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.

与白人同行相比，西班牙裔妇女的随访率较低。健康信念可能会影响依从性行为，以对异常宫颈细胞学的随访，但迄今为止，在西班牙裔妇女中尚无研究解决这个问题。具体目的：1。）确定西班牙裔和白人妇女之间的健康信念和癌症知识是否有所不同。 2.）确定对疾病和癌症的文化定义的信念是否影响了西班牙裔妇女的子宫颈抹片检查异常的后续延迟。方法：我们将进行一项回顾性队列研究，该研究由患者进行，然后是Kaiser Sunset的发育不良注册中心。在凯撒（Kaiser），很少有患者因随访而丢失，但是诊所任命的失败率很高。在研究期间，所有患有异常子宫颈抹片检查的妇女都将邮寄简短的问卷。除了人口特征外，调查问题还将确定对健康，疾病风险和癌症知识的信念。主要结局指标：护理延迟，定义为失败的第一次预定诊所就诊，无法进行异常的子宫颈抹片检查。意义：这项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妇女的依从性的信息。除了增加有关健康信念如何影响护理的知识之外，此信息将用于设计和测试干预措施以降低临床访问的失败率。在Kaiser系统中，诊所任命失败会造成服务交付问题，并要求注册表人员进行额外的劳动来重新安排随访。在许多组织较少的医疗保健环境中，例如大量西班牙裔妇女获得护理的公共设施，用于管理异常子宫颈抹片检查的任命失败可能会导致错过宫颈癌病例，并更大的可能出现晚期疾病。