The impact of a promotora on increasing routine chronic disease prevention among women aged 40 and older at the U.S.-Mexico border

Health Educ Behav. 2004 Aug;31(4 Suppl):18S-28S. doi: 10.1177/1090198104266004.


A randomized controlled intervention tested the effectiveness of a community health worker (CHW) program in increasing compliance with annual preventive exams among uninsured Hispanic women living in a rural U.S.-Mexico border area. During 1999-2000, household surveys were administered to women aged 40 and older. Uninsured women not receiving routine comprehensive preventive care were invited to participate in a free comprehensive clinical exam. Participants in the initial exam were eligible to participate in the CHW (promotora) intervention. Women were randomized to one of two intervention arms. One arm received a post-card reminder for an annual preventive exam, the other a postcard reminder and follow-up visit by a promotora. Receiving the promotora intervention was associated with a 35% increase in rescreening over the postcard-only reminder (risk ratio [RR] = 1.35, 95% confidence interval 0.95-1.92). Using promotoras to increase compliance with routine screening exams is an effective strategy for reaching this female population.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Chronic Disease*
  • Community Health Services / organization & administration
  • Community Health Workers / organization & administration*
  • Female
  • Humans
  • Medically Uninsured
  • Mexican Americans
  • Middle Aged
  • Physical Examination
  • Primary Prevention*
  • Socioeconomic Factors
  • Women's Health*