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Can Language-Concordant Prevention Care Managers Improve Cancer Screening Rates?

¹ Norris Cotton Cancer Center, ² Department of Anesthesiology, and ³ Department of Community and Family Medicine, Dartmouth Medical School; ⁴ Department of Sociology, Dartmouth College, Hanover, New Hampshire; ⁵ Clinical Directors Network; and ⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, New York, New York

Requests for reprints: Allen J. Dietrich, Department of Community and Family Medicine, Dartmouth Medical School, Rubin 7927, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756. Phone: 603-653-3648; Fax: 603-653-9093. E-mail: allen.j.dietrich{at}dartmouth.edu

Objective: There is evidence that non-English speakers in the United States receive lower quality health care and preventive services than English speakers. We tested the hypothesis that Spanish-speaking women would respond differently to an intervention to increase up-to-date status for cancer screening.

Study Design and Setting: A multisite randomized controlled trial showed that scripted telephone support, provided by a Prevention Care Manager (PCM), increased up-to-date rates for breast, cervical, and colorectal cancer screening. This subgroup analysis investigated the relative efficacy of the PCM among women who chose to communicate with the PCM in Spanish versus English.

Results: Of 1,346 women in this analysis, 63% were Spanish speakers. Whereas the PCM intervention increased cancer screening rates generally, Spanish-speaking women seemed to benefit disproportionately more than English-speaking women for cervical cancer screening (unadjusted odds ratio, 1.77; 95% confidence interval, 1.03-3.05). In addition, in this exploratory analysis, there was a trend toward Spanish-speaking women receiving more benefit than English-speaking women from the intervention in increased breast and colorectal cancer screening rates.

Conclusion: Spanish-speaking women seemed to benefit more than did English-speaking women from a bilingual telephone support intervention aimed at increasing cancer screening rates. (Cancer Epidemiol Biomarkers Prev 2007;16(10):2058–64)