Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, , PATIENT_CONSUMER

Intervention Description: This study focused on this population in a quantitative, randomized controlled trial using a low-cost, brief educational intervention, a Safety Baby Shower (SBS).

Intervention Results: Comparing self-report, safe sleep knowledge, attitudes, beliefs, and intent (KABI) to act scores across the two groups found intervention dyads to have more positive views on all four constructs than controls. Specifically, intervention dyad young mothers were significantly more likely to have positive beliefs about safe sleep and were more likely to report intent to practice infant safe sleep than control young mothers. Intervention dyad young mothers also had higher self-efficacy related to infant safety and more positive attitudes about safe sleep practices than control young mothers. Observations at a home visit conducted after delivery found no differences in the safe sleep practices by intervention status. Participant report of behaviors at the home visit also showed no differences in the use of safe position between the intervention and control groups.

Conclusion: It appears that even when young mothers gain knowledge and self-efficacy, they have difficulty implementing this knowledge. In practice, this suggests that exploring barriers prenatally with this population and offering suggestions to overcome them may be indicated.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: Six hundred thirteen women of Mexican origin in 3 treatment sites were randomized among 4 study arms: the full AMIGAS program with a video and a flip chart (n = 151), the AMIGAS program without the video (n = 154), the AMIGAS program without the flip chart (n = 155), and a usual care control group (n = 153). Six months after enrollment, women were surveyed and reported whether or not they had been screened.

Intervention Results: Women in any of the intervention arms were statistically significantly more likely to report being screened than those in the usual care group in both an intent-to-treat analysis and a per-protocol analysis. In the intent-to-treat analysis, 25% of women in the control group and 52% in the full AMIGAS program group reported having had Pap tests (P < .001); in the per-protocol analysis, the percentages were 29% and 62%, respectively (P < .001).

Conclusion: AMIGAS was effective in increasing Pap test screening among women of Mexican descent when used in a 1-to-1 setting. Future research should compare the 1-on-1 intervention with the group-based intervention.

Study Design: RCT: pretest-posttest

Setting: El Paso, TX; Houston, TX; and Yakima Valley, WA

Population of Focus: Mexican women with no Pap smear reported in the past 3 years

Data Source: Self-report and validated through medical records review

Sample Size: Intent-to-Treat Analysis (n=613) Intervention Group 1 (n=151); Intervention Group 2 (n=154); Intervention Group 3 (n=155); Control (n=153) Per-Protocol Analysis (n=513) Intervention Group 1 (n=128); Intervention Group 2 (n=125); Intervention Group 3 (n=127); Control (n=133)

Age Range: ≥21

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education,

Intervention Description: A case study shows us how group prenatal care may be one viable vehicle through which to affect this change. Group prenatal care is one of the few interventions shown to improve pregnancy outcomes for black women.

Intervention Results: The intervention increased the likelihood of diagnosing the unmet mental health needs, but the available mental health referral network for uninsured and underinsured patients in St. Louis was inadequate. Therefore, the collaborative identified a mental health referral network to care for pa- tients whose mental health needs excee- ded the ability of obstetrical clinicians to address in the group space

Conclusion: The underlying mechanism through which group prenatal care works may be through increased quantity and quality of patient and practitioner time together and communication. We hypothesize that this, in turn, fosters greater opportunity for cross-cultural exposure and decreases clinician implicit bias, explicit bias, and racism, thus increasing the likelihood that practitioners advocate for systems-level changes that directly benefit patients and improve perinatal outcomes.

Study Design: Qualitative

Setting: Community-based

Population of Focus: Predominantly low-income, black women

Sample Size: Unknown

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Community-Based Group Education, Patient Navigation,

Intervention Description: In 2014, the University of Illinois Health and Health Sciences System initiated the Coordinated Healthcare for Complex Kids (CHECK) program. This comprehensive care coordination demonstration project aimed to provide services for children and young adults with chronic health conditions in Chicago insured by Medicaid. CHECK adopted a holistic approach, addressing social determinants of health, caregiver wellness, mental health, and chronic disease management. The program targeted individuals with diagnoses such as asthma, diabetes, sickle cell disease, seizure disorder, or prematurity, spanning from birth to age 25. Participants were enrolled in the traditional, fee-for-service state Medicaid program or a Medicaid managed care organization (MCO) in Illinois. CHECK offered various services, including care coordination by community health workers (CHWs), mental health services by professionals, and disease-specific health education. CHWs assessed individual and family needs, analyzing health care utilization patterns in the year before enrollment. The program operated from May 1, 2014, to April 30, 2017, with data collection conducted in May 2018, covering the 12 months before and after randomization. For further details, refer to Table 4: Intervention Descriptions in the Evidence Review.

