer screening among Hispanic women and other women disproportionately affected by cervical cancer.
已有大量研究证实西班牙裔女性在接受宫颈癌筛查方面存在诸多障碍，但目前有效的干预措施却十分有限。社区预防服务工作组建议通过多种方法增加宫颈癌筛查。在此基础上，美国疾病控制与预防中心为一项基于证据和理论的干预措施的研究和测试阶段提供了资金，该措施旨在增加从未接受过或很少接受过宫颈癌筛查的墨西哥裔西班牙裔女性的宫颈癌筛查率。在本文中，我们描述了 AMIGAS（帮助女性获得信息、指导和关爱健康）干预措施的开发过程，强调了科学证据与社区参与式研究原则的融合，并确定了该干预措施推广、改编和实施的机会。
AMIGAS 团队由研究人员、促进者（社区卫生工作者）和项目管理人员组成。该多阶段、多年项目在德克萨斯州休斯顿、德克萨斯州埃尔帕索和华盛顿州雅基马进行。该团队完成了几轮形成性研究，设计了干预材料和方法，进行了一项随机对照试验，为项目管理人员编写了指南，并制定了干预措施传播计划。
试验结果表明，AMIGAS 成功地增加了西班牙裔女性的宫颈癌筛查率。对 AMIGAS 的改编显示，结果的减少幅度很小。正在进行传播工作，以便通过互联网以可下载的格式提供 AMIGAS。
开发基于证据和理论的基于社区的干预措施具有挑战性、时间密集且需要多个学科的合作。纳入关键利益攸关方——特别是方案实施者和管理者——并为传播和转化为实践进行规划是成功设计干预措施的组成部分。通过为方案实施者提供改编的明确指导、为方案管理人员提供相关信息以及通过互联网获得干预措施，AMIGAS 可用于帮助增加西班牙裔女性和其他受宫颈癌影响不成比例的女性的宫颈癌筛查率。
