Abstract B57: A RCT of a community health worker intervention using HPV self-sampling to increase cervical cancer screening among minority populations

Abstract

Abstract Background: Caribbean immigrants (both Hispanics and Blacks from Haiti) are less likely to be screened for cervical cancer than the general population. One promising approach is outreach strategies that employ Community Health Workers (CHWs). Yet even in well structured CHW programs, many women remain unscreened. In our NCI Community Networks sponsored project, we are testing an approach that combines CHWs with self sampling for the human papilloma virus (HPV) as a screening strategy among such hard to reach populations. Methods: Using a community based participatory research framework, community we are enrolling 600 Latina, Haitian and African American women ages 30-65 who have not had a Pap smear in the 3 last years into a randomized study. health workers (CHWs). Group one receives culturally tailored CHW led public health outreach and education. Groups 2 and 3 receive a one hour CHW home health education session and individualized navigation by the CHWs to Pap smear screening at community based facilities. Women in group 3 have the option of Pap smear or HPV self sampling. A research assistant blinded to study allocation performs a 6 month follow-up assessment. Results: In 20 months, CHWs have assessed over 3,000 women for study inclusion. One quarter have been study eligible and we have randomized 417 such women, approximately 40% Hispanic, 40% Haitian and 80% African American. To date, have analyzed 6 month follow-up data on 217 women. Among women randomized to culturally tailored health outreach, 32% reported having had a Pap smear at 6 months. In group 2, 54% have been screened. In groups 3, 87% have been screened. Among women in Group 3 to whom we offered HPV self-sampling or tailored navigation to a Pap Smear, 73% preferred to perform HPV self-sampling. Conclusions: Using the CBPR framework, we have randomized nearly 70% of our planned “hard to reach” study population into our RCT. Our preliminary data suggest that tailored health outreach and individualized CHW navigation are highly effective. Our data, also make an extremely strong case for HPV self-sampling as a strategy for screening among unscreened minority women. Citation Format: Olveen Carrasquillo, Tulay Koru-Sengul, Sheila McCann, Anthony Amofah, Erin Kobetz. A RCT of a community health worker intervention using HPV self-sampling to increase cervical cancer screening among minority populations. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B57. doi:10.1158/1538-7755.DISP13-B57