Sexual Health Empowerment for Cervical Health Literacy and Cancer Prevention

摘要 刑事司法系统中的女性患宫颈癌的可能性是非女性的4-5倍 被监禁的女性。在我们之前的研究中，我们发现导致宫颈癌的最重要的因素 风险，也许是缺乏后续跟进，是监禁妇女关于更广泛的生殖的低健康素养 健康问题。在我们有效地解决被监禁妇女独特的生殖健康知识需求之前， 被监禁和未被监禁的妇女之间的宫颈癌健康差距将持续存在。 这项研究的目的是评估性健康赋权(SHE项目)的有效性 提高宫颈健康知识的干预措施，减少筛查的障碍 宫颈癌，提高导航提供者和医疗保健系统的自我效能，并最终发挥作用 致力于预防宫颈癌。该目标响应PAR-10-133，因为它制定了 实施干预战略，解决弱势群体的健康素养和更广泛的健康结果问题。 为了达到这项研究的目标，我们建议评估性健康赋权的影响 宫颈健康知识干预(SHE项目)，筛查障碍与信念有关 宫颈癌，以及对出狱妇女进行筛查和随访的自我效能。更具体地说，我们 将从基线到为期一周的干预结束进行干预前和干预后评估，使用 等待列表控件设计。接下来，我们将使用一项为期三年的观察性研究设计，同时使用调查和 采用民族志方法进行追踪，了解知识、信念、自我效能感等因素 随着时间的推移，改变出院后的宫颈健康预防行为。这种方法将使我们能够观察到 女性在多大程度上增加了知识，减少了障碍，提高了自我效能 在临床接触期间付诸实践，或者如果其他因素解释随着时间的推移的健康行为。 这项研究对公众健康的影响是它有可能降低宫颈癌的发病率和死亡率 高危和脆弱的妇女群体。我们发展了一种有效和易于传播的健康 扫盲干预，可以适应许多健康状况和更广泛的癌症预防工作 机构化人口(监狱、监狱、社区惩教、军事机构)将对 公共卫生，以及制定有效的卫生知识干预措施的科学。

ABSTRACT 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 navigating 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 over 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.