Intervention Results: In this analysis of the Chicago-based CHECK program (a large care-coordination initiative for low-income children and youth with chronic health conditions), overall Medicaid expenditures and utilization decreased considerably during the first year of the CHECK program for both CHECK participants and the usual care group. Notably, expenditures did not increase among CHECK participants, which has been noted in other care coordination programs. The rate of inpatient and ED utilization decreased for both groups. The mean (SD) inpatient utilization before enrollment in CHECK was 63.0 (344.4) per 1000 PYs for the intervention group and 69.3 (370.9) per 1000 PYs for the usual care group, which decreased to 43.5 (297.2) per 1000 PYs and 47.8 (304.9) per 1000 PYs, respectively, after the intervention.

Conclusion: Medicaid expenditures and utilization patterns decreased similarly among participants who were enrolled in the CHECK program and those in the UC group. Among children and young adults with asthma and those considered medium and high risk, a comprehensive care coordination program indicated that it could decrease ED utilization.

Study Design: RCT

Setting: Community (Coordinated Healthcare for Complex Kids (CHECK) program; Illinois Medicaid)

Population of Focus: Children with chronic diseases

Sample Size: The study involved a total of 6,245 children and young adults, with 3,119 individuals in the control group and 3,126 individuals in the intervention group.

Age Range: The study included children younger than 1 year old and youth older than 18 years. The mean age of the participants was 11.3 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, Community Health Workers (CHWs), Outreach (caregiver),

Intervention Description: The study describes a community-specific and culturally coherent approach to youth mental health services, emphasizing culturally relevant adjustments in the delivery of youth mental wellness services and related community wellness initiatives, with a focus on connections to culture and traditional skills, and strengthening support systems to improve access to mainstream mental healthcare when needed.

Intervention Results: The study highlights the adaptation of the ACCESS Open Minds framework to Inuit paradigms in Ulukhaktok and its potential as a sustainable prototype for delivering youth mental health services in Indigenous communities.

Conclusion: The conclusion emphasizes the need for easier access to specialized mental health services when needed in Indigenous communities.

Study Design: Community-specific and culturally coherent approach to youth mental health services

Setting: Ulukhaktok, Northwest Territories, Canada

Population of Focus: Indigenous youth in the Ulukhaktok community

Sample Size: Not explicitly mentioned in the provided abstract

Age Range: Age range: Primarily focused on youth under the age of 25, with a specific emphasis on adolescents

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Other Media, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: Evaluate the effect of an educational intervention on four domains of health care utilization and cervical cancer prevention and screening in a Hispanic population.

Intervention Results: Educational interventions designed to meet the needs identified by the sample group led to an increase in HPV awareness throughout the entire population surveyed and an increase in health care service utilization and HPV vaccine acceptance for women living in the US for <5 years.

Conclusion: These tools should be promoted to reduce the cervical cancer burden on vulnerable populations.

Study Design: QE: pretest-posttest

Setting: Boston, MA

Population of Focus: Hispanic women in the Boston area

Data Source: Written survey in English or Spanish

Sample Size: Baseline (n=318) Follow-up (n=295)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Enabling Services, Educational Material, Community-Based Group Education, Designated Clinic/Extended Hours, PROVIDER/PRACTICE

Intervention Description: This paper summarizes impacts of a breast and cervical cancer screening intervention spearheaded by a Native Hawaiian community.

