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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    Full-text · Article · Nov 2013 · PLoS ONE
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    • "Needs assessment data may come from the literature, behavioral theories, and new data collection. To better understand why Hispanic women, especially those on the U.S.–Mexico border, were not being screened for cervical cancer, the AMIGAS research team (the university researchers and research assistants) completed a review of the literature, and conducted 13 focus groups (representing age categories: 18-25 years, 26-39 years, and ≥40 years) with 84 Hispanic women from El Paso (Byrd, Chavez, & Wilson, 2007). Results of the focus groups confirmed the content validity of existing survey instruments, informed the use of local vocabulary regarding cervical cancer, perceptions about risk for cancer, and benefits versus barriers to screening, and identified preferences about types of interventions and methods of intervention delivery. "
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    ABSTRACT: Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican origin. AMIGAS was developed with the participation of the community using intervention mapping (IM). Following the IM process, the authors completed a needs assessment, development of program objectives, selection of intervention methods and strategies, and program design. A benefit of IM is its linkage with community-based participatory research as it includes engagement of community members to identify and refine priority areas. The success of this strategy suggests it a useful tool for other populations. The resulting intervention program is currently being tested for efficacy and cost-effectiveness in three sites: El Paso, Texas; Houston, Texas; and Yakima, Washington.
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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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