Cultivando la Salud

Cultivando la Salud (Cultivating Health) is a lay health worker intervention to increase breast and cervical cancer screening among low-income Hispanic women. Hispanic women have lower survival rates for breast and cervical cancer than non-Hispanic women due to later detection and diagnosis. Lack of health insurance, regular health care, transportation barriers, and cost contribute to lower levels of cancer screening. In addition, psychological factors such as fear of cancer, invasive procedures, and pain, as well as lack of knowledge about cancer and screening, spiritual beliefs, language barriers, embarrassment, and partner disapproval reduce screening participation. Cultivando la Salud uses a lay health worker model in which community members educate peers in order to increase breast and cervical cancer screening among low-income, low-literacy, Hispanic female farmworkers aged 50 and older.

Lay health workers educate and motivate women to obtain screening as well as provide practical services to facilitate access to screening. Using a program manual, training curriculum, and teaching tools such as videos, breast models, and pamphlets lay health workers deliver screening information to women in the community in a one-on-one session at the participant's home. Following presentation and discussion of the Cultivando la Salud materials women are provided information about local providers of breast and cervical cancer screening. Participants are contacted two weeks following intervention to offer further assistance.

The goal of Cultivando la Salud is to increase breast and cervical cancer screening among low-income Hispanic women.

Six months following the intervention more women in the intervention group had completed screening than in the control group for both mammography (40.8% vs. 29.9%; P<0.05) and Pap test (39.5% vs. 23.6%; P<0.05). Women also displayed a significant increase in the perception of susceptibility and survivability of cancer as well as the perceived benefits of mammography and Pap testing. These data show that Cultivando la Salud is a successful one-on-one lay health worker educational intervention to improve low-income Hispanic women's perceptions and participation in cancer screening.