Intervention Results: Women in intervention community significantly more likely to be compliant with Pap smear guidelines than women in control community (X2=5.73. p=.02)

Conclusion: Positive changes in screening activities among women aware of the intervention support the importance of information diffusion by community consumers. Diffusion may occur beyond the boundaries of the community as defined.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Oahu, HI

Population of Focus: Native Hawaiian women

Data Source: Telephone survey

Sample Size: Total (N=1,260) Analysis (n=678) Intervention (n=318); Control (n=360)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Community-Based Group Education, Other Person-to-Person Education, Patient Navigation

Intervention Description: We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland–Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months.

Intervention Results: The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening.

Conclusion: A health literacy–focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.

Setting: 23 ethnic churches in the Baltimore,MD-Washington, DC area

Population of Focus: Korean American women who had not had a pap test in 24 months and who could read and write Korean or English

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, Prenatal Care Access,

Intervention Description: We linked birth certificates and Medicaid claims for women receiving group prenatal care in 18 healthcare practices and applied preferential-within cluster propensity score methods to identify a comparison group, accounting for the nested data structure by practice. We examined five standardized, claims-based outcomes: postpartum visit attendance; contraception within 3 days; and any contraception, long-acting reversible contraception (LARC), and permanent contraception within eight weeks. We assessed outcomes using logistic regression for two treatment levels: (1) any group attendance compared to no group attendance and (2) attendance at five or more group sessions to at least five prenatal care visits, including crossovers attending fewer than five group sessions (minimum threshold analysis).

Intervention Results: Women attending at least five group sessions had higher rates of postpartum visit attendance (71.5% vs. 67.5%, p < .05). Women with any group attendance (N = 2834) were more likely than women with individual care only (N = 13,088) to receive contraception within 3 days (19.8% vs. 16.9%, p < .001) and to receive a LARC within eight weeks' postpartum (18.0% vs. 15.2%, p < .001). At both treatment levels, group participants were less likely to elect permanent contraception (5.9% vs. 7.8%, p < 0.001). Women meeting the five-visit group threshold were not more likely to initiate contraception or LARCs within 8 weeks' postpartum.

Conclusion: Participation in at least five group compared to five individual prenatal care visits is associated with greater rates of postpartum visit attendance. Additional engagement and education in group prenatal care may influence postpartum visit attendance.

Study Design: Retrospective cohort

Setting: 18 healthcare practices serving Medicaid-enrolled women, South Carolina

Sample Size: 15922 Medicaid enrolled women (2834 women received CenteringPregnancy, 13088 received individual prenatal care)

Age Range: 14-44

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education, Group Education, Telephone Support, Educational Material, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: The objective of this trial was to test if parents’ participation in an intervention based on an empowerment ideology and participatory experiences decreased the number of cigarettes smoked in homes.

Intervention Results: The median number of cigarettes smoked in the home daily decreased from 18 to 4 in the total sample (both groups about equally), however no statistically significant difference was detected between groups at 6 months follow-up.

Conclusion: Participation in the study, independent of group, may have resulted in parents decreasing the number of cigarettes smoked in the home. Valuable lessons were learned about recruiting and working with this group of parents, all of whom faced the challenges of tobacco and almost half of whom lived in poverty

Study Design: RCT

Setting: Community (home)

Population of Focus: Families connected with public health nursing offices, family resource centers, daycare centers, and kindergartens in Prince Edward Island, with at least one cigarette smoked daily in the home, children up to 5 years of age residing there, and one parent (smoker or not) willing to participate

Data Source: Data were collected in two intervieweradministered questionnaires competed in participants’ homes at baseline and 6-months follow-up.

Sample Size: 60 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Group Education, Access, Community-Based Group Education, Sleep Environment Modification

Intervention Description: To investigate, by using qualitative methods, beliefs among African-American and American Indian families about infant safe sleep practices, barriers to acceptance of prevention recommendations, and more effective messaging strategies.

Intervention Results: Themes included reasons for and influences on sleep decisions, and concerns about safe sleep recommendations. Parental sleep decisions seemed to be driven by perceptions of what would make their infant most comfortable and safe, and what would be most convenient. Parents were aware of safe sleep recommendations but unaware of the rationale. Because they generally did not believe that their infants were at risk for a sleep-related death, day-to-day decisions seemed to focus on what was most effective in getting their infant to sleep. There appeared to be no distinctions in opinions among African-American and American Indian families. African-American and American Indian families seemed to have similar concerns about infant comfort and safety, and their perceptions about what would be most effective in achieving these goals appeared to be important influences on their sleep practices.

