Capturing Latino health disparities: Lessons from mail and community-based population health surveys in California

Background : Latinos face significant cancer health disparities and remain underrepresented in research. To address regional needs, the University of California Davis Comprehensive Cancer Center (UCDCCC) conducts regular Catchment Area Population Assessments (CAPAs) to inform outreach and engagement strategies. Our purpose was to understand best approaches for capturing Latino health needs responses and to understand breast and cervical cancer screening rates and risk factors. Methods : This cross-sectional study compared two CAPA survey methodologies used from July 2019 to March 2020: a mail-based approach using probabilistic sampling of residential addresses versus a community-based approach using bilingual coordinators for in-person interviews. Comparisons were made on catchment population representativeness and breast and cervical cancer screening outcomes. Results : The study included 361 Latino participants (255 community-based, 106 mail-based) across 16 of 19 UCDCCC catchment counties. Mail-based participants were significantly older, more educated, and had higher household incomes than community-based participants. Despite the differences in key demographics of participants in the two survey modalities, our results were inconclusive on whether up-to-date breast and cervical cancer screening rates differed between the two groups. Time since the last routine check-up, primarily among community-based participants, emerged as a key predictor of screening adherence. Conclusions : Mail-based methods captured more affluent Latinos, whereas community-based methods reached more underserved populations. Each method introduced distinct sampling biases, but together they provided a more balanced representation of the catchment area. Impact : Mail- and community-based survey methods enhances the representativeness of Latino health data and supports more equitable research recruitment strategies.