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Woman to Woman

Program Synopsis

Designed to increase breast and cervical cancer screening, this worksite intervention is led by peer health advisors who disseminate breast and cervical cancer information to coworkers, provide social support, and foster positive social norms for screening; meet with coworkers in small groups and one on one; and implement two worksite-wide events. The study showed an increase in Pap test screening.

Program Highlights

Purpose: Designed to increase breast cancer and cervical cancer screening in the worksite setting (2001).
Age: 40-65 Years (Adults)
Sex: Female
Race/Ethnicity: Hispanic or Latino, White (not of Hispanic or Latino Origin)
Program Focus: Awareness Building and Behavior Modification
Population Focus: Un- and/or Under-Screened People
Program Area: Breast Cancer Screening, Cervical Cancer Screening
Delivery Location: Workplace
Community Type: This information has not been reported.
Program Materials

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Implementation Guide

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Program Scores

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RE-AIM Scores

It is estimated that in 1998 in the United States, 4,900 women died from cervical cancer. Regular Pap screening may reduce cervical cancer mortality by as much as 98 percent. Pap tests are recommended every 1 to 3 years for women who are 18 years and older or who are sexually active. As of 1998, an estimated 69 percent of women 18 years and older had had a Pap test in the last year. Although the percentage of women receiving Pap tests had been increasing since 1987, a substantial number are not regularly receiving the tests. Low-income, less educated women are less likely than others to undergo regular screening. Worksite interventions may be an effective approach for reaching large numbers of women at regular intervals to encourage participation in screening.

Woman to Woman is a 16-month intervention aimed at improving adherence to screening guidelines for breast and cervical cancer among women aged 40 and older.

Volunteer advisory boards recruit and select peer health advisors (PHAs), tailor the intervention according to the needs and interests of the worksite, as well as assist in the planning and promotion of intervention activities. PHAs disseminate breast and cervical cancer information to coworkers, provide social support, and foster positive social norms for screening.

Over the course of the intervention, PHAs conduct an average of six small-group discussions on breast and cervical cancer screening. In addition, PHAs also conduct individual outreach to those who do not attend sessions while PHAs and the volunteer advisory boards implement two worksite-wide events over the intervention period.

Implementation Guide

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: group education interventions (Breast 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.

The intervention takes 16 months.

The program requires a volunteer advisory board to coordinate promotional activities and maintain a resource center. The board meets monthly for 1-2 hours. A worksite coordinator spends 45 minutes per week on project activities, including conducting advisory board meetings, publicizing project activities, and maintaining the resource center. One PHA is needed for about every 150 female employees.

PHAs need to be recruited, in which they receive 16 hours of training before program implementation. The topic areas include the following: cancer epidemiology, early detection methods, screening guidelines, community resources. PHAs also receive training on small group education, individual counseling, and program planning.

The program targets women over 40 years old employed in the service industry.

Woman to Woman is designed to be implemented in the workplace. It may also be suitable for implementation in churches or housing developments.

The program requires the use of the following items: 1) Woman to Woman Program Manual: A Complete Guide to Implementing the Woman to Woman Program in Your Workplace, 2) Lunch and Learn Session Kits, and 3) Woman to Woman Facilitator Manual.  Other resources such as posters, buttons, and incentives may be required for activities and campaigns.

A randomized controlled trial of 26 worksites with 2,747 participants aged 40 and older compared worksites that implemented Woman to Woman with those receiving no intervention over the course of 16 weeks.

Key Findings

  • Employees at Woman to Woman worksites were more likely to get Pap tests than those at comparison worksites (odds ratio=1.28).

Pre-Posttest Changes in Pap Test Screening 

      Graph of Study Results

  • The intervention did not appear to affect the likelihood of obtaining a clinical breast exam or a mammogram.

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Updated: 07/31/2020