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Health Education & Behavior
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The Impact of a Promotora on Increasing Routine Chronic Disease Prevention among Women Aged 40 and Older at the U.S.-Mexico Border

Jennifer B. Hunter, MPH, MA

Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson.

Jill Guernsey de Zapien, BA

Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson.

Mary Papenfuss, MS

Arizona Cancer Center, University of Arizona, Tucson.

Maria Lourdes Fernandez

Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson.

Joel Meister, PhD

Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson.

Anna R. Giuliano, PhD

Arizona Cancer Center, University of Arizona, Tucson.

A randomized controlled intervention tested the effectiveness of a community health worker (CHW) program in increasing compliance with annual preventive exams among uninsured Hispanic women living in a rural U.S.-Mexico border area. During 1999-2000, household surveys were administered to women aged 40 and older. Uninsured women not receiving routine comprehensive preventive care were invited to participate in a free comprehensive clinical exam. Participants in the initial exam were eligible to participate in the CHW (promotora) intervention. Women were randomized to one of two intervention arms. One arm received a post-card reminder for an annual preventive exam, the other a postcard reminder and follow-up visit by a promotora. Receiving the promotora intervention was associated with a 35% increase in rescreening over the postcard-only reminder (risk ratio [RR] = 1.35, 95% confidence interval 0.95-1.92). Using promotoras to increase compliance with routine screening exams is an effective strategy for reaching this female population.

Key Words: women’s health • community health • promotora • disease prevention • comprehensive preventive exam

Health Education & Behavior, Vol. 31, No. 4 suppl, 18S-28S (2004)
DOI: 10.1177/1090198104266004
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