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J Rural Health. 2014 Spring;30(2):196-205. doi: 10.1111/jrh.12044. Epub 2013 Aug 12.

Increasing cervical cancer screening in the United States-Mexico border region.

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Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.



Hispanic women living on the United States-México border experience health disparities, are less likely to access cervical cancer screening services, and have a higher rate of cervical cancer incidence compared to women living in nonborder areas. Here we investigate the effects of an intervention delivered by community health workers (CHWs, known as lay health educators or Promotores de Salud in Spanish) on rates of cervical cancer screening in Hispanic women who were out of compliance with recommended screening guidelines.


Hispanic women out of compliance with screening guidelines, attending clinics in southern New Mexico, were identified using medical record review. All eligible women were offered the intervention. The study was conducted between 2009 and 2011, and data were analyzed in 2012. Setting/participants--162 Hispanic women, resident in New Mexico border counties, aged 29-80 years, who had not had a Pap test within the past 3 years. Intervention--a CHW-led, culturally appropriate, computerized education intervention. Main outcome measures--the percentage of women who underwent cervical cancer screening within 12 months of receiving the intervention. Change in knowledge of, and attitudes toward cervical cancer and screening as assessed by a baseline and follow-up questionnaire.


76.5% of women had a Pap test after the intervention. Women displayed increased knowledge about cervical cancer screening and about HPV.


A culturally appropriate promotora-led intervention is successful in increasing cervical cancer screening in at-risk Hispanic women on the United States-México border.


cervical cancer screening; community health workers; education intervention; health disparities; health promotion

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