/////UAMS Research Project Removes Barriers to Help Screen Hispanics
UAMS Research Project Removes Barriers to Help Screen Hispanics 2018-01-05T09:16:49+00:00

FEB. 3, 2006 | The nighttime phone call would test Michelle Trevino’s skills as program manager of Esperanza y Vida (Hope and Life), a Fay W. Boozman College of Public Health program at the University of Arkansas for Medical Sciences (UAMS).

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As part of the research project led by Deborah O. Erwin, Ph.D., Trevino had recently persuaded the distressed caller to get the screening that detected her cervical cancer, just as she has done for hundreds of Hispanic women in Arkansas. Despite the life-saving help from Esperanza y Vida, the circumstances had created upheaval in the woman’s marriage.   


“She was really upset. She said, ‘My husband thinks I’m cheating on him,’” Trevino recalled.


Trevino talked to the distrusting husband by phone that night and later in person. She soon realized that he misunderstood the trigger for his wife’s cancer. She would explain to him that the human papilloma virus, which can cause cervical cancer, was probably latent for years and that it was possible the husband had passed the virus to her.


“I was over at their house for hours,” Trevino said, and the husband eventually softened his stance after a doctor confirmed Trevino’s explanation.


Trevino said that was her most difficult case, but it illustrates one of Hispanic women’s biggest obstacles to breast cancer and cervical cancer screenings: their husbands. Most are from countries where regular exams are uncommon, and they don’t like their wives seen or touched by male doctors.


Erwin, who designed the Esperanza y Vida program, was confronted with this cultural barrier while doing preliminary research in 2001. Although modeled after the Witness Project, intended to reach black women, Esperanza y Vida has had to account for the dominant role of men in Hispanic families, said Erwin, who is director of cancer education for the Arkansas Cancer Research Center, professor in the Department of Health Behavior and Health Education in the College of Public Health, and adjunct professor in the department of surgery in the UAMS College of Medicine.


“The machismo attitude has a positive connotation in terms of protecting and taking care of wives and family, so it’s important that men be knowledgeable,” Erwin said. “Our message is that healthy families begin with healthy women.”


For the women in Arkansas’ 100,000-plus population Hispanic community, early detection of breast and cervical cancer is critical.


“Hispanics have two times the rate of cervical cancer and a higher mortality rate than other groups from breast cancer,” Erwin said. “Cervical cancer is 100 percent curable if you find it with a Pap smear, so it’s more cost effective and better for the patients and the health care system for us to find these cancers as soon as possible.”


The Susan G. Komen Foundation funded the research project with an initial $240,000 in 2003 and in 2005 added $250,000. The research, Erwin believes, will show that her intervention program is effective in getting Hispanic women screened for breast and cervical cancer and Hispanic men and women screened for diabetes. </O:P>


Working through local churches and the Catholic Diocese of Arkansas, Trevino assembles groups of Hispanics in seven counties: Bradley (south Arkansas), Pulaski (central), Yell (west central), Sevier and Hempstead (southwest) and Washington and Benton (northwest). The program starts with a Hispanic woman telling her story of surviving breast or cervical cancer, then the group is split by gender. Trevino, a lay health adviser, speaks to the women, and a male lay health adviser addresses the men.


Despite language, transportation and cultural barriers, Esperanza y Vida is making headway. Erwin’s research is tracking 242 Hispanics from the first year of the grant and now has 374 participants, about 60 percent of whom are women. The Arkansas program is in conjunction with a program that reaches Hispanics in New York City.


Evidence suggests the program is working. Trevino said getting Hispanics to attend the education sessions isn’t easy, but those who do will get screened. Nearly every woman is willing to be screened, but success has depended on Trevino’s follow-through, which requires talking to reluctant husbands, scheduling screenings, providing transportation and acting as interpreter during clinic visits.


Much of the work can be done only at night and on weekends, and Trevino is often on the road to other parts of Arkansas where she helps Hispanics navigate their local health care systems. Despite the long hours and frequent obstacles, Trevino, whose mother is a native of Mexico, said she’s found her calling. She has abandoned her goal of becoming a doctor to continue working with Arkansas’ Hispanic community, and she is pursuing a master of public health degree at the College of Public Health. 


“I liked this program so much, and I knew that if I tried to go to medical school that I couldn’t do this,” she said. The gratitude of the people she helps brings rewards that Trevino said are hard to describe.


“I can’t explain the experience,” she said. “Straight out of college I couldn’t have asked for something better, and it’s very very fulfilling.”