Increasing Mammography Screening in Latinas with Diabetes
| Institution: | Golden Valley Health Centers | ||
| Investigator(s): |
Christine Noguera , M.S. -
Stergios Roussos , PhD, MPH -
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| Award Cycle: | 2008 (Cycle 14) | Grant #: 14BB-2801 | Award: $493,666 |
| Award Type: | CRC Full Research Award | ||
| Research Priorities | |||
| Disparities>Disparities: eliminating the unequal burden of breast cancer | |||
This is a collaboration with: 14BB-2800 -
Initial Award Abstract (2008)
Research shows that Latina women are less likely to get a mammogram when compared to non-Latino women. It is even less likely for Latina women with diabetes to get a mammogram despite more diabetes visits to their healthcare provider than non-diabetic women. Latinas are more likely to be diagnosed with breast cancer at a later stage and less likely to get or ask for a mammogram than non-Latino women. Studies have shown significant differences in mammography screening and greater risk for women with diabetes to develop breast cancer. Low rates of mammography screening among Latinas with diabetes offers an opportunity to medical providers to use the diabetes visits as a way toI increase mammography compliance according to the national recommended guidelines. This project asks the question can age-appropriate mammography screening be increased for Latinas with diabetes through a systems-integrated intervention that links their diabetes care with methods to promote mammography? Our hypothesis is that Latina patients ages 40 to 75 with diagnosed diabetes and non-current mammography screening are more likely to complete mammography screening after exposure to a system-integrated intervention that links their diabetes care with methods to promote mammography. The major specific aim to test our hypothesis is to assess the differential effects on compliance with age-appropriate mammography screening for Latina patients ages 40 to 75 with diabetes before and after exposure to a system-integrated intervention that links regular diabetes care with theory-driven methods to promote mammography screening. A team of people from different areas of the community will work together to address this underlying issue. The team includes Golden Valley Health Centers, CBEACH, and Women of Courage, who will be implementing the project components created during the pilot phase. With the help of the community advisory group (CAG), this team will test several tasks such as developing, designing and producing intervention components that intend to increase mammography screening among Latinas with diabetes over 40 years of age. The team for Project Perlas will address barriers for mammography screening by the development of a fotonovela, a life-size cutout, a modified diabetes progress note and a behavior assessment tool. Another component includes patient advocate visits by Women of Courage and the CAG to health center staff meetings. Fourteen community health center sites will receive the intervention components in a staggered timeline to prevent sharing across experimental conditions. Health disparities for mammography for Latinas are correlated with cultural and linguistic factors, such as fear due to the way many women correlate a mammogram with death, lack of trust and poor communication with health care staff and family priorities. With support from the three groups, the project seeks to address several of the psychosocial barriers many Latina women encounter and seeks to increase awareness among health care providers regarding these barriers. Women of Courage, a nonprofit, grassroots group led by breast cancer survivors including GVHC staff, helps Merced County women who may be too young to get a mammogram and have other barriers that prevent them from getting breast cancer screening services. Women of Courage participated in the design of the pilot award components and have been in charge of the community advisory group. The CAG is formed by women who have had breast cancer and diabetes, and who are interested in participating in all the different parts of the full award. The future for Project Perlas is to continue the collaboration between researchers, community partners and community health centers. It is also expected to ensure that the results and intervention components are shared with other heath centers in order to continue addressing health disparities in underserved communities like Merced County.
