Barriers and Facilitators of Cervical Cancer Screening among Hispanic Women

Division of Health Promotion and Behavioral Sciences, University of Texas Health Sciences Center-Houston, School of Public Health at El Paso, Texas 79902, USA.
Ethnicity & disease (Impact Factor: 1). 02/2007; 17(1):129-34.
Source: PubMed


Hispanic women are less likely than non-Hispanic white women to utilize Pap test screening. Additionally, Hispanic women have higher rates of cervical cancer than non-Hispanic white women. To better understand the barriers and facilitators for Pap test screening, we conducted 13 focus groups with 84 Hispanic women aged 18-61 years. The moderator guide was developed using the Health Belief Model. These focus groups were part of a larger study aimed at developing intervention materials for women on the US-Mexico border. Most of the women knew about cervical cancer and the Pap test. Perceived benefits of screening were finding cancer early, and feeling good about taking care of one's health. Personal barriers to having the test included embarrassment, fear, and pain. System barriers included physician gender and insensitivity to patient needs. Although the male partner was mentioned as a possible barrier in every group, most women expressed that this was not an issue for them personally. Facilitating factors fell into three categories: information/education, low cost or free tests, and supportive physicians and friends. Results of the focus group study were used in the subsequent development of a survey instrument and an intervention in a larger study.

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    • "A systematic review of interventions to increase Pap smear rates found that while patient-focused interventions tended to be effective, the impact of provider-focused interventions was heterogeneous and only marginally effective at best [18]. This finding suggests that many of the barriers to cervical cancer screening are patient-related, such as lack of education, forgetfulness, and fear of the test or disease itself [19], [20]. Nevertheless, there were two provider-centric factors that could have also affected our results. "
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    ABSTRACT: Student-run clinics increasingly serve as primary care providers for patients of lower socioeconomic status, but studies show that quality of care at student-run clinics has room for improvement. To examine change in provision of preventive services in a student-run free clinic after implementation of a student-led QI intervention involving prompting. Review of patient charts pre- and post-intervention, examining adherence to screening guidelines for diabetes, dyslipidemia, HIV, and cervical cancer. Adherence to guidelines among eligible patients increased after intervention in 3 of 4 services examined. Receipt of HIV testing increased from 33% (80/240) to 48% (74/154; p = 0.004), fasting lipid panel increased from 53% (46/86) to 72% (38/53; p = 0.033), and fasting blood glucose increased from 59% (27/46) to 82% (18/22; p = 0.059). This student-run free clinic implemented a student-led QI intervention that increased provision of prevention. Such a model for QI could extend to other student-run clinics nationally.
    PLoS ONE 11/2013; 8(11):e81441. DOI:10.1371/journal.pone.0081441 · 3.23 Impact Factor
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    • "To date, a low education level is a known barrier to breast and cervical cancer screening. Some studies have indicated that routine monitoring of coverage of screening and information polices affect breast and cervical cancer screening rates at various education levels [2,18,22,24]. Additionally, the perception of not needing the test due to good health or an absence of symptoms was the most frequently reported barrier to participation in breast and cervical cancer screening in all age groups. "
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    ABSTRACT: Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist. Data from 4,139 women aged 40 to 74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.
    BMC Cancer 06/2011; 11(1):257. DOI:10.1186/1471-2407-11-257 · 3.36 Impact Factor
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    ABSTRACT: Estimates of the percentage of women who have had Pap smears in Peru vary between 7% and 43%. This study explores what women know about cervical cancer and Pap smears, as well as their barriers to obtaining Pap smears. Focus group discussions (FGD) were conducted with a total of 177 women in four Peruvian cities. Discussions reveal that most women did not know what causes cervical cancer. Most women did not know the purpose of Pap smears, although knowledge about Pap smears was higher than knowledge about cervical cancer. Fear, embarrassment, and lack of knowledge were the main barriers identified for not getting Pap smears. Programs and policies aiming to increase Pap smear coverage must start by educating women on cervical cancer and its prevention in order to improve women's perceptions about the screening test and increase Pap smear seeking behaviors in the long term.
    International Quarterly of Community Health Education 01/2010; 31(3):245-63. DOI:10.2190/IQ.31.3.d
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