Lay health workers boost cancer screening rates
Home visits from peers trained as health workers may encourage more low-income Hispanic women to get screened for breast and cervical cancers, a new study suggests.
In the U.S., Hispanic women are generally diagnosed with breast and cervical cancers at a later stage and have poorer survival rates than non-Hispanic women. Lower screening rates are thought to be partly to blame.
The current study, published in the American Journal of Public Health, tested the effectiveness of a program that trains lay people to educate low-income Hispanic women about the importance of mammography for detecting breast cancer early and Pap screening for cervical cancer detection.
Researchers led by Dr. Maria E. Fernandez, of the University of Texas Health Science Center in Houston, offered the program to women in two communities with large migrant-worker populations. Women in two other similar communities served as a comparison group.
All of the more than 700 women in the study were age 50 or older and had not been adherent to mammography or Pap test screening guidelines.
Experts recommend that women at average risk of breast cancer have a yearly mammogram beginning at age 40; Pap tests should be done at least every three years, beginning three years after a woman becomes sexually active.
Study participants in the program each received a home visit from a lay health educator—a person from their community who, along with educating them on the importance of cancer screening, helped connect them with local health services.
Six months later, Fernandez and her colleagues found, 41 percent of the program participants had gotten a mammogram, versus 30 percent of the comparison group. Similarly, about 40 percent had gotten a Pap test, while less than one-quarter of the comparison group had.
Several studies have now shown the value of lay person health workers, according to the researchers.
The programs may work because the information is tailored to specific groups, or because people have greater trust in peers from their own community. Fernandez and her colleagues say that more studies are needed to understand the reasons so that even more effective programs can be developed.
SOURCE: American Journal of Public Health, May 2009.
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