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Cancer Control Research

Abstract

The proposed study is a 5-year group randomized controlled trial to test the efficacy of a theory based culturally relevant intervention focusing on primary and secondary prevention of cervical cancer among Latina immigrants. We propose 4 specific aims for the present study: (1) to conduct a formative evaluation phase to develop a theory-based, culturally relevant intervention to promote primary (sexual risk education) and secondary (pap smear) prevention of cervical cancer among Latina immigrants; (2) to develop the proposed intervention based on the results of Aim 1 as well as our previous extensive qualitative and quantitative assessments in this population; (3) to implement the developed intervention among 416 Latina immigrants between the ages of 19 and 50; and (4) to evaluate the efficacy of such intervention through a group randomized trial. Although the social construction model will be the overall conceptual framework used in the present study, the PEN-3 and Health Belief Model will guide intervention development and implementation. The intervention will combine elements of the sociologic approach (which takes into account cultural beliefs, attitudes, and behaviors) and cognitive-behavioral strategies, and it will be delivered by lay health educators. The intervention group will receive both knowledge and skills training regarding primary and secondary prevention of cervical cancer, and the control group will receive education on health topics (e.g., diabetes, health care access, etc.). The study will be carried out in 2 phases. In Phase I, we will develop and refine the intervention plans and assessment tools through formative assessment. In Phase we will recruit participants, gather baseline data, randomize participants to intervention and control groups, implement and evaluate the intervention. The primary outcomes will include: (1) compliance with the U.S. Preventive Services Task Force recommendation for cervical cancer screening, i.e., Pap Smear at least every 3 years (measured through self-report and validated through medical records); and (2) increased partner communication regarding sexual behavior as well as self-efficacy (measured through self report). Secondary outcome will include: changes in knowledge, attitudes, and beliefs regarding the relationship between the human papillomavirus (HPV) infection and cervical cancer.