Community level cancer control in a Texas barrio: Part I--Theoretical basis, implementation, and process evaluation

A theory-based program that used peer modeling and a network of peer communicators to promote breast and cervical cancer screening was designed and implemented in a barrio of San Antonio with a population of approximately 25,000 adult women. The implementation process was evaluated and documented through field notes, archival documents, content analyses, interviews, surveys, etc. Over a 21-month period, a total of 156 new stories and a network for distribution of more than 80,000 print pieces carried messages about positive role models who were receiving Pap smears and mammograms. A group of 85 volunteers were recruited to promote screening; these volunteers reached 2000-3000 women each month with personal contacts in which cancer screening was encouraged. A small group of volunteers offered particularly intensive assistance to their peers, e.g., helping them to make and keep appointments for screening examinations. The theoretical communication model for the program, which maximizes audience and community participation as sources and channels for messages, was well suited for the cross-cultural application presented here.