基于证据的干预措施，以减少服务不足的华裔美国妇女接受宫颈癌筛查的障碍。
Evidence-based intervention to reduce access barriers to cervical cancer screening among underserved Chinese American women.
机构信息
Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, Pennsylvania, USA.
出版信息
J Womens Health (Larchmt). 2010 Mar;19(3):463-9. doi: 10.1089/jwh.2009.1422.
OBJECTIVE
The primary objective of the present study was to evaluate the effects of a community-based pilot intervention that combined cervical cancer education with patient navigation on cervical cancer screening behaviors among Chinese American women residing in New York City.
METHODS
Chinese women (n = 134) who had not had a Pap test within the previous 12 months were recruited from four Asian community-based organizations (CBOs). Women from two of the CBOs received the intervention (n = 80) consisting of education, interaction with a Chinese physician, and navigation assistance, including help in identifying and accessing free or low-cost screening services. The control group (n = 54) received education delivered by Chinese community health educators and written materials on general health and cancer screening, including cervical cancer, the Pap test, and information about sites that provided free screening. Study assessments were obtained in-person at baseline and postintervention. Screening behavior was self-reported at 12-month postintervention and verified by medical staff.
RESULTS
In the 12-month interval following the program, screening rates were significantly higher in the intervention group (70%) compared to the control group (11.1%). Hierarchical logistic regression analyses indicated that screening behavior was associated with older age (OR = 1.08, 95% CI = 1.01-1.15, p < .05). In addition, women with poorer English language fluency (OR = 0.30, 95% CI = 0.10-0.89, p < .05) and who did not have health insurance were less likely to obtain screening (OR = 0.15, 95% CI = 0.02-0.96, p < .05). Among health beliefs, greater perceived severity of disease was positively associated with screening behavior (OR = 4.26, 95% CI = 1.01-18.04, p < .05).
CONCLUSIONS
Community-based programs that provide combined education and patient navigation may be effective in overcoming the extensive linguistic and access barriers to screening faced by Chinese American women.
目的
本研究的主要目的是评估一项基于社区的试点干预措施的效果，该措施将宫颈癌教育与患者导航相结合，以改变居住在纽约市的华裔美国女性的宫颈癌筛查行为。
方法
从四个亚裔社区组织（CBO）招募了过去 12 个月内未进行巴氏涂片检查的华裔女性（n=134）。CBO 中的两个组织中的女性（n=80）接受了干预，包括教育、与华裔医生互动以及导航协助，包括帮助识别和获取免费或低成本的筛查服务。对照组（n=54）接受了由华裔社区健康教育者提供的教育以及有关一般健康和癌症筛查（包括宫颈癌、巴氏涂片检查以及提供免费筛查的场所信息）的书面材料。在基线和干预后进行了研究评估。在干预后 12 个月时通过自我报告获得了筛查行为，由医务人员进行了核实。
结果
在项目实施后的 12 个月内，干预组的筛查率（70%）明显高于对照组（11.1%）。分层逻辑回归分析表明，筛查行为与年龄较大（OR=1.08，95%CI=1.01-1.15，p<.05）相关。此外，英语语言流利程度较差的女性（OR=0.30，95%CI=0.10-0.89，p<.05）和没有医疗保险的女性获得筛查的可能性较低（OR=0.15，95%CI=0.02-0.96，p<.05）。在健康信念方面，对疾病严重程度的感知越大与筛查行为呈正相关（OR=4.26，95%CI=1.01-18.04，p<.05）。
结论
提供综合教育和患者导航的基于社区的计划可能有助于克服华裔美国女性在筛查方面面临的广泛语言和获取障碍。
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