Group Versus Individual Culturally Tailored and Theory-Based Education to Promote Cervical Cancer Screening Among the Underserved Hispanics: A Cluster Randomized Trial

Am J Health Promot. 2020 Jan;34(1):15-24. doi: 10.1177/0890117119871004. Epub 2019 Aug 27.

Abstract

Purpose: To determine whether group education is as effective as individual education in improving cervical cancer screening uptake along the US-Mexico border.

Design: Cluster randomized controlled study.

Setting: El Paso and Hudspeth Counties, Texas.

Participants: Three hundred women aged 21 to 65 years, uninsured, due for a Pap test, no prior history of cervical cancer or hysterectomy.

Intervention: Theory-based, culturally appropriate program comprised of outreach, educational session, navigation services, and no-cost cervical cancer testing.

Measures: Baseline, immediate postintervention, and 4-month follow-up surveys measured knowledge and theoretical constructs from the Health Belief Model, Theory of Reasoned Action, and the Social Cognitive Theory.

Analysis: Relative risk regression analyses to assess the effects of educational delivery mode on the uptake of screening. Mixed effect models to analyze changes in psychosocial variables.

Results: One hundred and fifty women assigned to each educational group; 99% Hispanic. Of all, 85.7% completed the follow-up survey. Differences in screening rate at follow-up were analyzed by education type. Overall screening rate at follow-up was 73.2%, no significant difference by education type (individual: 77.6%, group: 68.9% P = .124). Significant increases among group education at follow-up for knowledge, perceived susceptibility, perceived seriousness, and subjective norms and significant decrease for perceived benefits.

Conclusion: This study provides evidence to support the effectiveness of group education to promote cervical cancer screening among vulnerable Hispanic women and offers an additional method to address cervical cancer disparities.

Keywords: awareness; cancer prevention; community; education/communications; gender specific; health disparities; interventions; medical self-care; population health; racial minority groups; specific populations; specific settings; strategies; underserved populations; women.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cluster Analysis
  • Cultural Competency*
  • Early Detection of Cancer*
  • Female
  • Health Education*
  • Health Knowledge, Attitudes, Practice
  • Hispanic or Latino*
  • Humans
  • Mass Screening*
  • Medically Underserved Area*
  • Mexico / ethnology
  • Middle Aged
  • Texas
  • Uterine Cervical Neoplasms / ethnology*
  • Uterine Cervical Neoplasms / prevention & control*
  • Young Adult