Group Versus Individual Culturally Tailored and Theory-Based Education to Promote Cervical Cancer Screening Among the Underserved Hispanics: A Cluster Randomized Trial

Purpose: To determine whether group education is as effective as individual education in improving cervical cancer screening uptake along the US–Mexico border. Design: Cluster randomized controlled study. Setting: El Paso and Hudspeth Counties, Texas. Participants: Three hundred women aged 21 to 65 years, uninsured, due for a Pap test, no prior history of cervical cancer or hysterectomy. Intervention: Theory-based, culturally appropriate program comprised of outreach, educational session, navigation services, and no-cost cervical cancer testing. Measures: Baseline, immediate postintervention, and 4-month follow-up surveys measured knowledge and theoretical constructs from the Health Belief Model, Theory of Reasoned Action, and the Social Cognitive Theory. Analysis: Relative risk regression analyses to assess the effects of educational delivery mode on the uptake of screening. Mixed effect models to analyze changes in psychosocial variables. Results: One hundred and fifty women assigned to each educational group; 99% Hispanic. Of all, 85.7% completed the follow-up survey. Differences in screening rate at follow-up were analyzed by education type. Overall screening rate at follow-up was 73.2%, no significant difference by education type (individual: 77.6%, group: 68.9% P = .124). Significant increases among group education at follow-up for knowledge, perceived susceptibility, perceived seriousness, and subjective norms and significant decrease for perceived benefits. Conclusion: This study provides evidence to support the effectiveness of group education to promote cervical cancer screening among vulnerable Hispanic women and offers an additional method to address cervical cancer disparities.

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Effectiveness of a health education program to improve health literacy among females in their 20s: A quasi-experimental study

10.21203/rs.2.10319/v1 ◽

2019 ◽

Author(s):

Shiho Kawata ◽

Emiko Saito

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Scale Score ◽

Sex Education ◽

Intervention Group ◽

Medical Practitioner ◽

Control Group ◽

Significant Difference

Abstract Background Japanese women cervical cancer rates are rising aged 20-30 years, few opportunities for sex education of appropriate for age are provided to females. Health literacy (HL) is an important concept in women’s health. To improve HL for cervical cancer prevention, we developed a health program for females in their 20s. This study aimed to examine the effectiveness of the program. Methods A quasi-experimental design with control groups was conducted on female undergraduate students. The inclusion criteria for both groups were: (i) Japanese females, (ii) aged 20 years or older. The sample size for each group was set at ≥13 people based in a previous study. The participants were evaluated HL variables: HL scale score, confidence in explaining one’s own body to a medical practitioner (Y/N), knowledge of women’s health, and indicated whether they had undergone cervical cancer screening. Assessments were conducted baseline and 6 months after (follow-up) the program was implemented. Analysis of the results consisted of calculating intergroup comparisons of HL variables at follow-up using the Mann-Whitney U test and Fisher’s exact test or chi-square test. Results 14 students for the intervention group participated in the study, while 60 students for the control group participated. Intergroup pair matching using the variables of concern for one’s own body and HL scale score yielded a total final analysis population of 28 participants (n=14 in each group). Comparison of both groups at follow-up revealed a significant difference in median HL scale score, at 66 in the intervention group versus 60 in the control group (P=.002), also a significant difference in the percentage of participants who felt confident in explaining their own body to a medical practitioner (P<.001), and median knowledge score was 16 in the intervention group and 14 in the control group, which was significantly different (P=.008). There were no significant intergroup differences in cervical cancer screening behaviors. Conclusions The results indicated that the program was effective in improving HL, but was not effective in changing cervical cancer screening behavior. Further research is needed to determine how to provide appropriate sex education among females in their 20s.

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Three-year follow-up of women who participated in a prison cervical cancer screening intervention

PsycEXTRA Dataset ◽

10.1037/e508992013-086 ◽

2005 ◽

Author(s):

Ruth Elwood Martin ◽

Greg Hislop ◽

Veronika Moravan ◽

Garry Grams ◽

Betty Calam

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening

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Clinical follow-up practices after cervical cancer screening by co-testing: A population-based study of adherence to U.S. guideline recommendations

Preventive Medicine ◽

10.1016/j.ypmed.2021.106770 ◽

2021 ◽

Vol 153 ◽

pp. 106770

Author(s):

Rebecca B. Perkins ◽

Rachael Adcock ◽

Vicki Benard ◽

Jack Cuzick ◽

Alan Waxman ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Population Based ◽

Population Based Study

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PCN52 SCREENING RATE IN THE HUNGARIAN ORGANIZED NATIONWIDE CERVICAL CANCER SCREENING PROGRAMME

Value in Health ◽

10.1016/s1098-3015(10)63482-1 ◽

2006 ◽

Vol 9 (6) ◽

pp. A291-A292

Author(s):

