Research has highlighted the higher incidence, prevalence, and disproportionately high mortality rates of cervical cancer among Hispanic women (Latinas) compared to non-Hispanic whites in the U.S., signaling health disparities and the need for innovative approaches. Effective community-based interventions are needed to address these health disparities, but the development of such interventions are limited by gaps in our understanding of: 1) Hispanic beliefs toward cervical cancer and HPV depending on country of origin, and 2) culturally specific curriculum designed for community health worker (promotora) programs working with these subpopulation groups. The current application extends previous research suggesting that education and outreach programs have to address cultural beliefs in order to be effective. This collaborative, ethnographic pilot study aims to address cervical cancer disparities by partnering with a rural, Hispanic-serving community organization in order to conduct a cross-cultural examination of Hispanic beliefs toward cervical cancer and HPV. The findings will inform the development of curriculum modules on cervical cancer and HPV designed to be used by a promotora de salud (lay health adviser) intervention program.
The specific aims are: 1) to explore levels of knowledge, cultural attitudes, perceptions of risk of cervical cancer and HPV, and screening behaviors with Hispanic subpopulations using ethnographic methods; and 2) to develop a pilot curriculum module on cervical cancer and HPV targeted to promotoras, infused with the ethnographic findings from Phase I. As the Hispanic immigrant population increases in the U.S., there is a growing recognition that interventions need to be tailored to Hispanics of different national origins and education levels. By gathering information on knowledge, risk perceptions, and cultural attitudes among various subgroups, culturally tailored public health outreach efforts can be targeted and potentially be more effective for impacting cervical cancer disparities in groups suffering the greatest burden of the disease. Systematic ethnographic research techniques are proposed to explore the knowledge, risk perceptions, and cultural attitudes of Hispanics toward cervical cancer and HPV in order to develop culturally and literacy-level appropriate educational interventions. Cultural consensus analysis will elicit cultural models of cognitive beliefs toward cervical cancer to collectively inform a comprehensive educational approach. This study is novel in that it 1) utilizes systematic ethnographic research techniques to develop curriculum modules on cervical cancer targeted to a diverse Hispanic audience, 2) recruits Hispanic CNA students to pilot the curriculum modules and introduces them to cancer outreach activities. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page 1 Continuation Format Page ? ? ? ? ?
A better understanding of knowledge, risk perceptions, and cultural attitudes among various Hispanic subgroups around cervical cancer may be helpful in developing more effective outreach efforts and impacting cervical cancer disparities in groups suffering the greatest burden of the disease, thereby improving public health. Additionally, ethnographic research methods are uniquely suited to elicit these cultural domains around cancer. The proposed study will examine Hispanic beliefs toward cervical cancer and HPV. The findings will inform the development of curriculum modules on cervical cancer and HPV designed to be used by a promotora de salud (lay health adviser) intervention program.
