The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jill M. Abbott, MPH, DrPH, Comprehensive Cancer Center, Ohio State University, 320 W. 10th Avenue, Columbus, OH 43210, 614-755-8799, abbott.34@osu.edu, Kathryn J. Luchok, PhD, Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 800 Sumter Street, HESC 216, Columbia, SC 29208, Ann L. Coker, PhD, School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler, PO Box 20186, Houston, TX 77225, and Irene Prabhu Das, MPH, Division of Cancer Prevention & Control, SC Department of Health and Environmental Control, PO Box 101106, Columbia, SC 29211.
BACKGROUND: Since its introduction in 1941, the Pap test has contributed significantly to early detection and prevention of cervical cancer. Although Pap test screening has increased dramatically in recent decades, adherence to follow-up recommendations after an abnormal test is still problematic. Further understanding of the multiple factors that affect a woman’s adherence to follow-up recommendations can increase the effectiveness of programs seeking to promote this behavior. METHODS: Fifty clients in the South Carolina Breast and Cervical Cancer Early Detection Program who had an abnormal Pap test within the last four years completed in-depth, in-person interviews addressing reasons why some women do not return for follow-up care in a timely manner. Women who have and have not received complete and timely follow-up care participated. The tape-recorded interviews were transcribed and analyzed to identify the complex factors that influence adherence behavior. RESULTS: Important factors identified by women as reasons for lack of Pap follow-up include misunderstandings of the importance of Pap test results, limited knowledge of follow-up procedures, difficulties in understanding clinicians, insufficient time for discussing women’s care, as well as clinic scheduling and other logistical issues. Coping strategies used to deal with abnormal Pap test results were particularly important for low-income women juggling competing life priorities. CONCLUSION: Insight into personal, provider, and system/environmental factors affecting a woman’s adherence behavior to follow-up recommendations after an abnormal Pap test reveals implications for clinical and community interventions that can increase adherence rates and ultimately reduce cervical cancer incidence and mortality.
Learning Objectives:
Keywords: Cervical Cancer, Women's Health
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.
Handout (.ppt format, 166.5 kb)