El Milagro Clinic proposes the Cancer Health Education & Leveraging Partnerships (C-HELP) program to raise awareness, knowledge and utilization of breast and cervical cancer screening dollars available in our community. Health resources are very limited in south Texas, and providers serving the underinsured and uninsured continually have to leverage existing resources and collaborate to maximize health benefits for our most economically challenged residents living in colonias.

Presently, there is underutilization of breast and cervical cancer screening services and limited requests for HPV (human papillomavirus) vaccines, which could reduce future cervical cancer cases by 80%. Reasons for th...

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El Milagro Clinic proposes the Cancer Health Education & Leveraging Partnerships (C-HELP) program to raise awareness, knowledge and utilization of breast and cervical cancer screening dollars available in our community. Health resources are very limited in south Texas, and providers serving the underinsured and uninsured continually have to leverage existing resources and collaborate to maximize health benefits for our most economically challenged residents living in colonias.

Presently, there is underutilization of breast and cervical cancer screening services and limited requests for HPV (human papillomavirus) vaccines, which could reduce future cervical cancer cases by 80%. Reasons for the underutilization include lack of awareness of available services and poor understanding of the cancers themselves. Other important barriers include transportation challenges as well as the fear of high costs and of diagnosis with cancer.

The heart of the C-HELP program involves culturally competent health education workers, locally known as promotoras, and targeting mothers and daughters. The greatest need in our community involves some of the most impoverished families in the United States, who reside in unincorporated rural areas (colonias), often in crowded, deteriorating buildings. The promotoras are well positioned to navigate the social infrastructure of the colonias, because they are members of the community and have the cultural competency and familiarity with the families who reside there.

The promotoras’ main responsibilities are outreach on breast and cervical cancer including culturally appropriate health education on these cancers and risk reduction strategies, and identification of at-risk women eligible for screening. Working as El Milagro employees as part of a health team, the promotoras will facilitate appropriate screening appointments for eligible clients, invite them to attend a monthly health education event, provide client reminders, solicit client feedback on the process, and help those with cancer-positive results access Medicaid and other appropriate treatment services. El Milagro has also negotiated with two other community-based agencies that will provide vans and a defined number of travel vouchers to mitigate the transportation barrier.

Finally, cultural competency requires focusing on leveraging the cultural relationship between mothers and daughters, because the initial promotion of awareness and education will be most effective in an intimate, trusting and nurturing context. For example, to make the clinic visits less threatening, El Milagro is partnering with a nearby salon to provide free manicures and other esthetic services at the educational events centered on cancer screening and HPV vaccination. The C-HELP program thus combines evidence-based prevention education programs and clinic services with culturally sensitive planning to reach medically isolated, underserved populations in great need.

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