4.2 Article

Comparing Different Interventions' Effects on Latinas' Screening Mammography Attainment and Participant-Driven Information Diffusion

Journal

HEALTH EDUCATION & BEHAVIOR
Volume 48, Issue 6, Pages 818-830

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/10901981211010448

Keywords

breast cancer disparities; comparative effectiveness; Latinas; social network methods

Funding

  1. National Cancer Institute [K01CA193918]
  2. National Institutes of Health

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The evaluation of multiple community-based approaches to improve Latinas' breast cancer screening utilization showed inconsistent results. A pilot study found that an empower+LA approach was more effective than an educate+LA approach in increasing mammography rates and promoting breast cancer discussions among Latinas. This study highlights the importance of evaluating behavioral interventions in terms of behavioral and spillover network effects.
Evaluation of multiple community-based approaches to improve Latinas' breast cancer (BC) screening utilization has resulted in inconsistent findings. Factors contributing to this variation include heterogeneity in approaches (e.g., types of conceptual frameworks) and study quality (e.g., lack of measurement of spillover effects). This pilot study sought to clarify which approach may be most effective by evaluating the relative efficacy of two conceptual approaches using an area-level design with 145 Latinas nonadherent to U.S. Preventive Services Taskforce (USPSTF) BC screening guidelines. Each study arm included identical intervention format and duration (e.g., three group-based sessions, logistic assistance (LA) via five monthly calls and referral to free/low-cost screening programs). However, study content differed. While educate+LA addressed participants' BC prevention and screening behavior, empower+LA addressed participants' and their social networks' BC screening. After adjusting for age, insurance status, and baseline mammography intention, when compared with educate+LA participants, empower+LA participants were more likely to report obtaining mammograms, engaging more individuals about BC, initiating BC conversations in public settings, and discussing mammography specifically. Our study has important implications regarding the utility of evaluating behavioral interventions overall in terms of behavioral and spillover network effects.

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