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Why a peer intervention program for Mexican-American women failed to modify the secular trend in cancer screening
L Suarez1, R A Roche, L V Pulley
1Texas Cancer Registry, Texas Department of Health, Austin 78756-3199, USA. lsuarez@discon.tdh.state.tx.us
Introduction:
We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening.
Methods:
The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older.
Results:
Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical.
Conclusions:
Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.