Empowering Promotores de Salud as Partners in Cancer Education and Research in Rural Southwest Kansas

Ana Paula Cupertino

Mercedes Saint-Elin

Johana Bravo de los Rios

Edward F. Ellerbeck

K. Allen Greiner

Anna M. Nápoles

promotores de salud, cancer research, Latinos, immigrants, lay health workers, community-based participatory research
ONF 2015, 42(1), 15-22. DOI: 10.1188/15.ONF.15-22

Purpose/Objectives: To describe community-based participatory processes used to develop promotore training on cancer research, and to assess the feasibility of training promotores from rural communities to disseminate cancer research information.

Design: Prospective, cohort design.

Setting: Rural communities in the state of Kansas.

Sample: 34 Spanish-speaking promotores attended an information session; 27 enrolled and 22 completed training.

Methods: With input from a community advisory board, the authors developed a leadership and cancer curriculum and trained Spanish-speaking promotores to disseminate information on cancer research. Promotores completed pretraining and post-training surveys in Spanish to assess demographic characteristics and changes in knowledge of cancer, cancer treatment and cancer research studies, and intent to participate in cancer research.

Main Research Variables: Cancer knowledge, awareness of cancer clinical trials, interest in participating in cancer clinical research studies.

Findings: Compared to pretraining, after training, promotores were more likely to correctly define cancer, identify biopsies, describe cancer stages, and report ever having heard of cancer research studies.

Conclusions: Completion rates of the training and willingness to participate in cancer research were high, supporting the feasibility of training promotores to deliver community-based education to promote cancer research participation.

Implications for Nursing: Nursing professionals and researchers can collaborate with promotores to disseminate cancer education and research among underserved rural Latino communities in Kansas and elsewhere. Members of these communities appear willing and interested in improving their knowledge of cancer and cancer clinical trials.

