) Hispanic farmworkers in California and nationwide suffer high rates of infectious and chronic disease. Cervical cancer mortality in California is higher for Hispanics than for any other ethnic group, and these statistics undercount rural poor and farmworkers in favor of urban Hispanics of low and middle income with access to health care. Research has shown that Hispanics in general, utilize curative rather than preventive health care services and manifest depressed rates of preventive health care practices such as mammography, breast self-exam and Pap smears. To build a model to increase the numbers of poor Hispanic women utilizing preventive care services, especially cancer screening, and improve participation in phase III research, we need primary data on health status of poor Hispanics, barriers to preventive care, and sources of health care information, especially about cancer. The Spanish-language BRFS has been used in many states to outline health status and barriers to care, primarily with urban populations. This project would form focus groups to review a modified version developed in Monterey County (CA) for face-to-face interviews, with additional BRFS subsets and questions eliciting sources of information about cancer, revise or remove inappropriate questions, translate and back-translate the resultant survey. In partnership with Community Medical Centers, Inc., the primary provider of health care to farmworkers in this area, and lay health advisers from the community, we propose to survey 400 women resident in 6 grant camps in 4 Northern California counties, conduct a multivariate analysis of barriers to and beliefs concerning preventive health care and the most effective sources of health care information in this population to aid in generating testable hypotheses about appropriate recruitment strategies for research and outreach in preventive health care. Providers of health care services will be targeted for continuing education lectures based on project findings, there to inform the shift to geographic managed care, and participants will be surveyed about attitudes and behaviors concerning cancer screening and risks among poor Hispanics.
