A Su Salud en Acción
|Program Title||A Su Salud en Acción|
|Purpose||Designed to increase cervical cancer screening among Mexican American women. (2003)|
|Program Focus||Awareness building|
|Population Focus||Medically Underserved|
|Topic||Cervical Cancer Screening|
|Age||This information has not been reported.|
|Gender||This information has not been reported.|
|Race/Ethnicity||This information has not been reported.|
|Setting||This information has not been reported.|
|Funded by||NCI (Grant number(s): 5-U01-CA-52939)|
|User Reviews||(Be the first to write a review for this program)|
Required resources for this program include the A Su Salud En Acción Manual, available in PDF or eBook versions, with accompanying video files.
For costs associated with this program, please contact the developer, Amelie Ramirez. (See products page on the RTIPs website for developer contact information.)
The study was conducted in selected census tracts in two underserved, urban, predominantly Mexican American neighborhoods in Texas. San Antonios West Side was selected to receive the program intervention, and Houstons Navigation area was selected as a comparison community. Women of Mexican origin who were 18 years or older and resided in the selected neighborhoods were eligible to participate in the study. Participants were selected randomly for baseline data collection. Pap smear and mammogram screening compliance were measured at baseline through in-person interviews. Prior to the baseline interview, participants were asked their preferred language (English or Spanish) to conduct the interview; language preference was also used in subgroup analyses. Approximately 2 years after the baseline interview, follow-up telephone interviews were conducted with those women who were non-compliant with the National Cancer Institutes cancer screening guidelines, as reported during the baseline interview. Women were selected for follow-up interviews if they had never had a Pap smear or had not completed a Pap smear in the 2 years prior to the baseline interview, or if they were older than 40 years of age and had never had a mammogram or had not completed a mammogram in the 2 years prior to the baseline interview. The second panel follow-up was conducted with non-compliant women over the phone 1 year later. A second follow-up telephone survey was conducted approximately 1 year after the first follow-up interview, following the conclusion of the intervention activities. Women were selected for this follow-up interview if they had never had a Pap smear or had not completed a Pap smear in the 12 months prior to the first interview, or if they were older than 40 years of age and had never had a mammogram or had not completed a mammogram in the 12 months prior to the first interview.
Pap smear screening compliance was measured by combining the answers to the following questions: When did you have your most recent Pap smear? and, if the respondent could not provide an exact date, Was your Pap smear done less than a year ago, between 1 and 2 years ago, between 2 and 3 years ago, or more than 3 years ago? The answers to these items were combined and coded as one dichotomous variable with two values: complied with cancer screening (had a Pap smear in the last 2 years) or did not comply with cancer screening (has never had a Pap Smear or had a Pap smear more than 2 years ago).
Mammogram screening compliance was measured using similar items: When did you have your most recent mammogram? If the respondent could not provide an exact date, then she was asked, Was your mammogram done less than a year ago, between 1 and 2 years ago, between 2 and 3 years ago, or more than 3 years ago? The questions about mammograms were asked only if the respondent was 40 years of age or older. The answers to these items were combined and coded in the same way as the items to assess Pap smear screening.
- Pap smear screening rates among women under the age of 40 were significantly higher in intervention neighborhoods than in comparison neighborhoods (p<.05).
Additional Findings From Reviewed Study
- For Pap smear screening, analyses of the first panel follow-up revealed a negative finding when results were analyzed by age subgroup. Women over 40 from comparison neighborhoods were significantly more likely to report a recent Pap smear compared with women in intervention neighborhoods (p<.05). At the second panel follow-up, there were no significant differences between the intervention and comparison neighborhoods in Pap smear screening rates, either for the entire sample or by subgroup.
- For mammogram screening, at both the first and second panel follow-ups, there were no significant differences between intervention and comparison neighborhoods, either for the entire sample or by language subgroup. (Age subgroup analyses were not conducted for this outcome.)
Additional Findings From a Maintenance Study Not Rated by RTIPs
The findings reported above are from a 2003 study that analyzed data collected more than 10 years ago. RTIPs accepted the study for review based on the existence of a more recent study of A Su Salud en Acción that reported significant findings. This maintenance study could not be rated because it did not utilize a quasi-experimental or experimental study design; however, key findings from this study are described below.
A 2011 study was conducted as a replication of A Su Salud en Acción in two Nevada community clinics serving a large Latino community. The intervention was designed for low-income Latinas aged 5064 who were eligible for NBCCEDP (National Breast and Cervical Cancer Early Detection Program) screening funds. The intervention was implemented by trained lay public health workers. The evaluation used a single-group, pre-test/post-test design, with a pilot test at one clinic and a replication at the second clinic. Baseline and post-intervention screening data were estimated based on data collected retrospectively by the State contractor for the Womens Health Connection, which oversees all NBCCEDP funding sites in Nevada. A summary of grouped screening data was provided to the research team as annual rates per thousand women based on the 2000 Census age-eligible women for each site.
At both the pilot and replication sites, the program significantly increased screening mammogram rates (pilot: 58.7%, replication: 33.7%) and Pap smear rates (pilot: 51.8%, replication: 7.5%) from baseline to post-intervention.
Ramirez AG, Chalela P, Suarez L, Gallion KJ. (2011). A Su Salud En Accion: Replicating a Model to Increase Utilization of Cancer Screening among Low Income Latinas. J Health Disparities Res Pract, 5 (1), 65-79.
McAlister AL, Fernández-Esquer ME, Ramirez AG, Trevino F, Gallion KJ, Villarreal R, Pulley LV, Hu S, Torres I, Zhang Q. (1995). Community level cancer control in a Texas barrio: Part II--Base-line and preliminary outcome findings. Journal of the National Cancer Institute. Monographs, 18 , 123-126. Bethesda, MD: National Cancer Institute.
Ramirez AG, McAlister A, Gallion KJ, Ramirez V, Garza IR, Stamm K, de la Torre J, Chalela P. (1995). Community level cancer control in a Texas barrio: Part I--Theoretical basis, implementation, and process evaluation. Journal of the National Cancer Institute. Monographs, 18 , 117-122. Bethesda, MD: National Cancer Institute.
(Be the first to write a review for this program)