01.09.2005
Race and Ethnic Disparities in Cervical Cancer Screening in a Safety-Net System
Erschienen in: Maternal and Child Health Journal | Ausgabe 3/2005
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Objectives: The three objectives of this
research were: 1) to examine the use of Pap smear tests among
low-income women, including minority and immigrant women who were
patients in a safety-net healthcare system; 2) to identify policy
relevant variables that could lead to changes in use of Pap smear
screening services for these women; and 3) to contribute to the
literature on use of Pap smear screening, especially among minorities
and immigrants. The Behavioral Model for Vulnerable Populations was
used as the theoretical framework. Methods: Pap smear screening predictors were
examined using telephone interviews with a random sample of women aged
18–60, including 465 Non-Hispanic Whites, 285 African
Americans, 164 Hispanic Americans, and 256 Hispanic immigrants,
enrolled in a safety-net healthcare system in Texas in Fall
2000. Binary logistic regression analysis was used. Results: The research revealed that
Non-Hispanic Whites were most likely to have been screened ever and in
the past 3 years, followed by African Americans, Hispanic immigrants,
and Hispanic Americans. Among Hispanics, immigrants were most likely
to have had Pap smear screening, supporting the “healthy
immigrant hypothesis.” Older women were most likely to have
ever been screened, with younger women, most likely in the past
year. Having a usual source of healthcare and a checkup for current
pregnancy increased screening, while competing needs (food, clothing,
housing) affected screening negatively. Conclusions: Culturally competent,
community-based care for women is needed to increase Pap smear
screening among minority groups, especially Hispanic immigrant and
Hispanic American women.
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