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ORIGINAL ANALYSIS The Result of Two Church-based Interventions on Cancer Of The Breast Screening Rates Among Medicaid-Insured Latinas

Adrienne L. Welsh, PhD, MSPH, Angela Sauaia, MD, PhD, Jillian Jacobellis, PhD, MS, Sung-joon Min, PhD, Tim Byers, MD, MPH

Recommended citation with this article: Welsh AL, Sauaia the, Jacobellis J, Min S, Byers T. the end result of two interventions that are church-based cancer of the breast testing prices among Medicaid-insured Latinas. Prev Chronic Dis serial on line 2005 Oct date cited.


Introduction Latinas face disparities in cancer assessment prices weighed against non-Latina whites. The Tepeyac Project is designed to lessen these disparities making use of a church-based approach to increase cancer of the breast testing among Latinas in Colorado. The goal of this research would be to compare the consequence of two Tepeyac venture interventions regarding the mammogram prices of Latinas and whites that are non-Latina in the Medicaid fee-for-service system.

Methods Two intervention teams were contrasted: 209 churches in Colorado that received academic im im printed materials in Spanish and English (the printed statewide intervention) and four churches into the Denver area that received customized training from promotoras , or peer counselors (the promotora intervention), as well as the printed intervention that is statewide. Biennial Medicaid mammogram claim prices in Colorado prior to the interventions (1998–1999) and after (2000–2001) were utilized to compare the end result regarding the interventions on mammogram use among Latinas and non-Latina whites aged 50 to 64 years who had been signed up for the Medicaid fee-for-service system. Modified rates had been computed utilizing general estimating equations.

Outcomes Small, nonsignificant increases in assessment were observed among Latinas exposed to your promotora intervention (from 25% at standard to 30per cent at follow-up P = .30) in comparison with 45% at standard and 43% at follow-up for the printed intervention that is statewideP = .27). Assessment among non-Latina whites increased by 6% into the promotora intervention area (from 32% at standard to 38per cent at follow-up P = .40) and also by 3% when you look at the im im printed statewide intervention (from 41% at standard to 44per cent at follow-up P = .02). No significant disparities in cancer of the breast testing had been detected between Latinas and non-Latina whites. The promotora intervention possessed a marginally greater impact compared to printed statewide intervention in increasing mammogram use among Latinas (generalized estimating equation, P = .07) after modification when it comes to confounders by general estimating equations.

Summary a individualized community-based training had been just modestly effective in increasing breast cancer assessment among Medicaid-insured Latinas. Education alone may possibly not be the solution with this populace. The obstacles for those Medicaid enrollees needs to be examined to make certain that interventions may be tailored to deal with their demands.


Disparities in mammogram testing prices have already been identified among Latinas, poor people, and people with reduced quantities of education (1-3). Individual values and techniques, usage of care that is medical low earnings, and language issues (4-6) are typical obstacles for those who have low usage of cancer testing solutions. Studies carried out especially with Latinas have actually identified social obstacles to getting these solutions, such as for example “fatalismo,” difficulties with acculturation, fear, and embarrassment (7-9). Barriers found to be related to not enough cancer of the breast assessment among low-income females consist of older age, low amount of training, not enough medical health insurance, work-related obligations, transport dilemmas, and lack of recent doctor visits (10). Interventions found in the population that is general at increasing the prices of mammogram assessment, such as for instance news promotions and chart reminders, have indicated small effectiveness among Latinas (11,12). Church-based interventions as well as the utilization of peer counselors are a couple of current approaches that are promising reaching the Latina community (12-14).

This research defines a pilot task targeted at increasing cancer of the breast assessment among Latinas in Colorado through two church-based interventions. The Colorado Foundation for health care bills (CFMC) carried out the research with money through the Centers for Medicare & Medicaid solutions (CMS), previously the healthcare Financing management. The study goal would be to compare the result associated with the two interventions in the mammogram prices of Latinas and non-Latina whites (NLWs) enrolled in the Medicaid fee-for-service system.

To ensure the interventions in this pilot research had been culturally appropriate, the involvement associated with the community ended up being tried in most stages associated with the project. The task ended up being called Tepeyac due to its value to Latinos whilst the web site in Mexico where Our Lady of Guadalupe did actually Saint Juan Diego. The interventions included themes identified because of the city, like the need for family members, and had been delivered through the Catholic church, a fundamental element of the Latino social networking.

This report may be the 2nd in a string that examines the effect for the Tepeyac interventions from the mammogram assessment prices among Latinas and NLWs signed up for Medicare, Medicaid, and wellness upkeep companies (HMOs). The Tepeyac task has formerly demonstrated success in decreasing the disparity between older Latinas and NLWs signed up for the Medicare fee-for-service system (15). This analysis centers on the consequence of the interventions on more youthful women included in the Medicaid fee-for-service system, an optimal automobile for assessing education initiatives in this high-risk, low-income team.

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