Conclusion: Adherence with safe sleep recommendations may be enhanced if health care providers and educational materials discussed rationale underlying recommendations and addressed common parental concerns. It may be beneficial to target educational interventions towards fathers, as they may be untapped sources in implementing safe sleep practices.

Study Design: N/A

Setting: Focus Groups

Data Source: Mother and supporters participating in focus groups

Sample Size: 73 participants

Age Range: Mean age for the participants was 24.9 years for the mothers and 30.7 years for the supporters, and mean age for the children was 5.6 months for both groups.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education, Patient Navigation

Intervention Description: Assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location.

Intervention Results: Screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6).

Conclusion: Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.

Study Design: Cluster RCT

Setting: Arkansas and New York City, NY

Population of Focus: Latina women

Data Source: Telephone survey

Sample Size: Baseline (n=487) Intervention (n=308); Control (n=179) Follow-up (n=238)

Age Range: Mean: 39.3

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education,

Intervention Description: This study was an analysis of focus group data generated as part of a larger project focused on community involvement in Black maternal health. English speaking pregnant or recently postpartum women age 18 or older who receive services from BIH were recruited to participated in the focus group analyzed in this study. All facilitators of the focus group were Black women in order to facilitate candid conversation about racism in prenatal care.

Intervention Results: The need for mental health care was common thread underlying all conversations about prenatal health improve- ments desired by our focus groups. Participants expressed the centrality of mental health access during our discussion of other themes (e.g.: ease of access, inclusion of partners, special classes for teen moms) by discussing them in terms of their relationship to mental health. Our participants’ clear expression of the centrality of mental health care to their prenatal health guided our decision to focus on mental health as a necessary pillar of any group prenatal care intervention designed to mitigate perinatal healthcare disparities in this paper. Three themes related to mental health integration into group pre- natal care emerged from thematic analysis of the transcripts. Participants expressed insufficient access and advocacy, and provider distrust

Conclusion: Evidence exists supporting group prenatal care as a tool for mitigation of perinatal health disparities among Black women. There is also a large body of data describing the disproportionate burden of mental health needs among Black women. The rich data we present here from Black women on their desire for the integration of these two needs fits well into the parallel conversation occurring in the literature. To our knowledge, this is the first study investigating desires of Black women regarding group prenatal care designed specifically for them. They expressed a strong desire for more access to mental health care providers who are racially conscious and aware of white supremacy, and nuanced opinions on the role of racial concordance in health equity.

Study Design: Qualitative

Setting: Community-based

Population of Focus: Black birthing people

Sample Size: 11

Age Range: 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Community-Based Group Education, PATIENT/CONSUMER

Intervention Description: This study examined the feasibility and efficacy of Salud Es Vida – a promotora-led, Spanish-language educational group session on cervical cancer screening (Pap tests), self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds.

Intervention Results: While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores.

Conclusion: The group intervention approach was associated with increased cervical cancer knowledge, but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: 4 rural counties in Southeast GA

Population of Focus: Hispanic/Latino immigrant women ages 21-65 who had not had a Pap test in 2 years or more

Data Source: Written survey; cervical cancer screening questions were derived from the Health Information National Trends Survey

Sample Size: Baseline (n=176) Intervention (n=86); Control (n=90) Follow-up/Analysis (n=90) Intervention (n=38); Control (n=52)

Age Range: 21-65

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education

Intervention Description: Between the pretest and posttest surveys, women in the intervention group participated in the educational program over three weekly educational sessions. The intervention group churches served as the education sites, with women participating in the educational sessions at the churches from which they were recruited. Each educational session lasted approximately two hours. Women participating in the educational sessions received a token payment of $5 for each session they attended. To implement the cervical cancer education program, we constituted 20 groups with 8 to 14 women per group. Women in the control group received the cervical cancer education booklets after the posttest surveys.

Intervention Results: Overall, there was a significant intervention effect, with intervention compared with control group women twice (adjusted odds ratio = 2.0, 95% confidence interval = 1.3–3.2, p<.01) as likely to self-report Pap smear use at the posttest.

