Preventing Chronic Disease | Designing Audience-Centered Interactive Voice Response Messages to Promote Cancer Screenings Among Low-Income Latinas - CDC

full-text ►

Preventing Chronic Disease | Designing Audience-Centered Interactive Voice Response Messages to Promote Cancer Screenings Among Low-Income Latinas - CDC

Designing Audience-Centered Interactive Voice Response Messages to Promote Cancer Screenings Among Low-Income Latinas

Navigate This Article

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables
• Appendix

Mary L. Greaney, PhD; Maria De Jesus, PhD; Kim M. Sprunck-Harrild, MSW, MPH; Trinidad Tellez, MD, MPH; Roshan Bastani, PhD; Tracy A. Battaglia, MD, MPH; James S. Michaelson, PhD; Karen M. Emmons, PhD

Suggested citation for this article: Greaney ML, De Jesus M, Sprunck-Harrild KM, Tellez T, Bastani R, Battaglia TA, et al. Designing Audience-Centered Interactive Voice Response Messages to Promote Cancer Screenings Among Low-Income Latinas. Prev Chronic Dis 2014;11:130213. DOI: http://dx.doi.org/10.5888/pcd11.130213.

PEER REVIEWED

Abstract

Introduction
Cancer screening rates among Latinas are suboptimal. The objective of this study was to explore how Latinas perceive cancer screening and the use and design of interactive voice response (IVR) messages to prompt scheduling of 1 or more needed screenings.

Methods
Seven focus groups were conducted with Latina community health center patients (n = 40) in need of 1 or more cancer screenings: 5 groups were of women in need of 1 cancer screening (breast, cervical, or colorectal), and 2 groups were of women in need of multiple screenings. A bilingual researcher conducted all focus groups in Spanish using a semistructured guide. Focus groups were recorded, transcribed, and translated into English for analysis. Emergent themes were identified by using thematic content analysis.

Results
Participants were familiar with cancer screening and viewed it positively, although barriers to screening were identified (unaware overdue for screening, lack of physician referral, lack of insurance or insufficient insurance coverage, embarrassment or fear of screening procedures, fear of screening outcomes). Women needing multiple screenings voiced more concern about screening procedures, whereas women in need of a single screening expressed greater worry about the screening outcome. Participants were receptive to receiving IVR messages and believed that culturally appropriate messages that specified needed screenings while emphasizing the benefit of preventive screening would motivate them to schedule needed screenings.

Conclusion
Participants’ receptiveness to IVR messages suggests that these messages may be an acceptable strategy to promote cancer screening among underserved Latina patients. Additional research is needed to determine the effectiveness of IVR messages in promoting completion of cancer screening.

Author Information

Corresponding Author: Mary L. Greaney, PhD, Department of Kinesiology, 25 West Independence Way, University of Rhode Island, Kingston, RI 02881. Telephone: 401-874-7499. E-mail: mgreaney@mail.uri.edu.

Author Affiliations: Maria De Jesus, Center on Health, Risk, and Society and School of International Service, American University, Washington, DC; Kim M. Sprunck-Harrild, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts; Trinidad Tellez, New Hampshire Department of Health and Human Services, Concord, New Hampshire; Roshan Bastani, University of California Los Angeles School of Public Health, Los Angeles, California; Tracy A. Battaglia, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts; James S. Michaelson, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Karen M. Emmons, Dana-Farber Cancer Institute and Harvard School of Public Health, Boston, Massachusetts.

