CHPPR’s SEMM-DIA Project Advances Cancer Prevention Through Community-Driven Innovation

Over the past 5 years, the Salud en Mis Manos-Dissemination and Implementation Assistance (SEMM-DIA) program at the UTHealth Houston Center for Health Promotion and Prevention Research (CHPPR) has examined how evidence-based interventions are implemented by clinics serving underserved communities. The SEMM-DIA implementation support strategy was developed by CHPPR researchers to provide clinics with strategies to facilitate implementation of the evidence-based program, Salud en Mis Manos (SEMM), with the goal to reach more women and increase breast and cervical cancer screening and prevention among medically underserved Latina adults. 

SEMM-DIA is CHPPR's Core Research Project as a CDC-funded Prevention Research Center (PRC). The original SEMM program was developed at CHPPR as an evidence-based community health worker (CHW) delivered breast and cervical (B&C) education and navigation program for Latina adults. The SEMM-DIA strategy was developed using the Implementation Mapping (IM) framework and builds on the success of SEMM by introducing a multi-level SEMM implementation support system that includes CHW trainings, digital tools, and a virtual learning network.   

Comparing clinics enrolled in the SEMM-DIA intervention arm to those in a comparison arm (clinics received the SEMM program materials only), the research team found that SEMM-DIA clinics tended to implement SEMM with greater fidelity and flexibility, and preliminary evidence suggests that SEMM-DIA will also help clinics to sustain the program. 

Timeline of Key Activities (2020–2025) 

Over five years, the project followed a step-by-step plan to design, test, and evaluate a SEMM-DIA implementation support tool: 

• 2020–2021: The team began by talking with health center staff to understand their needs. They then created tools and plans for the SEMM-DIA support system. 

• 2022–2023: The team built SEMM-DIA's digital dashboard, tested how easy it was to use, and brought in new health centers to try out the program. 

• 2024–2025: The team finished a pilot study, hosted a virtual training series, and began analyzing the results. 

From Vision to Impact 

SEMM-DIA has reached several important milestones: 

• Pilot Study: The team tested SEMM-DIA's implementation support tool in health centers to see how well it worked. They looked at how closely staff followed the program, how satisfied they were, and how easy it was to use. 

• ECHO Series: The team ran eight online sessions with partners from 11 cities. These sessions helped clinic staff learn about topics like patient records and HPV vaccine education and encouraged teamwork across clinics. 

• Digital Tools: The team launched a secure online platform with resources that help clinic staff tailor how they support patients, making the program easier to use and expand. 

• Data & Evaluation: The team has collected all the data we need and are now analyzing it. This includes interviews, website use, and health record data. 

Lessons Learned 

The 8-month pilot study surfaced critical insights that shaped SEMM-DIA’s implementation strategy: 

• Staffing is tight: Many clinics faced challenges finding staff time to deliver the program. Tailored training and planning tools helped ease the burden. 

• Competing priorities: Clinics had to balance SEMM with other demands. Aligning the program with existing quality goals made it easier to integrate. 

• Technology barriers: Tracking program outcomes in electronic records was difficult, so extra training and IT support were provided. 

• Community matters: A virtual learning network gave clinics a safe space to share ideas, troubleshoot problems, and support one another. These lessons underscore the importance of co-designing implementation strategies with end-users and adapting interventions to real-world constraints. 

Community and Statewide Partnerships 

SEMM-DIA’s success is rooted in its robust network of collaborators: 

• Health Centers: Five FQHCs across Texas participated in both the pilot and ECHO series, contributing critical insights and data. 

• Community Organizations: ProSalud (Houston) and the Cancer and Chronic Disease Consortium (El Paso) supported usability testing, outreach, and platform development. 

• Academic and State Partners: UTHealth faculty, the Wandersman Center, and the Texas HHS Breast and Cervical Cancer Services (BCCS) program provided strategic guidance and technical support. 

Why It Matters 

Cancer screening and prevention save lives, but too often, underserved communities face barriers to care. By co-designing SEMM-DIA with clinic staff and community partners, the project made it easier for health centers to bring life-saving information and services to women who need them most. 

"The SEMM-DIA project represents the power of collaboration between researchers, clinics, and communities,” said Lara Savas, PhD, Multiple Principal Investigator on the project. “By co-designing implementation strategies with clinic partners, we’ve not only advanced cancer prevention for medically underserved Latinas, but also built a model of sustainable, community-driven innovation. Our goal is to ensure that evidence-based interventions don’t remain on the shelf but become part of everyday practice in clinics across Texas and beyond.” 

Looking Ahead  

As the project reaches the close of its current funding cycle, the project team is preparing to build on the successful pilot and scale SEMM-DIA by expanding implementation across additional safety-net clinics, enhancing the platform with new features, and generating rigorous evidence on effectiveness, sustainability, and cost-efficiency. Ultimately, the team aims to expand on this work, such that SEMM-DIA may serve as a scalable model nationwide, empowering clinics, LHWs, and communities to increase cancer screenings and prevention services. 

Dissemination Through Publications 

Throughout the lifecycle of the SEMM-DIA program, the research team has prioritized the development and dissemination of academic products showcasing SEMM-DIA’s progress. Over the course of our five-year study, they have shared their findings with publications and across a number of academic conferences. For more information on SEMM-DIA’s research or publications please visit the SEMM-DIA program web page or contact [email protected].