Valdez Armando, Napoles Anna M, Stewart Susan L, Garza Alvaro
HealthPoint Communications Institute, 10 Jordan, Avenue Los Altos, CA, 94022, USA.
University of California, San Francisco, San Francisco, CA, 94143, USA.
J Cancer Educ. 2018 Feb;33(1):222-230. doi: 10.1007/s13187-016-1102-6.
US Latina women experience disproportionately high cervical cancer incidence and mortality rates. These health disparities are largely preventable with routine pap tests and human papillomavirus (HPV) screening. This study tested the efficacy of a cervical cancer education intervention to improve risk factor knowledge, attitudes, self-efficacy, and self-reported behavior related to cervical cancer screening among low-income Latinas who had not been screened in the past 2 years, compared to a usual care control group. Low-income Latinas who had not had a pap test in the prior 2 years were recruited from three Federally Qualified Health Centers and randomly assigned to intervention and control groups, with in-person assessment at baseline and 6-month follow-up. Women in the intervention group received a one-time low-literacy cervical cancer education program through an interactive, multimedia kiosk in either English or Spanish based on their language preference. Compared to the control group, the intervention group demonstrated greater knowledge (p < 0.0001) and more favorable attitudes at follow-up; fewer intervention group women never thought of getting a pap test (46 vs. 54 %, p = 0.050) or agreed that it is fate whether a woman gets cervical cancer or not (24 vs. 31 %, p = 0.043). The groups did not differ significantly on the proportion who had obtained or made an appointment for a pap test at follow-up (51 vs. 48 %, p = 0.35). Both groups reported high levels of self-efficacy regarding pap screening at post-intervention. A one-time interactive, multimedia educational intervention improved cervical cancer knowledge and attitudes among low-income Latinas but had no effect on cervical cancer-screening behavior. Exposure of the control group to the pre-test conducted on the multimedia kiosk may have influenced their screening behavior.
美国拉丁裔女性宫颈癌发病率和死亡率高得不成比例。通过常规巴氏试验和人乳头瘤病毒(HPV)筛查,这些健康差距在很大程度上是可以预防的。本研究测试了宫颈癌教育干预措施的效果,以提高过去两年未接受筛查的低收入拉丁裔女性与宫颈癌筛查相关的风险因素知识、态度、自我效能和自我报告行为,并与常规护理对照组进行比较。过去两年未进行巴氏试验的低收入拉丁裔女性从三个联邦合格健康中心招募,并随机分为干预组和对照组,在基线和6个月随访时进行面对面评估。干预组的女性根据其语言偏好,通过互动式多媒体信息亭接受了一次低识字水平的宫颈癌教育项目,信息亭使用英语或西班牙语。与对照组相比,干预组在随访时表现出更多的知识(p < 0.0001)和更积极的态度;干预组中从未想过进行巴氏试验的女性更少(46%对54%,p = 0.050),或者同意女性是否患宫颈癌是命中注定的女性更少(24%对31%,p = 0.043)。两组在随访时进行或预约巴氏试验的比例没有显著差异(51%对48%,p = 0.35)。两组在干预后都报告了对巴氏筛查的高度自我效能感。一次性互动式多媒体教育干预提高了低收入拉丁裔女性的宫颈癌知识和态度,但对宫颈癌筛查行为没有影响。对照组接触多媒体信息亭上进行的预测试可能影响了她们的筛查行为。