Improving knowledge and screening for colorectal cancer among Hispanics: overcoming barriers through a PROMOTORA-led home-based educational intervention.

In the U.S., nearly 67 % of Hispanics ages 50 and older report that they have never had a screening colonoscopy. Barriers to screening include cost, lack of health insurance, anticipation of pain, embarrassment, mistrust of medical/healthcare systems and institutions, a fatalistic belief system, as well as fear and lack of knowledge regarding cancer survival. These barriers are significantly more problematic among Hispanics who are poor and those who live in underserved rural and border communities. This study addressed barriers by using promotoras and a home-based educational intervention to improve knowledge of cancer and screening for colorectal cancer (CRC) among Hispanics in Yakima Valley, Washington. Study participants attended a promotora led home-based educational intervention consisting of home-health parties (HHPs) and completed baseline and follow-up surveys on general cancer knowledge and knowledge specific to CRC and related screening practices. Results suggest increase in knowledge of cancer and participation in screening for CRC. Promotora facilitated home-based interventions offer culturally appropriate ways to reach Hispanics in rural and other underserved communities to reduce barriers and improve access to CRC and other cancer screenings.