Sexual Health Empowerment for Cervical Health Literacy and Cancer Prevention

描述（由申请人提供）：刑事司法系统中的妇女患宫颈癌的可能性是非监禁妇女的四到五倍。在我们以前的研究中，我们发现宫颈癌风险的最重要因素，也许是缺乏后续行动，是被监禁妇女对更广泛的生殖健康问题的健康素养低。在我们有效解决被监禁妇女独特的生殖健康知识需求之前，被监禁妇女和非被监禁妇女之间的宫颈癌健康差距将持续存在。本研究的目的是评估性健康赋权（SHE项目）干预措施的有效性，以提高宫颈健康知识，减少与宫颈癌信念相关的筛查障碍，提高导航提供者和医疗保健系统的自我效能，并最终努力预防宫颈癌。这一目标是响应PAR-10-133，因为它制定了一项干预战略，以解决健康知识普及和弱势人口更广泛的健康成果。为了达到本研究的目的，我们建议评估的影响，性健康赋权干预（SHE项目）对宫颈健康知识;筛查的障碍，有关宫颈癌的信念，自我效能的筛查和后续的妇女离开监狱。更具体地说，我们将使用等待列表控制设计，从基线到为期一周的干预结束进行干预前和干预后评估。接下来，我们将使用为期三年的观察性研究设计，采用调查和人种学方法进行随访，以了解知识，信念，自我效能和其他因素如何随着时间的推移改变释放后的宫颈健康预防行为。这种方法将使我们能够观察女性在临床实践中增加知识、减少障碍和提高自我效能的程度，或者其他因素是否能解释健康行为。这项研究的公共卫生影响是它有可能降低宫颈癌发病率和死亡率的高风险和弱势群体的妇女。我们开发一种有效且易于传播的健康知识干预措施，可以适应许多健康状况，并在机构化人群（监狱，监狱，社区矫正，军事机构）中开展更广泛的癌症预防工作，这将对公共卫生产生影响，也会对 制定有效的健康知识干预措施的科学。

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. In our previous research, we found that the most important contributor to cervical cancer risk, and perhaps lack of follow-up, is incarcerated women's low health literacy about broader reproductive health issues. Until we effectively address incarcerated women's unique reproductive health literacy needs, the cervical cancer health disparity between incarcerated and non-incarcerated women will persist. The objective of this study is to assess the effectiveness of a sexual health empowerment (SHE Project) intervention to improve cervical health knowledge, reduce barriers to screening that are related to beliefs about cervical cancer, improve self-efficacy for navigatin providers and health care systems, and ultimately work towards preventing cervical cancer. This objective is responsive to PAR-10-133 in that it develops an intervention strategy to address health literacy and broader health outcomes in a vulnerable population. To meet the objectives of this study, we propose to assess the impact of a sexual health empowerment intervention (SHE Project) on cervical health knowledge; barriers to screening that are related to beliefs about cervical cancer, and self-efficacy for screening and follow-up among women leaving jail. More specifically, we will conduct a pre- and post-intervention assessment from baseline to the end of a weeklong intervention using a wait-list control design. Next, we will use a three-year observational study design employing both survey and ethnographic methods for follow-up, to understand how knowledge, beliefs, self-efficacy, and other factors change post-release cervical health prevention behaviors over time. This approach will allow us to observe the extent to which women translate, if at all, increased knowledge, reduced barriers, and increased self-efficacy into practice during clinical encounters, or if other factors explain health behaviors ove time. The public health impact of this study is its potential to reduce cervical cancer morbidity and mortality for this high risk and vulnerable group of women. Our development of an effective and easily disseminated health literacy intervention that can be adapted to many health conditions and broader cancer prevention efforts in institutionalized populations (jails, prisons, community corrections, military institutions) will have an impact on public health, and also on the science of developing effective health literacy interventions.