We propose an innovative research strategy to improve our understanding of factors that influence Hispanic women's knowledge, perceptions, and attitudes about breast and cervical cancer and to design interventions that will increase the use of cancer prevention and treatment services. The setting is North Orange County, California, a community in which approximately 23% of the population is Hispanic - Mexican-American, Mexican and Central American. A multidisciplinary team including clinicians, health services researchers, anthropologists, sociologists, oncologists, epidemiologists, gynecologists and statisticians will conduct the research. The project has several innovative components. First of all, we will conduct in-depth ethnographic interviews with Hispanic women and health care providers. Among the Hispanic women, we will study cultural beliefs about cancer, its causes, its treatment, and the perception of obstacles to cancer prevention and treatment services. Among the health care providers, we will assess perceptions about Hispanic women's knowledge about cancer and about their use of cancer prevention and treatment services. We will also assess the providers' knowledge and their cancer screening activities. Secondly, we will conduct broad-based surveys of Hispanics, health care providers, and health care facilities to assess the applicability of the ethnographic interview findings to general populations, to determine knowledge and use of cancer control services by providers, and to identify existing cancer control facilities and services in the community. Thirdly, we will establish a Council on Cancer and Hispanics that will develop, implement, and evaluate culturally appropriate interventions based upon results of the ethnographic interviews and the surveys. The Council will address barriers related to the consumers, the health care providers, and the structure of the health care system. These interventions will improve Hispanic women's knowledge about breast and cervical cancer and will increase their use of cancer prevention and treatment services.
