HPV; Cervical Cancer; Pap Smears; Latinas; Community-Based Intervention


Medicine and Health Sciences


Purpose/Background: Latinas are 20% less likely to receive the HPV vaccine and, in Idaho, are 35% more likely to die of cervical cancer than non-Latinas -16.2/100,000 in Latinas vs. 7.6/100,000 non-Latinas-. Research indicates that this disparity is due to low health literacy, and barriers of language, culture, and poverty. This project’s purpose was to assess the efficacy of a community-based intervention designed to increase rural Idaho Latina health literacy about cervical cancer prevention and detection, about the Women's Health Check program, and to assess participant attitudes towards child HPV vaccination.

Materials & Methods: Investigators trained six bilingual Latinas from rural SE Idaho as promotoras. Project investigators and promotoras created videos in English and in Spanish providing information about cervical cancer prevention, detection, treatment, the HPV vaccine, and the Women's Health Check Program. The promotoras identified Latina participants (n=44) from their communities, delivered educational materials in participant homes and at schools, and administered pre and post video surveys to assess changes in knowledge, attitudes and perceptions of cervical cancer, the Pap test, and the HPV vaccine. Participants, who were all Latinas, chose either English or Spanish language materials.

Results: 50% chose English and 50% chose Spanish language materials.100% of intervention completers (n=44, 18-70+ years), showed increases in knowledge of cervical cancer, the Pap Test, HPV vaccine and the Women's Health Check Program. Pre-intervention, 25% did not know that there was a vaccine for HPV, 18% had not heard of cervical cancer, and 44% had not heard about the Women's Health Check Program. Post intervention knowledge for these items was a 100%. With regard to intention to vaccinate for HPV, “How likely are you to get your child the HPV vaccine?” -- a 7 point LIKERT scale question with lower numbers reflecting more positive intention ---there was a significant mean difference in the total sample at pre (M = 2.07, SD = 1.44) and post (M = 1.23, SD = 0.53), F (1, 41) = 14.39, p < .001. Language choice (proxy for acculturation) was not a significant factor in intent to vaccinate F(1, 41) = 0.30, p = .588. Although not statistically significant, Spanish speakers showed a larger change in intention to vaccinate with mean scores of 2.14 to 1.18 compared to English speakers 2.00 to 1.41.

Discussion/Conclusion: All participants demonstrated increases in knowledge and intention to vaccinate. Results indicate that there was a significant movement in the report of increased intention to vaccinate children for HPV. The project shows that Latinas in rural SE Idaho lack knowledge of cervical cancer prevention and detection including the role of the HPV vaccine in the prevention of cervical and other associated cancers. Language choice indicates continued need for bilingual health education. Data shows that a community-based, bilingual intervention is effective in this community.