Latina women living in the U.S. are twice as likely to be diagnosed with cervical cancer and 40% more likely to die from the disease than non-Latina whites. Lower utilization of Pap smear contributes to greater cervical cancer mortality among Latinas, with recently-immigrated, uninsured women from Mexico at greatest risk of inadequate Pap smear utilization. To reduce this disparity, we propose to: 1. Increase routine Pap smear screening rates among uninsured Latina women living in the southeast using an empowerment-based, communication skills-building intervention. 2. Explore changes in knowledge, barriers, self-efficacy, and shared-decision making after the intervention and evaluate the impact of these factors on Pap smear screening rates. This pilot study uses a quasi-experimental community trial design to address these aims. The proposed community-based intervention uses a lay health advisor model to educate women about cervical cancer etiology and preventive strategies and to empower them with communication skills that will help them negotiate the medical encounter. Our research has several advantages beyond what has been documented to date: (1) The research is targeted to women in need of a Pap smear and who are at highest risk of not having one ; (2) The intervention combines education AND empowerment, a considerable advantage over previous research that has focused exclusively on increasing knowledge. (3) Empowerment, through skills- building, is grounded in theory and is culturally-appropriate; (4) The quasi-experimental community-trial design allows us to move beyond feasibility and actually test the effect of the intervention at the community- level; (5) The intervention will be easily replicated and disseminated given the size and scope of the project; (6) To date, no such interventions have been rigorously tested among newly arrived uninsured Latinas in the southeast. Given that the southeast has the fastest growing Mexican immigrant population in the U.S. and health systems are just beginning to respond to their health needs, this research study is strongly justified. Our research aims address NCI's 2006 strategic investment cancer research to "overcome the unequal burden of cancer experienced by various population groups by ....developing effective interventions to reduce those disparities, and facilitating intervention delivery."

R03CA115190

2007-09-01

2010-08-31