Psychological Distress in Women With Abnormal Pap Smear Results Attending Cervical Cancer Screening.

OBJECTIVE: Women often experience psychological distress upon receipt of an abnormal Pap test result. This study aimed to evaluate psychological distress and its correlates among women who received an abnormal Pap screening test result. MATERIAL AND METHODS: A cross-sectional study was performed in a cohort of 172 consecutive women who had attended screening for cervical cancer and who received abnormal Pap smear results and underwent additional diagnostic procedures (colposcopy/biopsy/endocervical curettage). The participants filled out a questionnaire on sociodemographic variables and the Cervical Dysplasia Distress Questionnaire. Multivariate linear regression was used for the analysis of the data. For multiple comparisons, the Bonferroni correction was applied to adjust the level of significance. RESULTS: In women who received an abnormal Pap smear result, the independent correlate of higher psychological distress (by Cervical Dysplasia Distress Questionnaire score) before diagnostic procedures was lower satisfaction with information/support received from other people ( p = .002). Correlates of psychological distress in women older than 40 years with abnormal Pap smear were anxiety ( p = .042) and worry about having cervical cancer, general health and having sex ( p = .044). CONCLUSIONS: The authors' findings could enable control of factors predictive of psychological distress in women who received a positive Pap smear screening test before undergoing diagnostic procedures, primarily via active provision of targeted information.

Development of a text message-based intervention for follow-up colposcopy among predominately underserved Black and Hispanic/Latinx women.

PURPOSE: Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women. METHODS: Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews. RESULTS: Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate. CONCLUSION: The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.

Is women's sexual function impaired by an abnormal pap smear?

OBJECTIVE: Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective was to assess the impact of an abnormal Pap smear on the sexual function of affected women. METHODS: A prospective study compared the sexual function of 48 women with an abnormal Pap smear (case group) with that of 48 women with a normal Pap smear (control group). Sexual function was assessed using the Female Sexual Function Index and the Hospital Anxiety Depression Scale. The questionnaires were mailed to the participants. RESULTS: Surprisingly, the risk of sexual dysfunction was comparable between women with and without an abnormal Pap smear (odds ratio [OR] 0.7; p = 0.4). The OR remained statistically non-significant after adjustment for risk factors. Multivariable analysis showed that only older age at first intercourse, depression and anxiety were identified as factors significantly associated with sexual dysfunction. CONCLUSION: Contrary to our clinical experience, female sexual function is not impaired by an abnormal Pap smear. Further research is needed to better understand how sexuality in women with abnormal Pap smears may be affected.

Understanding of Cervical Screening Adoption among Female University Students Based on the Precaution Adoption Process Model and Health-Belief Model.

This study aimed to identify the decisional stages for cervical screening and corresponding cognitive factors in female university students. A cross-sectional study was conducted among Korean female university students aged 20-29 years through an online survey. The main outcome was the decisional stage of cervical screening adoption using the precaution adoption process model. The stages were classified into pre-adoption (the unawareness, unengaged, and undecided stages), adoption (the decided to act and acting stages), and refusal (the decided not to act stage). The cognitive factors in each stage were analyzed using the key concepts of the health-belief model. Cervical screening was defined as a clinical Papanicolaou (Pap) smear performed by a physician in a clinic. The final analysis included 1024 students. Approximately 89.0%, 1.0%, and 10.2% were classified as the pre-adoption, refusal, and adoption stages, respectively. Compared to the pre-adoption stage group, the adoption stage group was more likely to be older and have higher self-efficacy and knowledge. Most participants belonged to the pre-adoption stage-those unaware of cervical screening. Furthermore, most had a low level of knowledge and perception of cervical cancer and its screening. Therefore, our study highlighted the need for education to increase awareness and knowledge of cervical screening in this population.

Knowledge and intentions regarding the Pap smear test among Saudi Arabian women.

