Resource Center Poster Session II

A Community-Academic Partnership to Reduce Mammography Disparities for Latinas with Diabetes
Wednesday, March 13, 2013: 07:30 AM - 05:30 PM, OAK, East Hall
Although Latinas are less likely to develop breast cancer, disparities in mammography screening contribute to greater morbidity and mortality for Latinas. Diabetes further contributes to Latina mammography disparities because diabetes is highly prevalent among Latinas and is a known contributor to poorer mammography rates. The complexity of caring for chronic illness such as diabetes interferes with preventive services. Project Perlas is a community-based participatory research (CBPR) project addressing disparities in mammography screening among Latina patients in community health centers within the Central Valley of California. Project Perlas is a collaboration between a community health center, a grass roots breast cancer community group, and a university-based academic team. The goal of Perlas is to implement a systems-level intervention to improve mammography screening for diabetic Latina patients in a primarily farmworking Mexican community. The collaboration also sought to improve the infrastructure and capacity for CBPR. Perlas is an innovative intervention that takes advantage of a highly prevalent chronic illness among Latinas (diabetes) to prompt for mammography screening, a periodic preventive service.

       Between 2009 and 2011, Perlas implemented one of the largest interventions to be conducted with Latinas with cultural and linguistic barriers. Over 2,500 patients ages 40 to 80 were reached during the intervention period. Intervention activities included clinician-based and patient-based education (e.g., fotonovelas, life-size, speaking “cut-outs” of providers) and system interventions (e.g., patient and clinician paper and electronic prompts). Mammography rates for Latinas exposed to intervention activities were statistically significantly higher than non-Latinas after controlling for demographic and system-care variables (e.g., 59% vs 47%, P<.01). Despite a higher rate of diabetes among Latinas, patients who spoke Spanish and were Latino were more likely to complete mammography screening than non-Latino, English-speaking patients. The intervention components were well accepted and became integrated within the system of care beyond the initial project period.

     Project Perlas illustrates the power of community-academic collaboration to address disparities that matter to communities with cultural and linguistic barriers. Challenges related to differences in goals, communication and approach between the academic researchers, health providers and community advocates were overcome by consistent and intentional opportunities to build relationships and learn to practice the principles of CBPR. This includes learning to balance the demands for quality services for vulnerable populations with the requirements for measurement and quality research. The end result was an innovative culturally appropriate systems intervention with substantial improvements in mammography screening for Latinas. The materials and protocols for Project Perlas are designed to be replicated and adapted for other health centers serving, especially those serving larger numbers of Latinas. The lessons learned about developing and sustaining meaningful community-academic partnerships can improve how community organizations use research to eliminate health disparities. Further, these lessons can guide how institutes of higher education and other training agencies prepare researchers to be meaningful collaborators in community-driven efforts for health equity.

Presentation Information:

Program: Poster Presentations (Main Conference)
Primary Category: Research
Subtopics: breast cancer, Disease specific focus, Disparity reduction

Region Addressed by Presentation: US - California
Organization: Clinic


Christine Noguera, MS , Golden Valley Health Centers, Merced, CA
    Golden Valley Health Centers
    737 W. Childs Avenue
    Merced CA, USA 95340

    Phone: 209-383-1848
    Email Address: cnoguera@gvhc.org

    Biographical Sketch:
    For over 20 years, Mrs. Noguera has been serving vulnerable and underserved minority populations through community-based services. Mrs. Noguera is a bilingual healthcare practitioner and administrator with extensive experience in developing and implementing culturally and linguistically appropriate services and programs.

Stergios Roussos, PhD, MPH , Hsri, UC Merced, Merced, CA
    Director of Community Research
    UC Merced
    Hsri
    936 W. 18th Street
    Merced CA, USA 95340

    Phone: 209-723-4399
    Fax: 714-415-5521
    Email Address: sroussos@acrd.us

    Biographical Sketch:
    Dr. Roussos is a researcher and educator for community health and health care initiatives with over 17 years of experience. He specializes in behavior change at the community and organizational levels. His current work aims to understand and improve how health and human services organizations eliminate health disparities, especially among persons with limited English proficiency. Areas expertise and current work include the design, evaluation, and support of initiatives to measurably improve culturally and linguistically appropriate services (CLAS) among providers and organizations. Since 2001, Dr. Roussos has led the development of methods for organizational assessment based on CLAS standards, and is actively assisting organizations nationwide to develop practical, cost-effective ways of monitoring and improving their CLAS. He has gained recognition for making measurement and evaluation easy to understand and apply even in settings with limited resources and evaluation capacity.

Felicia Batts, MPH , Golden Valley Health Centers, Merced, CA
    Golden Valley Health Centers
    737 W. Childs Avenue
    Merced CA, USA 95340

    Phone: 209-383-1848
    Email Address: fbatts@gvhc.org

Mary Bunyard , Women of Courage, Golden Valley Health Centers, Merced, CA
    Golden Valley Health Centers
    Women of Courage
    737 W. Childs Avenue
    Merced CA, USA 95340

    Phone: 209-383-1848
    Email Address: mbunyard@gvhc.org

Helen Roehlk , Women of Courage, Golden Valley Health Centers, Merced, CA
    Golden Valley Health Centers
    Women of Courage
    737 W. Childs Avenue
    Merced CA, USA 95340

    Phone: 209-383-1848
    Email Address: hroehlk@gvhc.org

Margaret Sigarroa , Women of Courage, Golden Valley Health Centers, Merced, CA
    Golden Valley Health Centers
    Women of Courage
    737 W. Childs Avenue
    Merced CA, USA 95340

    Phone: 209-383-1848
    Email Address: msigarroa@gvhc.org

Mel Hovell, PhD, MPH , Cbeach, SDSU Graduate School of Public Health, San Diego, CA
    SDSU Graduate School of Public Health
    Cbeach
    9245 Sky Park Ct., Ste 230
    San Diego CA, USA 92123

    Phone: (858) 505-4770
    Email Address: mhovell@projects.sdsu.edu