I Boncz ◽

A Sebestyén ◽

L Döbrõssy ◽

A Budai ◽

J Betlehem ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Programme ◽

Screening Rate ◽

Cancer Screening Programme ◽

Cervical Cancer Screening Programme

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FRI0516 FACTORS ASSOCIATED WITH DECREASED CERVICAL CANCER SCREENING IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3824 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 857.1-857

Author(s):

S. Bruera ◽

R. Zogala ◽

X. Lei ◽

X. Pundole ◽

H. Zhao ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cervical Cancer ◽

Cancer Screening ◽

Autoimmune Disease ◽

Cervical Cancer Screening ◽

Lupus Erythematosus ◽

Screening Rate ◽

Systemic Lupus ◽

Comorbidity Score ◽

Increased Risk

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that carries an increased risk for both viral illnesses and malignancies, including a greater risk for both human papilloma virus (HPV) infection and cervical cancer. Due to this increased risk, the American Society of Colposcopy and Cervical Pathology guidelines for SLE patients recommend more frequent cervical cancer screening. Few studies have examined patient characteristics associated with decreased cervical cancer screening in patients with autoimmune disease, specifically SLE.Objectives:To estimate cervical cancer screening rates in women with recently diagnosed SLE, and to identify characteristics associated with decreased screening.Methods:We identified women with an initial diagnosis of SLE in the United States MarketScan Commercial Claims and Encounter (CCAE, age 18-64) administrative claims database. We included patients with at least three claims with a lupus diagnosis (first and last at least >90 days apart), no lupus claims within the year before initial claim, and who had been on antimalarial drugs for at least 90 days. We excluded all patients with a previous claim for hysterectomy.Cervical cancer screening was ascertained using diagnosis and procedure codes within 1 year before and 2 years after the first SLE claim. Our covariates included the year of first SLE claim (2001-2014), age at first SLE claim, comorbidity score, insurance type, geographical region, and prescriptions for multiple types of corticosteroids. Control patients included age-matched females without autoimmune disease. Univariate comparison and multivariate logistic regression models were built to evaluate determinants of screening.Results:We included 4,316 SLE patients (median age 45) and 86,544 control patients. The screening rate in SLE patients was 73.4% vs 58.5% in the controls (P < 0.001). The screening rate was 71% in 2001, increased to 75% in 2004, then decreased to 70% in 2014 (trend P =0.005). In the multivariate model the following factors were associated with decreased cervical cancer screening: year of first SLE claim 2012-2014 versus 2001-2005 (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.53 – 0.84, P < 0.001); older age 61-64 versus 21-30 (OR 0.27, 95% CI 0.19 – 0.39, P < 0.001); comorbidity score of ≥2 versus <2 (OR 0.71, 95% CI 0.6 – 0.83, P < 0.001); and use of corticosteroids for ≥ 90 days versus <90 days (OR 0.73, 95% CI 0.59 – 0.9, P = 0.003). Insurance type and geographical region were not associated with cervical cancer screening.Conclusion:About three quarters of women with SLE underwent cervical cancer screening within 3 years of their first lupus claim, at higher rates than controls. However, there was a concerning downward trend in screening rates in recent years. In addition, higher risk populations for cervical cancer (older age, increased comorbidities, and longer duration of corticosteroids) had lower screening rates. These findings highlight the need to enhance education for healthcare providers to improve utilization of screening in women with SLE at high risk of cervical cancer.Disclosure of Interests:Sebastian Bruera: None declared, Richard Zogala: None declared, Xiudong Lei: None declared, Xerxes Pundole: None declared, Hui Zhao: None declared, Sharon Giordano: None declared, Jessica Hwang Grant/research support from: MERCK grant funding unrelated to SLE., Maria Suarez-Almazor: None declared

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Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

Canadian Oncology Nursing Journal ◽

10.5737/23688076313266274 ◽

2021 ◽

Vol 31 (3) ◽

pp. 266-274

Author(s):

Gaudence Niyonsenga ◽

Darius Gishoma ◽

Ruth Sego ◽

Marie Goretti Uwayezu ◽

Bellancille Nikuze ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Knowledge Utilization ◽

Sub Saharan Africa ◽

Eastern Africa ◽

Screening Rate ◽

Effective Prevention ◽

District Hospitals ◽

Screening Services

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal ‘yes’ or ‘no’ questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

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Uptake and acceptability of human papillomavirus self-sampling in rural and remote Aboriginal communities: Evaluation of a nurse-led community engagement model

10.21203/rs.2.23841/v2 ◽

2020 ◽

Author(s):

Tegan Dutton ◽

Jo Marjoram ◽

Shellie Burgess ◽

Laurinne Campbell ◽

Anne Vail ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Clinical Outcomes ◽

Cervical Cancer Screening ◽

Rural And Remote ◽

Service Model ◽

Community Based ◽

Aboriginal Women ◽

Never Screened

Abstract Background: Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants.Methods: Aboriginal women aged 25-69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model.Results: In total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n=46) were never-screened and one-third (n=69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women tested positive for a high risk type other than HPV 16/18 (HPV other), of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (>92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them.Conclusions: A community-based service model that respects Aboriginal Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.

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