BACKGROUND: The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease. Knowledge is one of the most leading factors to predict the health behaviors and a helpful factor in performing screening procedures. This study aimed to investigate Saudi Arabian women knowledge of Pap testing in relation to their intention to undergo the test. METHODS: An online survey including demographic characteristics (3 questions), knowledge (13 questions), and intentions (3 questions) towards Pap smear was completed by 467 Saudi Arabian women. Data were analyzed through SPSS version 22, using descriptive statistics and correlation to measure the relationship between knowledge, demographic factors, and intention. RESULTS: The study found that average level of knowledge was 1.3 which is between high and moderate knowledge, and the average score for the intention was 2.88, to indicate that the intentions to uptake Pap smear among the participants were above the average. The study revealed a significant correlation between demographic factors and intention (p<0.01). CONCLUSION: Findings from the current study can inform health care providers about Saudi Arabian women knowledge of Pap smear and the intention to uptake the test. Strategies to motivate women to undergo Pap screening should be introduced.

Knowledge, Attitudes, and Experiences of Anal Cancer and Anal Cancer Screening Among a Clinical Sample of Hispanic Women.

OBJECTIVE: Anal cancer screening has been recommended for women with lower genital tract neoplasia, lupus, Crohn disease, HIV, and/or organ transplantation recipients. This study described and compared knowledge, attitudes, and experiences related to anal cancer and anal cancer screening between women at high risk for anal cancer and their counterparts. METHODS: This is a cross-sectional study within colposcopy and gynecology oncology clinics in Puerto Rico; 278 women 21 years or older and with prior diagnosis of gynecological neoplasia completed an interviewer-administered questionnaire. Women were categorized according to their medical history as being high risk or non-high risk for anal cancer. The high-risk group included women with a history of lower genital tract neoplasia, lupus, Crohn disease, HIV, and/or organ transplantation. RESULTS: Overall, 40.7% of the study population were at high risk for developing anal cancer. History of anal cancer screening was low among high-risk and non-high-risk women (11.5% vs 5.6%, p > .05). Less than 1% of all women reported to have had a high-resolution anoscopy. Most women (87.6%) had little knowledge about anal Pap test but were willing to have one if their doctors recommended it (96.5%). No major differences in knowledge, attitudes, or screening history were observed between high-risk and non-high-risk women. CONCLUSIONS: Although experts do not recommend routine anal cancer screening for the general population, they do recommend it for women within certain high-risk groups. Study findings highlight the importance of increasing education and awareness of anal cancer among high-risk patients and physicians, to promote better preventive methods, achieve early detection, and improve disease outcomes.

Criminal Justice Involvement and Abnormal Cervical Cancer Screening Results Among Women in an Urban Safety Net Hospital.

OBJECTIVE: The aim of the study was to elucidate the risk factors underlying abnormal cytology-based cervical cancer screening (Pap testing) in justice-involved women (JIW) compared with non-JIW in an urban safety net hospital. METHODS: Retrospective chart review of women with a history of correctional involvement who received care at Grady Health System between 2010 and 2018 and had a Pap test was performed (n = 191). An age-matched cohort of women with no correctional involvement and had a Pap test at Grady served as the control (n = 394). Variables of interest were age, HIV, smoking, race, mental health history, and history of incarceration. Outcomes of interests were rate of abnormal Pap tests and follow-up. χ2 and logistic regression models evaluated associations between the variables of interest and outcomes. RESULTS: Rates of abnormal Pap tests were significantly higher in JIW (35.6%) than controls (18.5%, p < .0001). Compared with controls, JIW were significantly more likely to have high-grade cervical cytology (odds ratio [OR] = 3.89, p < .0005) and be lost to gynecologic follow-up (OR = 8.75, p < .0001) and a history of severe mental illness (29.5% vs 4.3%, p < .0001). Those with abnormal Pap tests were likely to be HIV-positive (OR = 20.7, p < .001) and have a history of incarceration (OR = 2.33, p < .001). Predictors of high-grade Pap test were smoking history (OR = 0.16, p = .014), HIV-positive (OR = 3.66, p = .025), and history of incarceration (OR = 3.96, p < .0005). CONCLUSIONS: Justice-involved women represent a high-risk subpopulation with significantly increased rates of high-grade cytology and lost to follow-up. This underscores the need for attention to screening programs and follow-up interventions for JIW.

Cervical Cancer Prevention: Screening Among Undocumented Hispanic Women Compared With Documented Hispanic Women.

