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The Impact of Navigation Services for Breast and Cervical Cancer Screening for Spanish-speaking Immigrant Latinas. Lina Jandorf Mount Sinai School of Medicine New York City Bridging the Health Care Divide April 19, 2007. Co-Authors.

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The Impact of Navigation Services for Breast and Cervical Cancer Screening for Spanish-speaking Immigrant Latinas

Lina Jandorf

Mount Sinai School of Medicine

New York City

Bridging the Health Care Divide

April 19, 2007


Co authors

Co-Authors Cancer Screening for Spanish-speaking Immigrant Latinas

LeaVonne Pulley - University of Arkansas for Medical Sciences

Michelle Trevino - University of Arkansas for Medical Sciences

Luisa Feliciano – Mount Sinai School of Medicine

Deborah Erwin – Roswell Park Cancer Institute


Topics to be covered today
Topics to be Covered Today Cancer Screening for Spanish-speaking Immigrant Latinas

  • Latinas in the United States

  • Breast Cancer

  • Esperanza y Vida

  • Where we are going


Latinas in the united states
Latinas in the United States Cancer Screening for Spanish-speaking Immigrant Latinas

  • Fastest growing immigrant group in the US

  • Over 20 different countries of Origin

  • Different Methods of Immigration

    • Puerto Rican

    • Mexican

    • Dominicans


Breast cancer and latinas
Breast Cancer and Latinas Cancer Screening for Spanish-speaking Immigrant Latinas

  • Most common cancer among Latinas

    • Lower incidence compared to White women

  • Diagnosed at later stage

    • More metastatic disease

  • Lower rates of screening

    • E.g. Mammography use is lower

  • Even greater for recent immigrants


Reasons for underutilization of screening
Reasons for Underutilization of Screening Cancer Screening for Spanish-speaking Immigrant Latinas

  • Access to Care

    • Insurance

    • Immigration Status

  • Acculturation

  • Language

  • Fatalistic Beliefs

  • Fear

    • Both of finding cancer and deportation


Esperanza y vida
Esperanza y Vida Cancer Screening for Spanish-speaking Immigrant Latinas


Esperanza y vida1
Esperanza y Vida Cancer Screening for Spanish-speaking Immigrant Latinas

“Familias Saludables Empiezan con Mujeres Saludables”

“Healthy Families begin with Healthy Women”


Study design
Study Design Cancer Screening for Spanish-speaking Immigrant Latinas

  • Educational Programs

    • Rural / Urban sites

    • New York City and Arkansas

  • Two study conditions

    • Breast and Cervical Cancer Screening

    • Diabetes

  • Pre and Post Test Knowledge

  • 2-Month Follow Up Telephone Call

  • Patient Navigation


Program components
Program Components Cancer Screening for Spanish-speaking Immigrant Latinas

  • Role Model

    • Breast Cancer Survivor

    • Living well with Diabetes

  • Lay Health Educators

    • Facts

    • Screening Guidelines

    • Risk Factors


Key program elements
Key Program Elements Cancer Screening for Spanish-speaking Immigrant Latinas

  • Faith based program

  • Family, including extended family

  • Address Medical Mistrust

  • Address Fatalism

  • Address Access to Care


Findings
Findings Cancer Screening for Spanish-speaking Immigrant Latinas

  • Program conducted November 2005 through November 2006

  • 65 Programs Completed

    • 35 in Arkansas and 30 in NYC

    • 40 on Cancer and 25 on Diabetes

  • 653 Participants – Per program

    • 11.3 (0.2) overall (range of 2 to 50)

      • 8.1 (6.6) Females

      • 3.2 (4.3) Men


Findings1
Findings Cancer Screening for Spanish-speaking Immigrant Latinas


Pre post knowledge at baseline
Pre/Post Knowledge at Baseline Cancer Screening for Spanish-speaking Immigrant Latinas

1st line = Diabetes Programs

2nd line = Cancer Programs


2 month follow up data
2 Month Follow Up Data Cancer Screening for Spanish-speaking Immigrant Latinas

  • 235 Women

    • 119 Under 40

    • 98 40 Plus

    • 18 Missing Age


Cancer screening
Cancer Screening Cancer Screening for Spanish-speaking Immigrant Latinas

Refers to women who were non-adherent at baseline


Implications
Implications Cancer Screening for Spanish-speaking Immigrant Latinas

  • Use of navigators

    • Bilingual

    • From the community

  • How to sustain these increases?

  • How to increase reach of the programs?


Future directions
Future Directions Cancer Screening for Spanish-speaking Immigrant Latinas

  • What are the factors related to the baseline screening rates

    • Knowledge pre program

    • Country of Origin

    • Age

    • Years in the US


Future directions1
Future Directions Cancer Screening for Spanish-speaking Immigrant Latinas

  • What predicts who gets screened within 2 months?

    • Knowledge post program

    • Country of Origin

    • Age

    • Years in the US

    • Marital Status

    • Partner at Program


Acknowledgements
Acknowledgements Cancer Screening for Spanish-speaking Immigrant Latinas

  • National Susan G. Komen Breast Cancer Foundation –Grants #POP 0201290 and #POP 0503950

  • Mount Sinai School of Medicine

  • University of Arkansas Medical Center

  • Our Communities!


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