) Promoting Breast Cancer Screening Among Hispanic Women: Companeras En Accion is a community-based, curriculum driven breast cancer education and screening program for women in San Diego, CA. Currently, in its final year of funding, the project has been successful in accomplishing most of its goals. One of the major barriers preventing participants from actually receiving clinical preventive services (mammography and clinical breast exams) after a referral is made, is a system error at the primary care facilities (staff, scheduling, and provider omissions). This competing continuation grant will build on the success of the current project and modify its structure to overcome this barrier. Two major changes include (1) adapting from a grassroots community-based model to a community clinic-based model, and (2) changing from targeting only indigent Spanish-speaking women to targeting both English and Spanish-speaking indigent women. The proposed 3-year project is a multi-level intervention package based in the community health center (CHC) and targeting indigent, age-appropriate women within the clinic's catchment area. Both inreach and outreach strategies will be employed. The major intervention objectives include (1) the recruitment and training of 8-1 0 community health centers (CHCs) on the use of the community health advisor (CHA) model for the dissemination of breast cancer education and screening information to women; (2) the dissemination and institutionalization within the CHC setting of a cancer education curriculum for CHAS; (3) the provision of technical assistance to the CHCs in the recruitment and training of 1-3 CHAs to deliver a 3-session, culturally sensitive breast cancer education and screening curriculum for clinic patients and community members; and (4) the facilitation of mammography services via CHAS and the resources available at the CHCs for women aged 50 plus in the CHC catchment areas.