OBJECTIVE: This study compared cervical cancer knowledge, screening practices, and barriers to screening among undocumented and documented Hispanic women. MATERIALS AND METHODS: An anonymous cross-sectional survey was administered to self-identifying Hispanic women older than 21 years at community-based clinics and health care-focused community sites in Rhode Island. The survey included demographics, immigration status, questions related to cervical cancer knowledge, screening practices, and barriers to screening. Participants were stratified based on their immigration status. Categorical variables were compared by χ2 or Fisher exact test. Knowledge scores and the number of barriers were compared by t test and Wilcoxon rank sum test, respectively. p values of less than .05 were considered statistically significant. RESULTS: Seventy-three undocumented women and 70 documented women were enrolled. Undocumented women had a significantly lower mean cervical cancer knowledge score (3.53, SD =1.97) compared with documented women (4.43, SD = 2.04; p = .0085) and also experienced more barriers to having cervical cytology or a human papillomavirus test (p = .001). Eighty-eight percent of the undocumented women and 47% of the documented women did not have health insurance (p < .0001). Sixty-two percent of the undocumented women felt that their lack of documentation was a barrier to cervical cancer screening. Fifty percent of the undocumented and 47% of the documented women had never heard of the human papillomavirus vaccine. CONCLUSIONS: Undocumented women have significantly lower mean cervical cancer knowledge scores compared with documented women. A lack of legal documentation is a significant barrier to cervical cancer screening among Hispanic women. Challenges inherent to being undocumented may contribute to women's lower knowledge scores and more pronounced barriers.

The Acceptability and Preference of Vaginal Self-sampling for Human Papillomavirus (HPV) Testing among a Multi-ethnic Asian Female Population.

Vaginal self-sampling for human papillomavirus (HPV) testing can potentially increase cervical screening coverage. This study aimed to investigate the acceptability of vaginal self-sampling for HPV testing and factors that might influence a woman's preference for this as a cervical screening method. This was a cross-sectional study that recruited 725 women from the urban and suburban areas of Selangor, Malaysia. All study participants were instructed to self-collect vaginal sample using a dry flocked swab before responding to a detailed questionnaire documenting their experience and preference for self-sampling. Most of the study participants (>80%) perceived vaginal self-sampling as easy, convenient, not embarrassing, comfortable, and were confident in performing the test. This suggests high acceptability toward vaginal self-sampling for HPV testing. Of the 725 women, 83% preferred self-sampling HPV testing over healthcare personnel sampling HPV testing and Pap test. Women with higher household income and full-time employment status were more likely to prefer self-sampling. Those who had not undergone Pap test also expressed preference for self-sampling HPV testing. Convenience and women's confidence in performing a vaginal self-sampling for HPV testing were the independent key factors that influenced the preference for self-sampling method. Vaginal self-sampling for HPV testing is highly acceptable among Malaysian women. It is the preferred choice as a primary cervical screening method and serves as an alternative to healthcare-acquired sample for Pap test. PREVENTION RELEVANCE: Organized cervical cancer screening remains unachievable in many countries. Self-sampling HPV testing is an evidence-based method that can remove barriers to cervical screening. This is particularly important for developing countries in order to achieve the WHO global strategy to accelerate cervical cancer elimination.

Anal Cancer and Anal Cancer Screening Knowledge, Attitudes, and Perceived Risk Among Women Living With HIV.

OBJECTIVES: The aims of the study were (1) to describe anal cancer knowledge, perceived risk, screening barriers, and acceptability of sample self-collection among women living with HIV (WLWH) at an integrated safety-net system and (2) to describe differences in demographic and psychosocial variables among a subsample of WLWH with a history of abnormal cervical cytology results versus those with normal results. MATERIALS AND METHODS: We conducted telephone surveys with English- and Spanish-speaking WLWH (N = 99) and used electronic health record data to extract insurance type, CD4+ cell count, RNA viral load, and cervical cytology results. We calculated descriptive statistics for participant demographics, HIV laboratory results, and psychosocial variables. Among the subsample of women who completed a recent cervical Pap, we used Fisher exact test to assess differences in demographic variables, CD4+ counts, RNA viral loads, knowledge, awareness, acceptability, and perceived risk by cervical cytology results. RESULTS: Most participants (70%) reported knowing nothing about anal cancer; 28% correctly responded that HIV increases one's chance of getting anal cancer. Most (68%) never heard of an anal Pap test. Forty percent would get an anal Pap if they could self-collect the sample, whereas 59% were neutral or disagreed. The 2 most commonly cited barriers to obtaining an anal Pap were "I do not know enough about it" (n = 15) and "It might hurt" (n = 9). CONCLUSIONS: This study highlights a gap in knowledge and awareness among WLWH regarding their heightened risk for anal cancer. It indicates the need for health education and suggests an opportunity for a self-collection intervention.

