A Multifaceted Intervention to Increase Cervical Cancer Screening among Underserved Korean Women
- 1Division of Population Science, Fox Chase Cancer Center, 2Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, and 3Jaisohn Medical Center, Philadelphia, Pennsylvania
- Requests for reprints:
Carolyn Y. Fang, Fox Chase Cancer Center, 510 Township Line Road, Cheltenham, PA 19012. Phone: 215-728-4062; Fax: 215-214-2178. E-mail: carolyn.fang{at}fccc.edu
Abstract
Objective: Despite the proven survival benefits associated with cervical cancer screening, use of the Pap test continues to be suboptimal in some population subgroups, such as among Korean-American women who face considerable barriers to screening. Therefore, we evaluated a multifaceted intervention that combined psychoeducational counseling with patient navigation to address both psychosocial and access barriers to screening.
Method: Women (n = 102) were recruited from Korean community centers and assigned to the intervention or control condition. The intervention group received cervical cancer education and patient navigation delivered by bilingual Korean health educators. The control group received general health education, including information about cervical cancer and screening. Assessments were obtained at baseline and postintervention. Screening behavior was assessed at 6 months postintervention.
Results: At baseline, 17% of participants reported having had a Pap test in the previous year. At 6 months postintervention, 83% of women in the intervention group had obtained screening compared with 22% in the control group, χ2(1) = 41.22, P < 0.001. Multivariate logistic regression analyses indicated that participation in the intervention was associated with screening (P < 0.001). Fewer psychosocial barriers (e.g., discomfort at having a stranger perform Pap) and greater self-efficacy were also associated with screening (P < 0.05).
Conclusion: A combined modality intervention that delivers education with patient navigation training and assistance resulted in increased screening rates. Multifaceted approaches may be effective in reducing the psychosocial, access, and language barriers that contribute to cancer health disparities in underserved populations. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1–5)
Footnotes
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Grant support: National Cancer Institute grants U01 CA114582 (to G.X. Ma) and K22 CA107115 (to C.Y. Fang).
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted April 6, 2007.
- Received January 31, 2007.
- Revision received April 2, 2007.
