Hispanic women in Texas show higher cervical cancer incidence rates as compared to all women in the United States. The rate of cervical cancer in the United States has reduced mostly due to regular cervical cancer screening. However, high cervical cancer among Hispanics in Texas may reflect low cervical cancer screening. The purpose of this quantitative study was to examine the insurance status (independent variable) and cervical cancer screening (dependent variable) among low-income Hispanic women, living in Texas Health Service Regions (HSRs), after controlling for age, marital status, and personal health care provider. The theoretical framework used in this study was the health belief model. Nine hundred and fifteen Hispanic women living in Texas HSRs, ages 21-65 years and who participated in Texas BRFSS 2015-2017, were the sample for this study. Univariate analysis was performed to obtain frequencies and percentages of all covariates. A Chi-square was conducted to determine if there was an association between any of the independent and the dependent variable and binomial logistic regression was used to answer the hypotheses. The findings from this study revealed no relationship with cervical cancer screening and the level of education. However, insurance status and income were statistically significant on receiving a Pap test among low-income Hispanic women in Texas HSRs (p

A mini-dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Nursing, Technikon Natal, 2002. / Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1:40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening. policyand-. programme was implemented in the province. The KZN Department of Health and the Sub-Directorate Maternal, Child and. Women's Health needed to know what was happening currently in terms of implementation of the cervical screening programme since it was first implemented three years ago. Therefore, the purpose of the study was to evaluate the implementation of the Provincial Cervical Screening Programme in selected Primary Health Care clinics in lIembe Region, KZN. This study took the form of formative evaluation research. The target population consisted of PHC clinics in KZN that have implemented the cervical screening policy and the programme. The accessible population for this study consisted of the clinics in the lIembe Region. A four-stage selection plan was applied to select the sample from the accessible population. The first stage involved a random selection of two clinics from an urban area and two from a rural area. Within each of the selected clinics, three types of evidence for the evaluation of the implementation of the cervical screening programme were sampled. Therefore, the second stage of the plan was the selection of records. A purposive sample of all records of clients who were diagnosed with abnormal smears was assessed. The third stage involved the selection of all Professional Nurses from each of the selected clinics. Lastly, the fourth stage involved the selection of the day for collecting data on the facilities and resources. The sources of evidence that were used to evaluate the implementation of cervical screening programme by the clinics were non-participant observation, which involved clinic audit, a review of abnormal smear records and self-reports from nurses regarding the cervical screening programme. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. The researcher also found that nurses lacked knowledge regarding the indications for taking smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. There was lack of necessary resources such as telephones needed to do proper follow-up. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results also indicated thatthe mechanisms of record keeping were poor. Nurses were of the opinion that women should have their first Pap smear at the age of 20 and thereafter at intervals of five years, once they start to be sexually active because of the high rate of sexually transmitted infections and HIV/AIDS in KZN. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme. / M

Background: Screening for breast and cervical cancers is important because early detection increases cancer survival. Since 1991, the U.S. government has helped finance a national early detection program for breast and cervical cancer among uninsured low-income women, known in Virginia (VA) as Every Woman's Life (EWL).Objectives: This study aims to determine whether there are differences in the prevalence of breast and cervical cancer screening based on insurance coverage, assess the prevalence of screening by health district, and evaluate the ability of EWL to effectively reach its target population.Methods: Cross-sectional data from the 2005 Behavioral Risk Factor Surveillance System survey were analyzed. Using population weights, descriptive statistics were generated and multiple regression was performed to assess the association between insurance coverage and screening prevalence among VA women 40 to 64 years of age (n=1,627). Adjusted screening prevalence by health district was also calculated. EWL client (n=4,959) and provider data from the VA Department of Health was obtained to create screening density maps with Geographic Information Systems.Results: After adjustment, women with insurance were significantly more likely to have a mammogram within the last two years compared to those without insurance (78% vs. 50%, pConclusion: The results of this study will be used to assist EWL in recruitment of additional screening and/or diagnostic sites in underserved areas of Virginia.

