Understanding the Cervical Cancer Health Gap for Women in Jail

描述（由申请人提供）：刑事司法系统中的女性患宫颈癌的可能性是非监禁女性的4 - 5倍。一些人将这种差异归因于异常Pap随访的困难，但很少有经验知道为什么涉及刑事司法系统的妇女Pap异常随访率低。这项应用的目的是双重的：从监禁妇女的角度理解Pap异常事件及其后续随访的解释；其次，根据对女性医疗记录的回顾，解释女性的异常Pap事件和随访。通过对医学图表的审查，对妇女的异常子宫颈抹片随访（或缺乏随访）的描述进行验证，将有助于理解为什么有些妇女没有获得随访护理。因此，我们将能够有针对性的干预措施，以解决妇女对Pap异常事件与实际事件的理解差距。为了实现这一目标，首先，我们将对堪萨斯城县监狱中的40名妇女进行焦点小组和深入访谈，了解异常子宫颈涂片检查和随后的随访事件。研究异常pap的妇女的经历和随访可以提供线索，了解她们的宫颈癌筛查知识，以及考虑到她们进出监狱的情况，她们实际寻求宫颈癌预防服务的过程。其次，我们将要求之前接受采访的40名妇女允许查阅她们的医疗记录，以调查被监禁妇女对异常Pap和随访事件的自我报告是否与这些事件的实际医疗记录相符。这一目标将使我们能够衡量妇女对子宫颈抹片事件的理解，验证妇女在试图获得随访护理时面临的医疗障碍，并证明通过对这一高危人群的医疗图表审查来评估卫生保健获取的可行性。该项目通过深入了解如何解决涉及刑事司法系统的妇女的子宫颈癌负担，对公共卫生影响具有重要意义。这个项目的创新之处在于，它的目标是评估在押妇女对宫颈异常事件的理解，并通过医疗记录审查来验证她们的理解。研究结果将有助于制定一项干预措施，试图缩小参与刑事司法系统的妇女与她们在“自由”世界中的姐妹之间的宫颈癌健康差距。

DESCRIPTION (provided by applicant): Women in the criminal justice system are four-five times as likely to have cervical cancer compared to non- incarcerated women. Some have attributed this disparity to difficulty in follow-up of abnormal Paps, but little is known empirically about why women involved in the criminal justice system have low abnormal Pap follow-up rates. The objective of this application is two-fold: to understand the interpretation of abnormal Pap events and their subsequent follow-up from the perspective of incarcerated women; second, to interpret women's abnormal Pap events and follow-ups based on a review of their medical records. The validation of women's accounts of abnormal Pap follow-up (or lack thereof) with medical chart review will provide an understanding as to why some women do not gain access to follow-up care. Thus, we will be able target interventions to address this documented gap in women's understanding of abnormal Pap events versus actual events. To meet this objective, first we will conduct focus groups and in-depth interviews with 40 women in a Kansas City county jail about abnormal Pap screening and subsequent follow-up events. Studying women's experiences with abnormal Paps and follow-up may provide clues as to their cervical cancer screening knowledge and the processes by which women actually seek out cervical cancer prevention services given their movement in and out of jails. Second, we will ask the 40 women previously interviewed for permission to access their medical records, in order to investigate whether incarcerated women's self-report of abnormal Pap and follow-up events matched actual medical records of these events. This aim will allow us to gauge women's understanding of Pap events, validate the medical barriers that women faced in trying to gain access to follow- up care, and demonstrate the feasibility of assessing health care access through medical chart review for this high-risk population. This project has significance for public health impact by providing insight into how to address the cervical cancer burden for women involved in the criminal justice system. This project is innovative in its goal of assessing incarcerated women's understanding of abnormal Pap events and validating their understanding with medical record review. Study findings will contribute to the development of an intervention that attempts to close the cervical cancer health gap between women involved in the criminal justice system and their sisters in the "free" world.