Cervical Cancer Control in Vietnamese Women

描述(申请人提供)：越南裔美国女性的浸润性宫颈癌发病率高于其他种族/民族(43/10万，而非拉美裔白人女性为8/10万)。此外，大约25%的越南妇女从未接受过巴氏涂片检查(相比之下，非拉丁裔白人妇女的这一比例为5%)。美国国立卫生研究院关于宫颈癌的共识发展小组建议，资助的优先事项应包括以少数族裔人口和从未做过巴氏涂片检查的妇女为重点的研究。 我们之前已经为越南妇女开发了一种在文化和语言上合适的宫颈癌控制外展干预措施，并证明了其在项目交付方面的可接受性和可行性。我们的主要目标是评估我们的外展干预措施在增加从未接受筛查的越南妇女接受巴氏杆菌检测方面的有效性。次要目标如下：检查干预措施在提高宫颈癌和巴氏检测知识方面的有效性；记录该计划的成本；并评估干预措施的成本效益。 将进行随机对照试验。试验参与者将包括250名年龄在20-79岁之间的越南裔美国女性，她们从未接受过宫颈癌筛查。这些妇女将通过对1000个越南家庭的社区调查来确定。参与者将被单独随机分配到干预或对照状态。双语、双文化的越南妇女将在干预部门向妇女提供宫颈癌控制外展干预。干预措施将包括家访、跟踪电话、使用视频和小册子，以及量身定做的咨询和后勤援助。结果评估将基于后续调查以及自我报告的巴氏试验的病历核实。 如果有效和具有成本效益，我们的宫颈癌控制干预措施可以纳入医疗保健机构和服务于越南裔美国人的社区组织开展的外联计划，以及国家乳腺癌和宫颈癌早期检测计划。

DESCRIPTION (provided by applicant): Vietnamese American women have higher rates of invasive cervical cancer than any other racial/ethnic group (43 per 100,000 compared to 8 per 100,000 among non-Latina white women). Further, approximately 25% of Vietnamese women have never received a Pap smear (compared to 5% of non-Latina white women). The National Institutes of Health Consensus Development Panel on cervical cancer has recommended that funding priorities should include research focusing on racial/ethnic minority populations and women who have never had a Pap smear. We have previously developed a culturally and linguistically appropriate cervical cancer control outreach intervention for Vietnamese women, and documented its acceptability and feasibility in terms of program delivery. Our primary objective is to evaluate the effectiveness of our outreach intervention in increasing the uptake of Pap testing among never screened Vietnamese women. Secondary objectives are as follows: to examine the effectiveness of the intervention in improving knowledge about cervical cancer and Pap testing; to document the costs of the program; and to assess the cost-effectiveness of the intervention. A randomized controlled trial will be conducted. Trial participants will include 250 Vietnamese American women, aged 20-79 years, who have never been screened for cervical cancer. These women will be identified from a community-based survey of 1,000 Vietnamese households. Participants will be individually randomized to intervention or control status. Bilingual, bicultural Vietnamese women will deliver the cervical cancer control outreach intervention to women in the intervention arm. The intervention will include home visits, follow-up telephone calls, use of a video and pamphlet, and tailored counseling and logistic assistance. Outcome evaluation will be based on a follow-up survey as well as medical record verification of self-reported Pap testing. If effective and cost-effective, our cervical cancer control intervention could be incorporated into outreach programs conducted by health care facilities and community-based organizations serving Vietnamese Americans, as well an the national Breast and Cervical Cancer Early Detection Program.