Conclusion: The findings support the efficacy of the multifaceted, theory-guided, culturally tailored community-based participatory cervical cancer education program for Samoan women in effecting positive changes in Pap smear use and cervical cancer-related knowledge and attitudes.

Study Design: Cluster RCT

Setting: Twenty-six Samoan-speaking churches on the main island of Tutulia in the American Samoa

Population of Focus: Samoan women a with no selfreported Pap smear in the past 2 years, no history of cervical cancer or hysterectomy, and plans to stay in the Territory throughout the study period

Data Source: Personal interviews

Sample Size: Total (N=416) Analysis (n=398) Intervention (n=201); Control (n=197)

Age Range: ≥20

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Enabling Services, Other Media, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: A 48-month community intervention was conducted to improve breast and cervical cancer (BCC) screening among Korean American (KA) women in Alameda County (AL), California. KA women in Santa Clara (SC) County, California served as a comparison group.

Intervention Results: After adjusting for all covariates, no significant difference in Pap smear rates between intervention and comparison counties.

Conclusion: Although our overall intervention did not appear to enhance screening practices at the community-level, attendance at a women's health workshop appears to have increased cervical cancer screening.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Total (N=2,176) Baseline (n=1,093); Follow-up (n=1,083) Analysis (participated in baseline or follow-up) (n=1,902) Baseline (n=818) Intervention (n=404); Control (n=414) Follow-up (n=1,084) Intervention (n=418); Control (n=458)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Patient Navigation, Enabling Services, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education, Designated Clinic/Extended Hours, Female Provider, COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: Development and implementation of a multifaceted intervention using community-based participatory research (CBPR) methodology and evaluated with a quasi-experimental controlled design with cross-sectional pre-intervention (2000) and post-intervention (2004) telephone surveys. Data were analyzed in 2005.

Intervention Results: Significantly greater odds of Pap smear for women in intervention county than in control county (OR=2.02, 95% CI: 1.37-2.99)

Conclusion: A multifaceted community-based participatory research (CBPR) intervention was associated with increased Pap test receipt among Vietnamese-American women in one community.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Santa Clara County, CA and Harris County, TX

Population of Focus: Vietnamese women living in either county

Data Source: Computer-assisted telephone interviewing system

Sample Size: Baseline(n=1,566) Intervention (n=798); Control (n=768) Follow-up (n=2,009) Intervention (n=1,004); Control (n=1,005)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: The current study is a randomized trial of a promotora-led educational intervention focused on cervical cancer in a local Hispanic community.

Intervention Results: Follow-up data revealed significant improvements in all outcome measures.

Conclusion: The observed association between cervical cancer knowledge and Pap smear receipt underscores the importance of educating vulnerable populations about the diseases that disproportionately affect them.

Study Design: RCT: pretest-posttest

Setting: South Philadelphia, PA

Population of Focus: Hispanic women

Data Source: In-person interview administered in Spanish by the promotoras

Sample Size: Total (N=120) Intervention (n=60); Wait-List Control (n=60) Analysis (n=70) Intervention (n=34); Wait-List Control (n=36)

Age Range: 18-65

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Community-Based Group Education, COMMUNITY, Other Media

Intervention Description: The objective of this study was to determine the feasibility and effectiveness of translating films, and whether the use of narrative is an effective vehicle for producing changes in knowledge, attitudes, and behaviors regarding cervical cancer compared with a nonnarrative film. A randomized controlled telephone trial surveyed the effectiveness of two films our team produced among a sample of 300 monolingual Spanish-speaking women, ages 25 to 45, who were of Mexican origin. Participants were recruited using random digit dialing (RDD) procedures from 2013 to 2014 in Los Angeles County and were randomly selected to view either a narrative or nonnarrative film. Data were collected by phone at baseline, 2 weeks, and 6 months after viewing. On average, participants arrived in the USA 25 years ago. The majority reported having less than high school education and limited English proficiency.

Intervention Results: Compared with their nonnarrative counterparts, women who received the cervical cancer–related information in the narrative film showed a significantly greater increase in new knowledge (p = 0.01) and in supportive attitudes about Pap tests expense (p = 0.05). Importantly, at 6 months, although not statistically significant, women who viewed the narrative film were also more likely to have had or scheduled a Pap test (62% vs 42%).