Perceptions of Midwives on Pap Smear Tests during Pregnancy.

PURPOSE: The aim of the study was to explore and describe perceptions of midwives on Papanicolaou (Pap smear) test during pregnancy. METHODS: The study used qualitative, exploratory type of design. A probability purposive sampling was used to sample 12 registered midwives based in gynaecological units in a public hospital in Tshwane District, South Africa. Open-ended questionnaires, field notes, and audio tape were used to collect data. Data analysis process involved grouping and categorization into themes and sub-themes. RESULTS: This study showed that majority of midwives lacked scientific knowledge behind Pap smear test during pregnancy. Some of the participants could relate with the test and verbalized that there may be complications such as bleeding, which may lead to miscarriage. CONCLUSIONS: Findings showed that midwives were not performing Pap smear tests among pregnant women due lack of knowledge. This points out that Pap smear test is not prioritised as a secondary preventive tool at facility level. It is therefore recommended that refresher workshops be conducted at hospital level.

Demand for Cancer Screening Services: Results From Randomized Controlled Discrete Choice Experiments.

OBJECTIVES: Low uptake of cancer screening services is a global concern. Our aim was to understand factors that influence the screening decision, including screening and treatment subsidies and a gain-frame message designed to present screening as a win-win. METHODS: We analyzed preferences for mammography and Pap smear among women in Singapore by means of discrete choice experiments while randomly exposing half of respondents to a gain-framed public health message promoting the benefits of screening. RESULTS: Results showed that the message did not influence stated uptake, and given the levels shown, respondents were influenced more by treatment attributes, including effectiveness and out-of-pocket cost should they test positive, than by screening attributes, including the offer of a monetary incentive for screening. Respondents also underestimated the survival chances of screen-detected breast and cervical cancers. CONCLUSIONS: Combined, these findings suggest that correcting misconceptions about screen-detected cancer prognosis or providing greater financial protection for those who test positive could be more effective and more cost-effective than subsidizing screening directly in increasing screening uptakes.

A prevalence and psychometric study on fear of cancer in women with abnormal cervical cytology undergoing colposcopy.

OBJECTIVE: To determine the levels of fear of cancer in women who were referred for colposcopy and to determine validity and reliability of the Cancer Worry Scale (CWS) in gynaecology patients. METHODS: The study was conducted between March-November 2017 with 200 women at the Gynaecologic Oncology Clinic at Akdeniz University Hospital in Turkey. Reliability analysis, confirmatory factor analyzes, and multidimensional sum-score estimation were used for psychometric analyzes. One-way ANOVA and independent samples t-test were also used. RESULTS: Total score for the CWS of the participants was determined as 20.05 ± 7.87 in colposcopy patients. Marital status, information about the Papanicolaou (Pap) smear test and colposcopy, and fear of colposcopy were strongly associated with fear of cancer. We determined that a one-factor structure emerged for the scale and that the total contribution of this factor to the explained variance was 53.35%. CFA was applied to obtain additional evidence of structural validity in line with the scores obtained from the scale. The overall Cronbach's alpha coefficient of the scale was 0.87. CONCLUSIONS: Our study revealed that levels of fear of cancer were high in women who were referred for colposcopy. Furthermore, the CWS was determined as a valid and reliable tool to measure the fear of cancer in women undergoing cervical screening/follow-up for abnormal cytology.

Health Literacy, Knowledge on Cervical Cancer and Pap Smear and Its Influence on Pre-Marital Malay Muslim Women Attitude towards Pap Smear.

