Paper
Friday, July 23, 2004
Barriers and Motivators on Re-attendance of Cervical Cancer Screening
Miok Catherine Lee, RN, EdD, CS, ANP, Hunter-Bellevue School of Nursing, The Schools of the Health Professions, Hunter-Bellevue School of Nursing, The Schools of the Health Professions, Hunter College, The City University of New York, New York, NY, USA
| Learning Objective #1: Identify the major barriers on re-attendance of cervical cancer screening among low-income minority women |
| Learning Objective #2: Identify the motivators on re-attendance of cervical cancer screening among low-income minority women |
Objective:Cervical cancer is preventable and curable with 5-year survival rate of nearly 100% if diagnosed in precancer stage with a Pap test. Korean-American women showed low rates of initial screening using Pap test and substantial number not returning for annual follow up. The purpose of the study was to explore influencing factors in these women’s decision process of not to return as well as to return for follow-up Pap test. Design: The qualitative design with focus group approach was used with a purposeful sampling method. The Health Belief Model was the conceptual base of the study. Sample and Setting: The sample was drawn from the Korean women, who participated in either annual Korean Health Fair or Cervical Cancer Early Detection Program during 2000 in New York City. All participants were 40 or older, immigrants, have low income and no health insurance. Concepts: The study explored and identified the influencing factors in follow-up Pap test, specifically barriers, motivators along with risk perceptions and knowledge of cervical cancer. Methods: Seven focus groups -- 4 nonfollow-ups and 3 follow-ups were conducted using 12 guiding questions based on HBM from January 2003 to May 2003. All sessions were taped, transcribed, translated into English and analyzed thematically using Nudist V software, and triangulated by another consultant making conceptual maps. Findings: The major barriers were service quality at clinics-long waits and crowds and humility, embarrassments, no time and money, lack of knowledge, and low concern for preventive health. Motivators were free cost, reminder card, illness experiences, peer involvements, and high concern for health. Conclusion: Psychological barriers were negative predictors as much as socioeconomic barriers in screening for cervix cancer in Korean-American Women. Implications: The findings will help advance practice nurses to design and implement appropriate interventions for these women to participate in annual cervical cancer screening.
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