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DELAYS IN CARE FOR ABNORMAL PAP SMEARS AMONG HISPANICS

西班牙裔子宫颈抹片检查异常的延误治疗

基本信息

批准号：
6208464
负责人：
KARIN M. NELSON
金额：
$ 4.26万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-08-01 至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/6208464
关键词：
Hispanic Americans behavioral /social science research tag belief cervical /vaginal smear clinical research female health behavior health care service utilization health services research tag human subject questionnaires therapy compliance women's health

项目摘要

Hispanic women have lower rates of follow-up for abnormalities found on routine Pap smear screening than their white counterparts. Health beliefs may influence adherence behavior for follow-up of abnormal cervical cytology but to date no studies have addressed this question among Hispanic women. SPECIFIC AIMS: 1.) To determine if health beliefs and cancer knowledge differ between Hispanic and white women. 2.) To determine if culturally defined beliefs about illness and cancer influence delays in follow up for abnormalities on Pap smear among Hispanic women. METHOD: We will perform a retrospective cohort study drawn from patients followed by the Dysplasia Registry at Kaiser Sunset. At Kaiser, very few patients are lost to follow-up, but there is a significant failure rate for clinic appointments. All women with abnormal Pap smears during the study period will be mailed a brief questionnaire. In addition to demographic characteristics, survey questions will ascertain beliefs about health, risk of disease, and cancer knowledge. MAIN OUTCOME MEASURE: Delays in care, defined as failing the first scheduled clinic visit to follow up on an abnormal Pap smear. SIGNIFICANCE: This study will provide information about how health beliefs and cancer knowledge impact patient adherence among white and Hispanic women. This information will be utilized to design and test an intervention to decrease failure rates for clinic visits, in addition to increasing knowledge about how health beliefs may impact care. In the Kaiser system, failed clinic appointments create service delivery problems and require additional labor by the Registry staff to reschedule follow-up. In many less organized health care settings such as public facilities where a substantial number of Hispanic women receive care, a failed appointment for management of an abnormal Pap smear may lead to missed cases of cervical cancer and a greater likelihood of presenting with advanced disease.

与白人女性相比，西班牙裔女性在常规子宫颈抹片检查中发现异常情况后的随访率较低。健康信念可能会影响宫颈细胞学异常随访的依从行为，但迄今为止，还没有研究解决西班牙裔女性中的这个问题。具体目标： 1.) 确定西班牙裔女性和白人女性的健康信念和癌症知识是否存在差异。 2.) 确定文化上对疾病和癌症的信念是否会影响西班牙裔女性子宫颈抹片检查异常的随访延误。方法：我们将对患者进行一项回顾性队列研究，然后在 Kaiser Sunset 进行发育异常登记。在 Kaiser，很少有患者失访，但诊所预约的失败率很高。所有在研究期间子宫颈抹片检查异常的女性都将收到一份简短的调查问卷。除了人口特征外，调查问题还将确定有关健康、疾病风险和癌症知识的信念。主要结果指标：护理延误，定义为未能对异常子宫颈抹片检查进行跟进的首次预约门诊就诊。意义：本研究将提供有关健康信念和癌症知识如何影响白人和西班牙裔女性患者依从性的信息。除了增加有关健康信念如何影响护理的知识外，这些信息还将用于设计和测试干预措施，以降低就诊失败率。在凯撒系统中，失败的诊所预约会造成服务提供问题，并需要登记处工作人员额外的人力来重新安排随访时间。在许多组织较差的医疗保健机构中，例如大量西班牙裔妇女接受护理的公共机构，未能预约处理异常子宫颈抹片检查可能会导致漏诊宫颈癌病例，并更有可能出现晚期疾病。