Volume 31, Issue 4: August Supplemental Issue, 2004

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, Jill Guernsey de Zapien, BA, Mary Papenfuss, MS, Maria Lourdes Fernandez, Joel Meister, PhD, Anna R. Giuliano, PhD

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 postcard 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.