The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57913

Carol P. Somkin, PhD¹, Stephen SJ McPhee, MD², Tung T. Nguyen, MD³, Sarah Shema, MS⁴, Susan L. Stewart, PhD⁴, Bang H. Nguyen, DrPH⁵, and Rena J. Pasick, DrPH⁶. (1) Division of Research, Kaiser Foundation Research Institute, 2000 Broadway, Oakland, CA 94611, 510 891 3555, carol.somkin@kp.org, (2) Vietnamese Community Health Promotion Project, University of California, San Francisco, 44 Page St., Suite 500, San Francisco, CA 94102, (3) Division of General Internal Medicine, University of California, San Francisco, 400 Parnassus Avenue, Box 0320, San Francisco, CA 94143, (4) Biostatistics, Northern California Cancer Center, 32960 Alvarado-Niles Road, Suite 600, Union City, CA 94587, (5) School of Medicine, University of California, San Francisco, 44 Page Street, Suite 500, San Francisco, CA 94102, (6) Comprehensive Cancer Center, University of California San Francisco, 74 New Montgomery, Suite 200, San Francisco, CA 94143

Background: Access and satisfaction are determinants of preventive service use, but few studies have evaluated their role in regular breast and cervical cancer screening in multiethnic populations. Methods: We conducted a telephone survey in 4 languages with 1463 African American, Chinese, Filipina, Latina, and White women aged 40 to 74 residing in Alameda County, California. Outcome variables were receipt of regular mammography (most recent within 15 months and another within 2 years prior) and Pap smears (36 months and 3 years, respectively) among ever-screened women. Independent variables included race/ethnicity, other sociodemographics, access and satisfaction variables. Results: Among women who had ever had a mammogram or Pap smear, 54% and 77%, respectively, received regular screening. Mammography and Pap smear rates, respectively, differed significantly among Whites (60%, 86%), African Americans (57%, 78%), Chinese (50%, 67%), Latinas (45%, 73%) and Filipinas (48%, 73%). Regular mammography was positively associated with having private insurance (OR=1.7), a checkup in the past year (OR=2.3), knowing where to get a mammogram (OR=3.0), and greater satisfaction with processes of care (OR=1.04 per unit), and negatively with unknown co-payment amount (OR=0.4), too many forms to fill out (OR=0.5), and embarrassment (OR=0.6) at the last mammogram. Filipinas remained less likely than Whites to have regular mammograms, controlling for other sociodemographic, access and satisfaction variables. Similar results were found for Pap smears. Conclusions: Access and satisfaction were important predictors of screening, but did not explain all racial/ethnic variation. Interventions to improve mammography and Pap receipt in multiethnic populations should address these factors.

Learning Objectives:

• To understand the relationship between access and satisfaction with breast and cervical cancer screening and ethnicity among African American, Chinese, Filipina, Latina, and White women; to understand the effect of access, satisfaction, and ethnicity on regular mammography and Pap smear receipt.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.