BACKGROUND: Cervical cancer is preventable. In Malaysia, women are found to have good awareness of the disease and yet, the Pap smear uptake is still poor. Measuring health literacy level could explain this discrepancy. This study aims to determine the relationship between health literacy, level of knowledge of cervical cancer and Pap smear with attitude towards Pap smear among women attending pre-marital course. METHODS: A cross sectional study was performed in three randomly selected centres that organised pre-marital courses. All Malay Muslim women participants aged 18 to 40 years old were recruited while non-Malaysian, illiterate, and had hysterectomy were excluded. Validated self-administered questionnaires used were European Health Literacy Questionnaire (HLS-EU-Q16 Malay) and Knowledge and attitude towards Cervical Cancer and Pap Smear Questionnaire. The mean percentage score (mean± SD) was calculated, with higher scores showed better outcomes. Multiple linear regression was used to measure the relationship of independent variables with attitude towards Pap smear. RESULTS: A total of 417 participants were recruited with a mean age of 24.9 ± 3.56 years old. Prevalence of awareness of cervical cancer was 91.6% (n=382, 95% CI: 89.0%, 94.2%) and mean percentage score was 74.7%±7.6. Prevalence of awareness of Pap smear was 59.0% (n=246, 95% CI: 54.2%, 63.8%) and mean percentage score was 80.2% ± 6.5. The health literacy mean score was 13.3±3.6, with minimum score 0 and maximum score 16. The mean percentage score of attitudes towards Pap smear was 64.8%±9.3. Multiple linear regression analysis demonstrated significant relationship between health literacy (p=0.047) and knowledge of Pap smear (p<0.001) with attitude towards Pap smear. CONCLUSION: A higher health literacy with high knowledge of Pap smear improves the attitude towards Pap smear. Pre-marital course is an opportunistic platform to disseminate information to improve health literacy and knowledge of cervical cancer and Pap smear screening.

Persistent Disparities in Cervical Cancer Screening Uptake: Knowledge and Sociodemographic Determinants of Papanicolaou and Human Papillomavirus Testing Among Women in the United States.

OBJECTIVES: Cervical cancer is the second-most common type of cancer among women aged 15-44, and racial, ethnic, and economic disparities exist in survival rates despite widely available screening tests and early treatment options. The objective of this study was to describe the association among knowledge, sociodemographic characteristics, and cervical cancer screening, with the goal of developing interventions to prevent cervical cancer in populations at risk of the disease. METHODS: In 2017, we conducted a nationwide survey of women in the United States aged ≥18 who had ever received a Papanicolaou (Pap) test (N = 630). We conducted t tests and one-way analysis of variance to determine sociodemographic differences (age, education, race, ethnicity, income, type of health insurance) in knowledge about cervical cancer screening (Pap test and human papillomavirus [HPV] test). We used logistic regressions to define significant determinants of cervical cancer screening behaviors in the previous 5 years. RESULTS: Of 629 respondents, 407 (64.7%) had an annual household income <$30 000, and 322 of 536 (60.1%) respondents had government-provided health insurance. Of 630 women who had ever had a Pap test, 425 (67.5%) had an HPV test. Hispanic and non-Hispanic white women were more likely than Hispanic and non-Hispanic black women (odds ratio [OR] = 2.49; 95% CI, 1.12-4.54; P = .02) and women with government-provided health insurance (OR = 1.91; 95% CI, 1.08-3.37; P = .03) were more likely than women with private health insurance to have received a Pap test in the previous 5 years. Knowledge of HPV was a significant predictor of having received an HPV test in the previous 5 years (OR = 1.37; 95% CI, 1.22-1.54; P < .001). CONCLUSION: Disparities in cervical cancer screening among sociodemographic groups of women suggest the need for targeted interventions to improve knowledge about Pap and HPV tests.

Does YouTube Provide Reliable and High-Quality Information? Assessment of Pap Smear Test Videos.

AIM: YouTube is one of the most popular video-sharing platforms and is used by many people as a source of information regarding health conditions. Although there are many studies examining YouTube health-related videos in terms of quality, content and accuracy, there is not any study observing the content of YouTube videos about the "Pap smear test." Therefore, we intended to evaluate YouTube videos related to the Pap smear test. METHODS: We made a search by typing "Pap smear test" and observed the first 100 videos. According to our selection criteria, only 42 videos were reviewed. We used 3 different questionnaires to rate the videos. The videos were independently rated by 2 gynecologists in terms of technical aspects, follow-up protocol, and video quality. RESULTS: Our study showed that clarity of the technical aspects of Pap smear testing (Q1) was 40% and that of the follow-up protocol (Q2) was only 11%. In terms of video quality (Q3), the adequacy rate was 34%. There was a statistically significant negative correlation between search rank and the video power index (which increased as the ranking decreased to rank 1, r: -0.481). CONCLUSION: We did not find quality and reliable information on YouTube videos about the Pap smear test, which is important for early detection of cervical cancers. While preparing health-related videos for YouTube and similar websites, the support of professional healthcare workers will help provide more accurate content.

