A multifaceted intervention to increase cervical cancer screening among underserved Korean women
A multifaceted intervention to increase cervical cancer screening among underserved Korean women
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DOI：
10.1158/1055-9965.epi-07-0091
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发表时间：
2007-06-01
影响因子：
3.8
通讯作者：
Chi, Nungja
中科院分区：
文献类型：
--
作者：
Fang, Carolyn Y.;Ma, Grace X.;Chi, Nungja
目的：尽管已证明与宫颈癌筛查相关的生存益处，但巴氏试验的使用在某些人群亚组中仍然是次优的，例如在面临相当大的筛查障碍的韩裔美国妇女中。因此，我们评估了一个多方面的干预措施，结合心理教育咨询与患者导航，以解决心理和访问障碍screening.Method：妇女（n = 102）从韩国社区中心招募，并分配到干预或控制条件。干预组接受由韩语双语健康教育者提供的宫颈癌教育和患者导航。对照组接受一般健康教育，内容包括宫颈癌知识和筛查知识。在基线和干预后进行评估。筛查行为在6个月postintervention.Results评估：在基线，17%的参与者报告有一个巴氏试验在前一年。在干预后6个月，干预组83%的妇女获得了筛查，而对照组为22%，卡方（2）（1）= 41.22，P < 0.001。多因素Logistic回归分析表明，参与干预与筛查相关（P < 0.001）。减少心理障碍（例如，结论：通过对患者进行教育、导航培训和协助的综合干预，提高了筛查率。多方面的方法可以有效地减少心理社会，访问和语言障碍，有助于癌症的健康差距在服务不足的人群。
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, chi(2)(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.