There has been a rapid migration of Latinos to the south of the U.S. in the past five years placing Alabama among the top 8 """"""""emerging Latino states"""""""" and Birmingham as 6th among U.S. cities with the fastest growing Latino population. Although immigration brings diversity and enrichment to the community, it also brings social, environmental, and economic restructuring that is likely to affect its residents. Among the crucial issues that need to be addressed with recent immigration are the health status and access to health care among the newcomers. It has been documented that recent Latina immigrants have less access to health care and information (including cancer screening) than U.S. born Latinas. Therefore, community-based educational programs that are linked to health care services may be a suitable avenue to promote cancer education among Latina immigrants. The Sowing the Seeds of Health is an educational program to promote cervical cancer screening and awareness regarding the importance of breast cancer early detection among Latina immigrants of reproductive age, and it is based on the following foundation: (a) extensive formative evaluation through which members of the target audience were involved in all steps of program development; (b) it can be delivered by lay individuals; (c) it is theory-based; (d) it is connected to affordable and accessible health care services; and (e) it uses Latina immigrants' interest in family planning as a catalyst to promote cervical screening and awareness regarding the importance of breast cancer early detection within this population, thereby making it unique. The overall goal of this proposal is to reduce the incidence of breast and cervical cancer in Latinas immigrants via community health advisors or """"""""promotoras."""""""" We will first conduct a formative evaluation phase to adapt and refine a pilot-tested, theory-based, culturally relevant educational program to promote cervical screening and early detection of breast cancer among Latina immigrants of reproductive age which is """"""""packaged"""""""" as a family planning program. We will then identify, recruit, and train 10 """"""""promotoras"""""""" in the Birmingham area. These """"""""promotoras"""""""" will implement the developed educational program among 200 Latina immigrants between the ages of 19 and 42. Immediate as well as annual outcomes of the proposed educational program will be carefully and extensively evaluated. Finally, based on a """"""""hub and spoke"""""""" approach, we will disseminate the tested educational program to other counties within the state of Alabama. The rationale for this proposal is that further development and evaluation of such an educational program will increase cervical cancer screening rates and awareness regarding the importance of breast cancer early detection among Latina immigrants.
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