American journal of preventive medicine
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Historical Article
A legacy of distrust: African Americans and medical research.
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Comparative Study
Use of peer role models to increase Pap smear and mammogram screening in Mexican-American and black women.
We evaluated the use of a community-based intervention model to increase Pap smear and mammogram screening in minority women. The community programs were based on the A Su Salud (To Your Health) model, which includes the presentation of positive role models in the media and positive social reinforcement by community volunteers. Mexican-American women 40-70 years of age in Corpus Christi, Texas, and black women 40-70 years of age in Galveston, Texas, were targeted. ⋯ Mammogram use (past two years) increased 57% among Mexican-American women (prevalence rate ratio [PRR] = 1.57; 90% confidence interval [CI] = 1.19, 2.08) and 30% among black women (PRR = 1.30; 90% CI = 1.04, 1.63). We demonstrated the feasibility of implementing a peer role model intervention at the local health department level. The improvement in mammogram use among high-risk women is encouraging, but further controlled research is needed to test the effectiveness and cost-efficiency of this approach.
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Low-income, urban, African-American and Hispanic youth have been identified as a group that may be at risk for the spread of human immunodeficiency virus (HIV). This article evaluates general knowledge of acquired immunodeficiency syndrome (AIDS), knowledge of routes of sexual transmission of HIV, risk behaviors related to sex, and perceived susceptibility to AIDS of urban low-income youth in Detroit. We drew data from a household probability sample of 1,435 of these Detroit youth. ⋯ Young Hispanic women reported the latest initiation of sexual activity and the fewest partners. A substantial minority of the youth were concerned about becoming infected with HIV, and these concerns were related to risk behavior. We demonstrate from these data a need for interventions in this population to correct misconceptions and to promote use of condoms and other safer sexual behaviors.
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Our objective is to describe the clinical findings from a nurse-practitioner-based breast and cervical cancer screening program for poor, elderly, black women. We designed a cross-sectional descriptive study set at an urban public hospital medical clinic. All women 65 years of age and older were eligible to be screened. ⋯ Interestingly, one-fifth of women with a hysterectomy had an intact cervix, including one with cervical neoplasia. Nearly one-third of women with abnormal Paps or mammograms failed to complete follow-up. Success of screening programs for the elderly will depend on the risk group targeted, careful examination, degree of sensitivity and specificity of the tests, and acceptability of follow-up diagnosis and treatment.