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    Anwuri, V. V., Hall, L. E., Mathews, K., Springer, B. C., Tappenden, J. R., Farria, D. M., … Colditz, G. A. (2013). An institutional strategy to increase minority recruitment to therapeutic trials. Cancer Causes Control, 24, 1797-1809. doi:10.1007/s10552-013-0258-1
    Ayala, G. X., Vaz, L., Earp, J. A., Elder, J. P., & Cherrington, A. (2010). Outcome effectiveness of the lay health advisor model among Latinos in the United States: An examination by role. Health Education Research, 25, 815-840. doi:10.1093/her/cyq035
    Baquet, C. R., Commiskey, P., Daniel Mullins, C., & Mishra, S. I. (2006). Recruitment and participation in clinical trials: Socio-demographic, rural/urban, and health care access predictors. Cancer Detection and Prevention, 30(1), 24-33. doi:10.1016/j.cdp.2005.12.001
    Baquet, C. R., Ellison, G. L., & Mishra, S. I. (2009). Analysis of Maryland cancer patient participation in National Cancer Institute-supported cancer treatment clinical trials. Journal of Health Care for the Poor and Underserved, 20(2 Suppl.), 120-134. doi:10.1353/hpu.0.0162
    Barthow, C., Jones, B., Macdonald, L., Vernall, S., Gallagher, P., & McKinlay, E. (2014). Researching in the community: The value and contribution of nurses to community based or primary health care research. Primary Health Care Research and Development. [Advance print exclusive]. doi:10.1017/S1463423614000097
    Chiu, C. G., Mitchell, T. L., & Fitch, M. I. (2013). From patient to participant: Enhancing the validity and ethics of cancer research through participatory research. Journal of Cancer Education, 28, 237-246. doi:10.1007/s13187-013-0464-2
    Comis, R. L., Miller, J. D., Aldigé, C. R., Krebs, L., & Stoval, E. (2003). Public attitudes toward participation in cancer clinical trials. Journal of Clinical Oncology, 21, 830-835. doi:10.1200/JCO.2003.02.105
    De las Nueces, D., Hacker, K., DiGirolamo, A., & Hicks, L. S. (2012). A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Services Research, 47, 1363-1386. doi:10.1111/j.1475-6773.2012.01386.x
    Elliott, P. F., Belinson, S. E., Ottolenghi, E., Smyth, K., & Belinson, J. L. (2013). Community health workers, social support and cervical cancer screening among high-risk groups in rural Mexico. Journal of Health Care for the Poor and Underserved, 24, 1448-1459. doi:10.1353/hpu.2013.0180
    Guadagnolo, B. A., Petereit, D. G., Helbig, P., Koop, D., Kussman, P., Fox Dunn, E., & Patnaik, A. (2009). Involving American Indians and medically underserved rural populations in cancer clinical trials. Clinical Trials, 6, 610-617. doi:10.1177/1740774509348526
    Guthrie, T. (2002). Cancer 101: A cancer education and training program for American Indians and Alaskan Natives. Retrieved from
    Holmes, D. R., Major, J., Lyonga, D. E., Alleyne, R. S., & Clayton, S. M. (2012). Increasing minority patient participation in cancer clinical trials using oncology nurse navigation. American Journal of Surgery, 203, 415-422. doi:10.1016/j.amjsurg.2011.02.005
    Hubbard, G., Kidd, L., Donaghy, E., McDonald, C., & Kearney, N. (2007). A review of literature about involving people affected by cancer in research, policy and planning and practice. Patient Education and Counseling, 65, 21-33. doi:10.1016/j.pec.2006.02.009
    Klinger, K., Figueras, C., Beney, K. M., Armer, J. M., & Levy, S. (2014). Nursing contributions in community clinical oncology research programs. Seminars in Oncology Nursing, 30, 38-43. doi:10.1016/j.soncn.2013.12.007
    Larkey, L. K., Herman, P. M., Roe, D. J., Garcia, F., Lopez, A. M., Gonzalez, J., … Saboda, K. (2012). A cancer screening intervention for underserved Latina women by lay educators. Journal of Women's Health, 21, 557-566. doi:10.1089/jwh.2011.3087
    Livaudais, J. C., Coronado, G. D., Espinoza, N., Islas, I., Ibarra, G., & Thompson, B. (2010). Educating Hispanic women about breast cancer prevention: Evaluation of a home-based promotora-led intervention. Journal of Women's Health, 19, 2049-2056. doi:10.1089/jwh.2009.1733
    Loue, S., Faust, M., & Bunce, A. (2000). The effect of immigration and welfare reform legislation on immigrants' access to health care, Cuyahoga, and Lorain Counties. Journal of Immigrant Health, 2, 23-30. doi:10.1023/A:1009535322184
    McCloskey, J. (2009). Promotores as partners in a community-based diabetes intervention program targeting Hispanics. Family and Community Health, 32, 48-57. doi:10.1097/01.FCH.0000342816.87767.e6
    Murthy, V. H., Krumholz, H. M., & Gross, C. P. (2004). Participation in cancer clinical trials: Race-, sex-, and age-based disparities. JAMA, 291, 2720-2726. doi:10.1001/jama.291.22.2720
    National Cancer Institute. (2014). What is cancer? Retrieved from
    Native American Cancer Research. (2012). Clinical trials education for Native Americans. Retrieved from
    Native American Programs. (2012). Cancer 101 + 1. Retrieved from
    Otero, M. (2006). Cancer 101: Entendiendo el cancer. University of New Mexico Cancer Research and Treatment Center. Albuquerque, NM.
    Rubin, S. L. (2014). The clinical trials nurse as subject advocate for minority and culturally diverse research subjects. Journal of Transcultural Nursing, 25, 383-387. doi:10.1177/1043659614523999
    Sateren, W. B., Trimble, E. L., Abrams, J., Brawley, O., Breen, N., Ford, L., … Christian, M. C. (2002). How sociodemographics, presence of oncology specialists, and hospital cancer programs affect accrual to cancer treatment trials. Journal of Clinical Oncology, 20, 2109-2117. doi:10.1200/JCO.2002.08.056
    Schensul, J. J., & Trickett, E. (2009). Introduction to multi-level community based culturally situated interventions. American Journal of Community Psychology, 43, 232-240. doi:10.1007/s10464-009-9238-8
    Schmotzer, G. L. (2012). Barriers and facilitators to participation of minorities in clinical trials. Ethnicity and Disease, 22, 226-230.
    Schnoll, R. A., Wang, H., Miller, S. M., Babb, J. S., Cornfeld, M. J., Tofani, S. H., … Engstrom, P. F. (2005). Change in worksite smoking behavior following cancer risk feedback: A pilot study. American Journal of Health Behavior, 29, 215-227. doi:10.5993/AJHB.29.3.3
    Wallerstein, N., & Bernstein, E. (1988). Empowerment education: Freire's ideas adapted to health education. Health Education Quarterly, 15, 379-394. doi:10.1177/109019818801500402
    Wallington, S. F., Luta, G., Noone, A. M., Caicedo, L., Lopez-Class, M., Sheppard, V., … Mandelblatt, J. (2012). Assessing the awareness of and willingness to participate in cancer clinical trials among immigrant Latinos. Journal of Community Health, 37, 335-343. doi:10.1007/s10900-011-9450-y
    Wells, K. J., Luque, J. S., Miladinovic, B., Vargas, N., Asvat, Y., Roetzheim, R. G., & Kumar, A. (2011). Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiology, Biomarkers and Prevention, 20, 1580-1598. doi:10.1158/1055-9965.EPI-11-0276
    Wendler, D., Kington, R., Madans, J., Van Wye, G., Christ-Schmidt, H., Pratt, L. A., … Emanuel, E. (2005). Are racial and ethnic minorities less willing to participate in health research? Retrieved from