The Implementation Guide is a resource for implementing this evidence-based program. It provides important information about the staffing and functions necessary for administering this program in the user’s setting. Additionally, the steps needed to carry out the program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded on the Program Materials page.
This program uses an intervention approach recommended by the Community Preventive Services Task Force: one-on-one education interventions (Cervical Cancer Screening). This program also uses the following intervention approach for which the Community Preventive Services Task Force finds insufficient evidence: group education interventions (Cervical Cancer Screening). Insufficient evidence means the available studies do not provide sufficient evidence to determine if the intervention is or is not effective. This does not mean that the intervention does not work. It means that additional research is needed to determine whether the intervention is effective.
Program Synopsis
Designed to increase cervical cancer screening among Somali women living in the United States, this intervention includes an infographic in a print and video format and a health seminar encouraging women to undergo a Pap test. The study showed higher Pap test completion.
Program Highlights
Purpose:
The program is designed to increase cervical cancer screening among Somali women living in the United States (2023).
Age:
18-39 Years (Young Adults); 40-65 Years (Adults); 65+ Years (Older Adults)
Sex:
Female
Race/Ethnicity:
Black or African American (not Hispanic or Latino)
Program Focus:
Cognitive or Psychosocial Determinants; Healthcare Satisfaction and/or Utilization
Population Focus:
Adults; Racial and Ethnic Minorities
Program Area:
Cervical Cancer Screening
Suitable Settings:
Community-Based Settings; Health Care Facilities; Homes
Community Type:
Suburban or Urban
Program Materials
Preview and order the materials from the developer
Implementation Guide
Download Implementation Guide
Program Scores
The Need
Each year in the United States, about 11,500 new cases of cervical cancer are diagnosed, and cervical cancer causes about 4,000 deaths. The Pap test (or Pap smear) can help prevent cervical cancer or detect it early when treatment can be most effective. For women aged 21 to 29, the U.S. Preventive Services Task Force (USPSTF) recommends Pap testing every 3 years. For women aged 30 to 65, USPSTF recommends cervical cancer screening every 3-5 years depending on the woman’s risk level.
Some may experience additional burden of cervical cancer due to social and economic challenges. Interventions are needed to improve cancer health outcomes.
The Program
The Cervical Cancer Screening Toolkit is a linguistically and culturally appropriate package of resources designed to increase cervical cancer screening among Somali women living in the United States. The toolkit content was developed from themes identified during focus groups using grounded theory analysis. The toolkit has the following components to educate women about the importance of Pap tests:
-- Infographic (print): The print infographic describes cervical cancer, offers actionable steps to protect against and prevent cervical cancer, and encourages women to promote cervical cancer screening among friends and family.
-- Infographic (video): The video infographic is an animated version of the print infographic and covers the same content.
The program also includes a 30-minute, in-person health seminar led by community health workers. They hand out the print infographic, show the video, and answer the participants’ questions. The video version of the infographic is also sent to participants by text messaging.
The infographic was developed to be culturally tailored for a Somali audience. Since it was created, it has been translated into multiple languages and is now available in Amharic, Arabic, Chinese, Hmong, Pashto, Spanish, Swahili, Tagalog, Tigrinya, and Vietnamese.
Implementation Guide
Community Preventive Services Task Force Finding
This program uses an intervention approach recommended by the Community Preventive Services Task Force: one-on-one education interventions (Cervical Cancer Screening). This program also uses the following intervention approach for which the Community Preventive Services Task Force finds insufficient evidence: group education interventions (Cervical Cancer Screening). Insufficient evidence means the available studies do not provide sufficient evidence to determine if the intervention is or is not effective. This does not mean that the intervention does not work. It means that additional research is needed to determine whether the intervention is effective.Time Required
-- Time to train community health workers to lead the seminar and answer questions about the infographic
-- Time to identify participants and send the video via text messaging
-- About 30 minutes for community health workers to lead the health seminar
Intended Audience
The intended audience for the program is Somali women living in the United States.
Suitable Settings
The program is suitable for implementation in the home and in clinical settings.
Required Resources
Required resources to implement the program include the following:
-- Infographic (print)
-- Infographic (video)
For costs associated with this program, click on Contact the Program Developer on the Program Materials page.
About the Study
A randomized controlled trial was conducted with Somali women living in San Diego, California. Participants were randomly assigned to one of two groups: the intervention group (n=28), which received the Cervical Cancer Screening Toolkit, or the control group (n=27), which did not receive any intervention.
Participants were recruited using the Somali Family Service’s existing database of Somali women and distributing flyers in the community. Women who expressed interest were contacted to determine their eligibility. Participants were eligible if they were women aged 21 to 70, self-identified as Somali, and had not had a Pap test in the past 3 years. Women were excluded if they were unable to provide verbal informed consent, had a history of a total hysterectomy, were currently pregnant, were currently incarcerated, or were already enrolled in a research study.
The average age of participants was 37 in the intervention group and 43 in the control group. Because of privacy concerns within this study population, limited demographic data were collected.
Each participant was given a health passport for data collection either by email or mail or in person at a community health center. The health passport included a check box for completion of a Pap test and a designated space for confirmation with a provider’s signature or clinic stamp. All participants who returned their health passport during the 6-month collection period received a $40 gift card.
The primary outcome was completion of a Pap test by the end of the 6-month data collection period as verified by a provider’s signature or clinic stamp.
Key Findings
- At 6 months, a higher proportion of intervention group participants than control group participants had completed a Pap test (p<.0001).
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Updated: 09/23/2025