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This study developed and evaluated the efficacy of next-generation, digital, interactive, multimedia touchscreen kiosks to deliver tailored, bilingual (Spanish/English), cervical cancer education to low-income, low literacy Latinas. The kiosks are designed as small-form-factor units for use with or without a base, which makes them relatively portable. The intervention kiosks offer five interactive modules that address Latina information needs, interests and concerns based on the findings our prior formative research. A user-friendly interface enabled women to access information and engage in a self-directed, individualized learning experience.



Digital Multimedia Cervical Cancer Kiosks for Latinas

Despite a national decline in cervical cancer rates, the incidence and mortality rates for Latinas remains high. Latina rates for invasive cervical cancer are almost twice those of other women regardless of stage of the disease. Latinas also are more likely than other women to be diagnosed at an advanced stage of the disease due to relatively low screening rates. Healthy People 2010 sets a 90% screening rate as a national goal for having had a Pap test within the past three years, but only 71% of Latinas meet that standard. This is a critical gap because invasive cervical cancer can be largely prevented through regular screening.

This research project developed and tested an innovative cervical cancer education intervention designed specifically for low-income, less educated Latinas. The long-term objective of this study was to determine the efficacy of an intervention that employs interactive multimedia kiosks to deliver cervical cancer screening and risk reduction information to Latinas. The specific objectives of this study were to (a) develop culturally and linguistically appropriate cancer screening and risk reduction messages tailored for low-income, low-literacy Latinas, and (b) to evaluate the efficacy of an intervention that uses interactive, multimedia kiosks to deliver those health promotion messages.

Cervical cancer messages were tailored by age-group, language preference and screening status of Latinas. The messages were designed to increase awareness of cervical cancer risk factors and stress the importance of regular screening behavior to reduce risk. Interactive, multimedia kiosks equipped with touchscreens delivered tailored messages that permitted women to assess their own risk for the disease and to recommend specific actions they can take to reduce their risk. The over-aching goal of the intervention was to educate and empower women to understand their own level of risk and the importance of screening to reduce that risk.

The study employed a randomized, pretest and posttest, control-group experimental design. A total of 900 low-income Latinas were accrued at one rural and two urban community clinics in California. Study participants were randomly assigned to either an experimental or control condition in equal numbers after were administered a pre-test. The experimental group was exposed to a multimedia cervical cancer education intervention while the control group received a cervical cancer brochure, which represents standard care for cervical cancer education. Six-months from baseline, a post-test wase administered to both treatment and control groups. These data was analyzed using chi-square tests to compare the study arms to determine behavioral and attitudinal outcomes, as well as change in self-efficacy and decisional balance. Multivariate models were used to examine covariates of the intervention effect.

This study was funded through the Small Business Innovative Research Grants Program by the National Caner Institute, Multimedia Technology, Health Communication Informatics Research Branch, Behavioral Research Program




Publications pending. Please check back later for an update.



Research Team

Project Management

Armando Valdez, PhD, Principal Investigator

Angie Fischetti, M.S., Research Coordinator

Diana Martinez, M.D., Research Associate

Cathy Wu, Project Associate

Subject-matter Experts

Carol Somkin, PhD, Division of Research, Kaiser Permanente-Northern California

Anna Napolis-Springer, PhD, Medical Effectiveness Research Center for Diverse Populations,
Department of Medicine, University of California-San Francisco

Alvaro Garza, M.D., MPH, San Mateo County Health Department


Susan L. Stewart, PhD, Comprehensive Cancer Center, University of California-San Francisco

Research Assistants

Irma Avelar-Solario

Julie Guillen

Maria D. Alejo

Cuiyao Gutierrez

Norma L, Molina

Lidia Doniz

Collaborating Clinics


Sequoia Community Health Centers, Fresno, CA

John L. Maffeo, MD, Chief Executive Officer

Patricia Quintana-Van Horne, MD, Chief Medical Officer

Scott Sales, Center Director


El Proyecto del Barrio, Family Health Care Clinic, Arleta, CA

Corrine Sanchez, Esq., President and CEO

Gilbert Varela, MD, MBA, Medical Director

Jorge M. Lopez, Clinic Administrator-Arleta Clinic

Javier Venegas, Clinic Administrator-Winnetka Clinic


Gardner Family Health Network, Inc. San Jose, CA

Reymundo Espinoza, MPH, Chief Executive Officer

Efrain Coria, B.S., CPA, Chief Operations Officer

Gloria Sanchez, FNP, Family Practice-Women’s Clinic




Production Team

Video Production

Sandra Holden, Media 360, Video Producer/Director

Gareth Smith, Shadowplay Productions, Video Producer/Editor

Dave Mercy, Associate Producer

Juan Carlos Aguirre, HTV Studio Post & FX, Editor

Rosalinda Morales, Casting Director


Production Coordinator

Dan Farias



David Smith


Art Director

Zoe Uttly



Peter Good


Lighting and Sound

Don Jones


Teleprompter Operator

Lita Campos

Multimedia Development

Damon Seeley, Interface Design/Multimedia Authoring

Kevin Tanaka, Programming

Gareth Smith, Graphic Design

Craig Anderson, Cabinet Fabrication


Damon Seeley, Kiosk system design/integration

Actors (listed alphabetically)

Yeni Alvarez
Lina Gallegos
Lorena Mena
Theresa Galarza
Virginia Pereira
Julia Vera
Lina Acosta
Silvia Curiel
Maria Elena Gaitan
Gloria Garayua
Eva Campbell-Morales
Elia Saldana
Elena Campbell-Martinez
Jacqueline Calderon-Guido
Daniel E. Mora
Jane Castillo
Kristina Sexton
Tina D'Marco
Monica Estrada
Natalia Santamaria