Biomedical subjects

Irene Agurto

Publications and source records attributed to Irene Agurto.

4 recordsLinked to original sources

PubMed2006

Improving cervical cancer prevention in a developing country.

OBJECTIVE: to enhance the delivery of services, using continuous quality improvement, and an outreach strategy. DESIGN AND SETTING: pre and post measurements in a Primary Health Care system in El Salvador. Outcome indicators: women screened for the first time in their lifetime, unsatisfactory samples, turnaround time, and follow-up. INTERVENTION: involvement of policy, service provision and community levels in 4 plan-do-study-act cycles, facilitating linkages between work processes and a quality control group. RESULTS: 3,408 women screened for the first time in their lifetime in 1 year in regular services; unsatisfactory samples reduced by 1/2; turnaround time reduced by almost 1/3; follow-up increased from 24% (22/90) to 100% (196/196) .146 of the 151 women cytologically defined as low and high-grade squamous intraepithelial lesions (L-HSIL) were confirmed on histology as cervical intraepithelial neoplasia (CIN), while 5 showed benign changes. Of the 43 women classified as having high-grade squamous intraepithelial lesion on cytology, 36 were diagnosed with CIN2 lesions, 7 with CIN3 and 2 were confirmed with invasive carcinoma. CONCLUSION: improvements in delivery of screening can be made with few additional resources in the absence of an organized system. We promoted linkages between detection and diagnosis through enhancement of teamwork and functional coordination, which improved follow-up rates. We restored links between screening and reading processes through minor adjustments, which improved the turnaround time of samples. Trained outreach workers created new links between community and health services, identifying women who had never been screened before in their lives and facilitating their access to regular clinic services.

Adult↗

PubMed2006

Promoting healthy behaviors to prevent chronic disease in Panama and Trinidad & Tobago: results of the women as agents of change project.

In order to address the growing burden of chronic diseases in the Americas, the Pan American Health Organization implemented the Women as Agents of Change project in Panama and Trinidad & Tobago. The project focused on low income, middle aged women and promoted increased physical activity, intake of 5 servings of fruits and vegetables daily, and yearly screening for cervical cancer. One hundred women per country participated in the 6 week program which consisted of weekly meetings and participation in a behavior change curriculum. Gollwitzer's theory of implementation intentions and the theory of social support provided the methodology for the design of the curriculum. At baseline, end of project, and at 6 months, participants completed physical activity and fruit and vegetable consumption surveys. Results show an increase in consumption in Panama between the pre and post-tests, though the increase was not maintained at the 6 month period. Physical activity decreased in both countries over the intervention period, likely due to misreporting on the pretest. Notably, most participants reported on the 6 month follow up survey that they had continued or intensified the behavior changes they undertook during the project. The paper describes barriers identified by the participants as well as strategies they devised to overcome them.

Adult↗

PubMed2006

Women's perspectives on cervical screening and treatment in developing countries: experiences with new technologies and service delivery strategies.

This review of studies conducted by partners in the Alliance for Cervical Cancer Prevention (ACCP) examines women's perspectives on, and acceptability of, new cervical cancer screening and treatment approaches, management by mid-level staff, single-visit strategies, treatment side effects, and post-treatment abstinence requirements in low-resource settings. All screening, managed by female nurses and irrespective of method or constellation of methods, appeared to be highly acceptable. Similarly, cryotherapy treatment, including cryotherapy managed by nurses immediately after screening, was well-received by women in the studies. Minor side effects, although rather prevalent, and difficulties with post-treatment abstinence, did not appear to significantly deter women from recommending the procedure to friends. Rather, a sense of relief was evident, a feeling that it was better to be treated than not treated, and better to be treated sooner rather than later. While full replication may not be possible, this does not lessen the fact that screening and treatment in developing countries, even with new technologies, immediate treatment and even using mid-level providers, can be very acceptable to women if provided in a safe, caring and preferably all-female environment.

Adult↗

PubMed2003

Factors affecting utilization of cervical cancer prevention services in low-resource settings.

Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided. This paper is available too at: http://www.insp.mx/salud/index.html.

Adult↗