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健康即生命:针对农村拉丁裔移民妇女的宫颈癌筛查干预措施

Salud es Vida: a Cervical Cancer Screening Intervention for Rural Latina Immigrant Women.

作者信息

Luque John S, Tarasenko Yelena N, Reyes-Garcia Claudia, Alfonso Moya L, Suazo Norma, Rebing Laura, Ferris Daron G

机构信息

Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 135 Cannon Street, Ste. 303, MSC835, Charleston, SC, 29425, USA.

Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.

出版信息

J Cancer Educ. 2017 Dec;32(4):690-699. doi: 10.1007/s13187-015-0978-x.

Abstract

This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

摘要

本研究考察了“健康即生活”项目的可行性和有效性,该项目是由健康促进员主导、以西班牙语开展的关于宫颈癌筛查(巴氏试验)的教育小组活动,涉及来自农场工人家庭背景的西班牙裔/拉丁裔移民女性的自我效能感(安排并完成巴氏试验的信念)和知识水平。这些女性承受着不成比例的宫颈癌负担,死亡率显著高于非西班牙裔白人。2014年至2015年,在佐治亚州东南部的四个乡村县进行了这项双臂准实验研究。年龄在21至65岁且 overdue for a Pap test的西班牙裔/拉丁裔移民女性被纳入干预组(N = 38)和对照组(N = 52)。该干预措施是与一组健康促进员合作开发的,以创建一套材料工具包,其中包括课程指南、宣传册、活动挂图、简短动画视频和课堂活动。干预组中有12名(32%)参与者接受了巴氏试验,而对照组中有10名(19%)参与者接受了巴氏试验(p = 0.178)。干预组在宫颈癌知识回忆和保留方面的得分显著高于对照组(p < 0.001)。虽然两组参与者在宫颈癌筛查自我效能感得分上没有统计学上的显著差异,但在调整基线得分后,两组在随访时的得分都更高。小组干预方法与宫颈癌知识的增加有关,但与巴氏试验的接受率无关。可能需要采用更强化的干预措施,如使用患者导航方法或积极跟踪参与者的健康促进员,或开展一对一而非小组活动,以改善该人群的筛查结果。

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