As Wisconsin's only comprehensive cancer center, the University of Wisconsin Carbone Cancer Center reaches out to residents of Wisconsin and the region - providing them with important health education messages. From technical assistance to educational programs, the UW Carbone Cancer Center provides a bridge between new research discoveries and their application in the community.
Cuidándome: Helping Improve Cancer Prevention for Latinas
Ana Martinez-Donate, PhD, a member of the Cancer Center's Cancer Control Program, is currently studying the effectiveness of Cuidándome, a program led by Planned Parenthood of Wisconsin, Inc. to promote breast and cervical screening among Latinas in Dane County.
There is a higher incidence of cervical cancer among the Latina community, and Latinas tend to present with more advanced breast cancer. To help promote screening and early-detection, and educate women on the diseases, Planned Parenthood of Wisconsin received grants from the Wisconsin Partnership Program to create a campaign aimed at reducing breast and cervical cancer among Latinas of Dane County.
"The great thing about the spirit behind the Wisconsin Partnership Fund is that they really promote community-academic partnerships that really meet the community's needs," commented Dr. Martinez-Donate, assistant professor of Population Health at UW-Madison. "It's helping the community groups evaluate their programs so they can in turn reap the benefit from the data by knowing what is effective."
Decreasing Barriers to Care
Language barriers, a lack of health insurance, cost of medical care, fear due to undocumented status, lack of knowledge about risk factors and prevention, and even not knowing where or how to access care are just a few of the many reasons why there may be a higher incidence of breast and cervical cancer among the Latina community.
Through a program called Cuidándome, Planned Parenthood of Wisconsin seeks to decrease barriers to preventive screenings for Hispanic women. Cuidándome uniquely combines small-group education delivered by lay health advisors, a community-wide media campaign and cultural competency training for health care providers.
"The experience of going to the doctor can be stressful," said Rhea Vedro, Cuidándome project director for Planned Parenthood of Wisconsin.
She explained that it can be intimidating for someone who speaks limited English to complete the routine patient forms during a visit, or even understand directions from the physicians.
One of the main efforts of the program are home health parties, casual workshops led by community health promoters (or Promotoras de Salud) who received training to conduct two-hour home health parties focused on educating women about breast and cervical cancer, the availability of preventive screening programs, and helping women learn to navigate the health care system.
"The health promoters are themselves the demographic we're trying to reach," explained Vedro.
The Latina women who serve as community health promoters are from a variety of backgrounds including those with no high school education, to those from very professional backgrounds in their home country.
According to Vedro, the concept of the lay health promoter is not a new one. It has been used in programs throughout the country, in rural communities in Mexico, and throughout the globe to help educate people about health issues.
"Wherever the Latino community is, people have opened up their spaces for this work," said Vedro. "People do see the need for this project and its importance to the community."
The home health parties are generally organized by a hostess who gathers her friends together for the evening. There are games designed to help women learn about health issues in a relaxed and fun setting.
During the parties food and childcare are provided, which is key for encouraging participation. Over the course of the project, 157 parties have been held reaching 1,277 participants. With a goal of 10 more parties before the grant concludes.
Determining the Effectiveness
While the concept of the home health party isn't a new one, there is little research examining the effectiveness of the program. As the academic partner, Dr. Martinez-Donate is in the middle of a two-year grant from the Medical Education Research Committee (MERC) to evaluate the strengths and limitations of the program.
"There are not many programs that have been evaluated," said Dr. Martinez-Donate. "There is some promising research but there is a need for a more rigorous evaluation."
Dr. Martinez-Donate is tracking a cohort of almost 300 women through this project. It's challenging as they tend to be a very mobile population, but the women are often very excited to participate in the process. She explained that the goals of the evaluation are to identify whether the program works, and if so, the best way to implement the program so that agencies that are interested in serving the Latino population can use this as a model.
"The program really capitalizes on relationships that exists within the community," said Dr. Martinez-Donate. "The information comes from someone they trust. To be a Promotora you have to have some leadership and literally open your doors. That is what makes the program fun and culturally appropriate."
It is still too early in the process to discuss results, but the hope is that there will be higher rates of Latinas getting screened and ultimately that there would be lower incidence of breast and cervical cancer across the population.
Anecdotally, there is strong support for the program within the community. Planned Parenthood has a waiting list of individuals interested in becoming Promotoras. And, as the program continues to grow, they can address other health care topics, including reproductive health and even men's health.
"Investing in the model of Promotoras is critical because they can become the change makers and leaders within their communities," said Vedro. "But it's also a model that should continue to evolve to meet the needs of the community so the community can advocate for what they need."