Conclusion: Narratives are a useful and underutilized tool to communicate information about cancer prevention. These findings have important implications for the delivery of health education among Spanish-speaking, low-literacy immigrant women, and for the reduction of cancer-related disparities.

Setting: Los Angeles county, CA

Population of Focus: monolingual Spanish-speaking women, ages 25 to 45, who were of Mexican origin.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Educational Material, Peer Counselor, Motivational Interviewing, Pharmacotherapy (Nicotine), Other Person-to-Person Education, Group Education, Community-Based Group Education

Intervention Description: To assess the feasibility and acceptability of implementing a culturally tailored, intensive smoking cessation program, including contingency-based financial rewards (CBFR), for pregnant Aboriginal women.

Intervention Results: Twenty-two of 38 eligible women (58%) enrolled in the program, with 19 (86% remaining at the end of their pregnancy. The program was highly acceptable to both women and providers. Feasibility issues included challenges providing twice-weekly visits for 3 weeks and running fortnightly support groups. Of the 19 women who completed the program, 15 (79%) reported a quit attempt lasting >=24 hours, and 8 (42%) were CO-confirmed as not smoking in late pregnancy. The rewards were perceived to help motivate women, but the key to successful quitting was considered to be the intensive support provided.

Conclusion: 'Stop Smoking in its Tracks' was acceptable and is likely to be feasible to implement with some modifications. The program should be tested in a larger study.

Study Design: Single group pre-post test

Setting: Aboriginal Maternal and Infant Health Services clinics

Population of Focus: Pregnant aboriginal women seeking prenatal care at health services sites who were smoking and older than 16 years and less than 20 weeks gestation who were local residents

Data Source: Self-reported smoking levels, breath CO

Sample Size: 38, 19 completed the program

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education, Community-Based Group Education, Group Education, Incentives

Intervention Description: Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy.

Intervention Results: The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others.

Conclusion: This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.

Study Design: Cohort-Multiple-baseline intervention pilot studymultiple interrupted time series approach

Setting: Community-based prenatal clinics

Population of Focus: English speaking pregnant women who are current smokers without alcohol or drug dependency or mental health disorders

Data Source: Urine cotinine, self-report calendar of cigarette use

Sample Size: 30

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Community-Based Group Education, Telephone Support

Intervention Description: To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on maternal and child health outcomes.

Intervention Results: At 12 and 18 months, there was little impact for either intervention on the main outcomes: child injury (SHV: relative risk 0.99; 95% confidence intervals 0.68 to 1.45, CGS: 0.91; 0.61 to1.36), maternal smoking (SHV: 0.86; 0.62 to 1.19, CGS: 0.97; 0.72 to 1.33) or maternal depression (SHV: 0.86; 0.62 to1.19, CGS: 0.93; 0.69 to 1.27). SHV women had different patterns of health service use (with fewer taking their children to the GP) and had less anxious experiences of motherhood than control women. User satisfaction with the SHV intervention was high. Uptake of the CGS intervention was low: 19%, compared with 94% for the SHV intervention.

Conclusion: There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population. The SHV intervention was associated with improvement in some of the secondary outcomes.

Study Design: RCT with two intervention groups

Setting: Community (Well-child visit)

Population of Focus: Women from culturally diverse background with infants in two disadvantaged boroughs of London, UK

Data Source: Questionnaires at baseline, 12 and 18 month follow-ups.

Sample Size: 731 mothers with 183 allocated to support health visitor intervention, 184 to community group services intervention, and 364 to control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: A community intervention program was launched in 1996 to improve breast and cervical cancer screening among Korean American women in Alameda County, California.

Intervention Results: No significant differences in Pap smear rates between the intervention and comparison counties

Conclusion: After 18 months, interim program assessment revealed that mammograms improved, but Pap smears, breast self-examinations, and clinical breast examinations did not change significantly. However, results were similar for the control county probably because the program was not implemented fully. Several strategies for improving program implementation are discussed including recommendations for researchers planning community intervention projects.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Baseline (n=818) Intervention (n=404); Control (n=414)

Age Range: ≥18