Top of Page

References

1. American Cancer Society. Cancer facts & figures for Hispanics/Latinos 2012–2014. Atlanta (GA): American Cancer Society; 2012.
2. US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2009;151(10):716–26. CrossRef PubMed
3. Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2012: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2012;62:129–42. CrossRef PubMed
4. Moyer VA. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2012;156(12):880–91. Erratum in Ann Intern Med 2013;158(11):852. Ebell, Mark [added]. CrossRef PubMed
5. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 2008;149(9):627–37. CrossRef PubMed
6. Allen SV, Solberg Nes L, Marnach ML, Polga K, Jenkins SM, Files JA, et al. Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids. BMC Womens Health 2012;12(1):36. CrossRef PubMed
7. Squiers LB, Holden DJ, Dolina SE, Kim AE, Bann CM, Renaud JM. The public’s response to the U.S. Preventive Services Task Force’s 2009 recommendations on mammography screening. Am J Prev Med 2011;40(5):497–504. CrossRef PubMed
8. Smith RA, Cokkinides V, Brawley OW. Cancer screening in the United States, 2008: a review of current American Cancer Society guidelines and cancer screening issues. CA Cancer J Clin 2008;58(3):161–79. CrossRef PubMed
9. Baron RC, Melillo S, Rimer BK, Coates RJ, Kerner J, Habarta N, et al. Intervention to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers a systematic review of provider reminders. Am J Prev Med 2010;38(1):110–7. CrossRefPubMed
10. Brouwers MC, De Vito C, Bahirathan L, Carol A, Carroll JC, Cotterchio M, et al. What implementation interventions increase cancer screening rates? a systematic review. Implement Sci 2011;6:111. CrossRef PubMed
11. Heisler M, Piette JD. “I help you, and you help me”: facilitated telephone peer support among patients with diabetes. Diabetes Educ 2005;31(6):869–79. CrossRef PubMed
12. Feldstein AC, Perrin N, Rosales AG, Schneider J, Rix MM, Keels K, et al. Effect of a multimodal reminder program on repeat mammogram screening. Am J Prev Med 2009;37(2):94–101. CrossRef PubMed
13. Corkrey R, Parkinson L, Bates L, Green S, Htun AT. Pilot of a novel cervical screening intervention: interactive voice response. Aust N Z J Public Health 2005;29(3):261–4. CrossRef PubMed
14. Simon SR, Zhang F, Soumerai SB, Ensroth A, Bernstein L, Fletcher RH, et al. Failure of automated telephone outreach with speech recognition to improve colorectal cancer screening: a randomized controlled trial. Arch Intern Med 2010;170(3):264–70. CrossRef PubMed
15. Mosen DM, Feldstein AC, Perrin N, Rosales AG, Smith DH, Liles EG, et al. Automated telephone calls improved completion of fecal occult blood testing. Med Care 2010;48(7):604–10. CrossRef PubMed
16. Schneider J, Waterbury A, Feldstein A. Maximizing acceptability and usefulness of an automated telephone intervention: lessons from a developmental mixed-methods approach. Health Informatics J 2011;17(1):72–88. CrossRef
17. US Census Bureau. State & county quickfacts. http://quickfacts.census.gov. Accessed September 1, 2013.
18. Merriam PA, Tellez TL, Rosal MC, Olendzki BC, Ma Y, Pagota SL, et al. Methodology of a diabetes prevention translational research project utilizing a community-academic partnership for implementation in an underserved Latino community. BMC Med Res Method 2009;9:20.
19. Emmons KM, Cleghorn D, Tellez T, Greaney ML, Sprunck KM, Bastani R, et al. Prevalence and implications of multiple cancer screening needs among Hispanic community health center patients. Cancer Causes Control 2011;22(9):1343–9. CrossRef PubMed
20. Screening for cervical cancer: recommendations and rationale. Am Fam Physician 2003;67(8):1759–66. PubMed
21. Smith RA, Cokkinides V, von Eschenbach AC, Levin B, Cohen C, Runowicz CD, et al. American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin 2002;52(1):8–22. CrossRef PubMed
22. Summaries for patients. Screening for breast cancer: recommendations from the US Preventive Services Task Force. Ann Intern Med 2002;137(5 Part 1):347–60.
23. Summaries for patients. Screening for colorectal cancer: US Preventive Services Task Force recommendation. Ann Intern Med 2008;149(9):1–44.PubMed
24. Sorensen G, Emmons K, Hunt MK, Barbeau E, Goldman R, Peterson K, et al. Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations. Prev Med 2003;37(3):188–97. CrossRef PubMed
25. Neuendorf KA. The content analysis guidebook. Thousand Oaks (CA): Sage; 2001.
26. Piette JD. Patient education via automated calls: a study of English and Spanish speakers with diabetes. Am J Prev Med 1999;17(2):138–41.CrossRef PubMed
27. Green AR, Peters-Lewis A, Percac-Lima S, Betancourt JR, Richter JM, Janairo MP, et al. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med 2008;23(6):834–40. CrossRef PubMed
28. Ogedegbe G, Cassells AN, Robinson CM, DuHamel K, Tobin JN, Sox CH, et al. Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers. J Natl Med Assoc 2005;97(2):162–70. PubMed
29. Joseph DA, King JB, Miller JW, Richardson LC. Prevalence of colorectal cancer screening among adults — Behavioral Risk Factor Surveillance System, United States, 2010. MMWR Morb Mortal Wkly Rep 2012;61(Suppl):51–6. PubMed
30. Miller JW, King JB, Joseph DA, Richardson LC. Breast cancer screening among adult women — Behavioral Risk Factor Surveillance System, United States, 2010. MMWR Morb Mortal Wkly Rep 2012;61(Suppl):46–50. PubMed