National Center for Farmworker Health


CLS: Breast and Cervical Cancer Education Program: An Evidence Based Program



NCFH is proud to offer one of our premiere health education programs, Cultivando la Salud.   Cultivando la Salud is an evidence-based program that has been proven effective in increasing mammography, clinical breast exam, and Pap test screening rates among farmworker women nationwide. This breast cancer education program was developed specifically for farmworker women 50 years and older and centers on the lay health worker model, but Cultivando la Salud has also been utilized with other Hispanic communities nationwide and with women 40 years of age and older .  Its overall goal is to reach farmworker women (and other Hispanic women) with culturally appropriate breast and cervical cancer screening messages and encourage them to get screened.

To see published articles and publications on Cultivando la Salud, click on the following:

Effectiveness of Cultivando la Salud: A Breast and Cervical Cancer Screening Promotion Program for Low-Income Hispanic Women,  American Journal of Public Health, May 2009

Using Intervention Mapping to Develop a Breast and Cervical Cancer Screening Program for Hispanic Farmworkers: Cultivando La Salud,  Health Promotion Practice, October 2005

Cultivando la Salud,  Chapter 14: Planning Health Promotion Programs, An Intervention Mapping Process, Second Edition 2006


Cultivando la Salud is a comprehensive package that includes training by seasoned, and well qualified experts in the field of cancer prevention and control; it offers a complete set of teaching and educational tools to facilitate the implementation of the program in your communities; and can be offered in two distinct ways:


CLS Program Development and Planning: Train the Trainer Program

The Cultivando la Salud train the trainer program is intended to provide program planners with the knowledge, step-by-step process, and the tools to successfully plan and develop a comprehensive breast and cervical cancer education program for the farmworker population as well as other Hispanic communities. The training includes basic program planning information from designing the program goals and objectives to developing a budget to recruitment and training of lay health workers. The program also includes an evaluative component and specialized focus on the teaching tools lay health workers will be using in the community. At the end of the training, training participants will be provided with a complete training curriculum, a program manual to guide the implementation of the program, and the CLS teaching tools for lay health workers to use in the community. (See materials description below.)

Training for Lay Health Workers

This workshop, available in English or Spanish, is designed to specifically train lay health workers in conducting breast and cervical cancer education outreach with farmworker women and other Hispanic women in their respective communities using the Cultivando la Salud bilingual educational materials.

Topics include: What is Breast and Cervical Cancer?, Barriers and Solutions to Seeking Screening, Teaching Strategies; and Referral and Evaluation Strategies.


The educational materials include:
  • A bilingual flipchart which includes the most important messages lay health workers need to convey when conducting their sessions in the community. The flipchart has an easy-to-use format, displaying text on one side for the lay health worker to read out loud, and images with key messages on the other for the participants to see.

  • A 20-minute Spanish language video presented in a novella format which focuses on the female farmworker population and the lay health worker model. The video highlights the breast and cervical cancer screening exams, explores the common barriers the population faces with regards to these screening exams and provides the participants with potential solutions.

  • English and Spanish lesson plans to guide lay health workers during their education sessions. These lesson plans provide the lay health workers with step-by-step guidance while conducting their sessions based on time availability.

  • A bilingual training curriculum to train lay health workers on the CLS program as well as the program manual, which is the how-to-manual on implementing CLS.




Please note that materials are not available for purchase separately. In order to receive the full benefit of the program in your community, the program materials must accompany the full implementation training provided by NCFH.   

For more information on the program and training possibilities, please contact Alicia Gonzales at 512-312-2700 ext. 5469 or by email at:

(*This program was funded by the Centers for Disease Control and Prevention, the National Organizational Strategies for the Prevention, Early Detection and Control of Cancer, Program Announcement #773, Cooperative Agreement U57/CCU614491, 1998-2002.)