Factors associated with cervical intraepithelial neoplasia (CIN2/CIN3), early stage and advanced stage of cervical cancer diagnosis in the Brazilian Amazonian region.

To understand the impact of demographic, behavioral and contextual factors on cervical cancer, we examined the profile of women classified according to cervical cancer staging [precursor lesions cervical intraephitelial neoplasia (CIN2/CIN3), early- and advanced-stage cancer]. Patients were identified in the main oncological reference hospital in Pará State, Brazil, from 2013 through 2015. Adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression with robust variance. The study included 172 cases of CIN2/CIN3 lesions, 158 of early stage and 552 of advanced stage of cervical cancer. The proportion of gynecological complaints as a reason for clinic visit was 2.3 times higher among patients at an early stage compared with patients with CIN2/CIN3 lesions. Compared with early-stage cancer groups, the prevalence of advanced-stage cancer was higher among older patients, those without paid activity (adjusted prevalence ratio = 1.15; confidence interval 95%: 1.03-1.29), those who never had a Pap test (adjusted prevalence ratio = 1.23; confidence interval 95%: 1.08-1.40), those who were seen at the hospital clinic due to gynecological complaints (adjusted prevalence ratio = 1.48; confidence interval 95%: 1.19-1.85) and those who underwent biopsy in the private care system (adjusted prevalence ratio = 1.12; confidence interval 95%: 1.02-1.22). These differences seem to reflect problems in the health system, low socioeconomic level and poor awareness of the importance of Pap tests among those with a diagnosis of advanced-stage cervical cancer.

The impact of community-based multimedia intervention on the new and repeated cervical cancer screening participation among South Asian women.

OBJECTIVES: The objectives of this study were to reveal the screening uptake of South Asian women who had participated in the community-based multimedia intervention and to identify the reasons among those women who remained unscreened after receiving the intervention. STUDY DESIGN: This was a cross-sectional study. METHODS: South Asian women (Indian, Pakistani and Nepalese) who had attended a community-based multimedia intervention and who agreed to participate in a follow-up telephone survey were contacted. A structured telephone survey was conducted to collect data on their screening uptake status. RESULTS: There were altogether 371 women who completed the survey. Before attending the intervention, 220 of them had never had a Pap test. After the intervention, 75 of those 220 women (34.1%) decided to attend screening, of which 43 underwent their first Pap test, while 32 made their first Pap test appointment. Among those 151 women who previously underwent screening, 76 of them completed the screening or had scheduled a repeated test. Perceived barriers to screening such as lack of time, language barriers and perception that it was unnecessary to attend screening remained the major reasons for women who were not screened. CONCLUSION: Some South Asian women started to have their first Pap test, while some continued to attend screening after the intervention. As barriers that affect women's screening participation still exist, continuous and sustainable efforts should be made to improve the overall screening uptake.

Using a Culturally Tailored Narrative to Increase Cervical Cancer Detection Among Spanish-Speaking Mexican-American Women.

The objective of this study was to determine the feasibility and effectiveness of translating films, and whether the use of narrative is an effective vehicle for producing changes in knowledge, attitudes, and behaviors regarding cervical cancer compared with a nonnarrative film. A randomized controlled telephone trial surveyed the effectiveness of two films our team produced among a sample of 300 monolingual Spanish-speaking women, ages 25 to 45, who were of Mexican origin. Participants were recruited using random digit dialing (RDD) procedures from 2013 to 2014 in Los Angeles County and were randomly selected to view either a narrative or nonnarrative film. Data were collected by phone at baseline, 2 weeks, and 6 months after viewing. On average, participants arrived in the USA 25 years ago. The majority reported having less than high school education and limited English proficiency. Compared with their nonnarrative counterparts, women who received the cervical cancer-related information in the narrative film showed a significantly greater increase in new knowledge (p = 0.01) and in supportive attitudes about Pap tests expense (p = 0.05). Importantly, at 6 months, although not statistically significant, women who viewed the narrative film were also more likely to have had or scheduled a Pap test (62% vs 42%). Narratives are a useful and underutilized tool to communicate information about cancer prevention. These findings have important implications for the delivery of health education among Spanish-speaking, low-literacy immigrant women, and for the reduction of cancer-related disparities.