Orientador: Maria de Lourdes da Silva Marques Ferreira / Banca: Maria José Sanches Marin / Banca: Silvia Franco da R. Tonhom / Resumo: Introdução: O câncer de colo do útero é a terceira neoplasia maligna mais comum entre as mulheres no Brasil. Uma das formas de prevenção, assim como da detecção precoce da doença é iniciada na rede de atenção básica com a realização do exame Papanicolaou. Objetivo: Apreender a percepção de mulheres sobre a prevenção do câncer de colo uterino por meio da citologia oncótica, visando a elaboração de material educativo. Método: Trata se de um estudo com abordagem qualiquantitativo, realizada com vinte mulheres que procuraram uma Unidade Básica de Saúde de um município do interior paulista para realização do exame Papanicolaou. Para a coleta de dados foi utilizada a entrevista áudio gravada e a análise foi feito por meio do método do discurso do sujeito coletivo (DSC) e sustentado pela representação social. Resultados: Os DSCs foram construídos por meio das falas expressadas pelas participantes e agrupados em três temas, o tema um contemplou a percepção das mulheres em relação ao exame de Papanicolaou que relataram os sentimentos e a vulnerabilidade envolvida no exame, os significados, a falta de conhecimento e as dúvidas em relação ao exame. O tema dois compreendeu a participação e as experiências das mulheres na prevenção do câncer de colo de útero que narraram ter participação ativa em relação a prevenção e a periodicidade do exame. O tema três revela que a participação do serviço público na realização do exame é boa e posto como obrigatória, o desejo da consulta medica com o ginecologista e da ampliação dos dias e horários da coleta foram relatados pelas participantes. Conclusão: Observou-se que as ideias e os pensamentos das mulheres envolvidas neste estudo valorizam e se preocupam com a realização do exame, mais ainda existe falta de conhecimento e dúvidas em relação a prevenção... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cervical cancer is the third most common malignant neoplasm among women in Brazil. One of the forms of prevention, as well as the early detection of the disease are initiated in the primary care network with the Papanicolaou examination. Purpose: To understand the perception of women about the prevention of cervical cancer through oncotic cytology, aiming at the elaboration of educational material. Method: This was a study with a qualitative approach, performed with twenty women who sought a Basic Health Unit in a city in the interior of São Paulo to perform the Pap smear test. For the data collection the recorded audio interview was used and the analysis was done through the collective subject discourse (DSC) method and sustained by social representation. Results: The CSDs were constructed using the speeches expressed by the participants and grouped into three themes, the theme one considered the perception of women in relation to the Pap smear, which reported the feelings and vulnerability involved in the examination, the meanings, the lack of Knowledge and doubts regarding the examination. Topic two comprised the participation and experiences of women in cervical cancer prevention who reported having an active participation in the prevention and periodicity of the examination. Topic three reveals that the participation of the public service in the accomplishment of the examination is good and it becomes mandatory, the desire of the medical consultation with the gynecologist and the extension of the days and times of the collection were reported by the participants. Conclusion: It was observed that the ideas and thoughts of the women involved in this study value and care about the test, but there is still a lack of knowledge and doubts regarding the prevention of cervical cancer. Product: Understanding the need for educational strategies with the... (Complete abstract electronic access below) / Mestre

Cervical cancer is the fifth most common cancer in United States with more than 12,000 women diagnosed each year and more than 4,000 preventable deaths with minorities disproportionally represented. Cervical cancer prevention strategies rarely focus on the management of abnormal screening results. The purpose of this quality improvement project was to standardize the management program for abnormal cervical cancer screening results within an integrated health delivery system serving a large minority community. The Plan-Do-Study-Act model guided a comprehensive program evaluation with process improvement, including the creation of an electronic quality data reporting tool to formalize the work process and a quality control and assurance program with exception reports. The evaluation was completed with data to measure the timeliness of abnormal results outreach and continued clinical management. The data were evaluated over time with run charts. Also, an analysis of the data was done through pre- and post-test comparisons with 2-sample t tests to evaluate abnormal cervical cancer screening management before and after the revisions. Although the project did not show a statistically significant difference in the timeliness of outreach and follow-up of abnormal cervical cancer screening results due to the limited data set, the run charts trended positively for timeliness and consistent data reporting with no missed screening reports. Effective cervical cancer screening includes the accurate and timely management of abnormal results to reduce disparities in cervical cancer deaths. This project contributes to positive social change by responding to the Healthy People 2020 goal to reduce the incidence of cervical cancer deaths through a formal process to insure timely intervention for abnormal results in a largely minority community.

In 2015, there were 257,524 women with cervical cancer (CC) in the United States (U.S.). CC is preventable; screening detects early-stage cancer when treatment is most successful. This study aimed to identify predictors for CC screening adherence among U.S. women, describe predictors for screening adherence by marital status, and examine physician recommendation for CC screening and adherence to those recommendations. Predictors were grouped as demographic, acculturation, access to care, chronic conditions, and health behaviors. Descriptive analyses were performed on a sample of 10,667 women from the 2015 National Health Interview Survey, and multiple logistic regression models determined predictors of CC screening adherence, physician recommendations, and adherence to physician recommendations. Overall, 81.7% (95%CI=80.7-82.7%) of U.S. women adhered to CC screening guidelines. Adherence declined with increasing age after 39 years old. Never married women (adjusted odds ratio[aOR]=0.67, CI=0.56-0.79) or current smokers (aOR=0.70, CI=0.59-0.84) had lower odds, while college-educated women had greater odds (aOR=1.38, CI=1.14-1.67) of CC screening adherence. Among unmarried women, 78.6% adhered to CC screening. Unmarried women who were unemployed (aOR=0.48, CI=0.38-0.62), had no physician visits (aOR=0.58, CI=0.40-0.85), no usual source of care (aOR=0.67, CI=0.50-0.89), never heard of HPV (aOR=0.59, CI=0.46-0.76), never received HPV vaccine (aOR=0.50, CI=0.34-0.75), no birth control use (aOR=0.33, CI=0.23-0.47), no flu shot (aOR=0.62, CI=0.48-0.80), and perceived low breast cancer risk (aOR=0.66, CI=0.47-0.92) had lower odds of adherence. Among women with a physician, 55.6% received screening recommendations. Race/ethnicity, access to care, HPV knowledge and vaccine receipt, age when first child was born, and flu shot were significant predictors of physician recommendation for CC screening. Significant predictors of adherence to physician recommendation included education, employment, English proficiency, outpatient clinic visits, usual source of care, age when first child was born, birth control, alcohol use, smoking status, flu shot, and health status. Based on our results, two levels of intervention should be explored. First, targeted interventions are needed for women who are unmarried, have low socio-economic status, and limited access to care to reduce cervical cancer risk. Second, interventions for physicians to increase screening recommendations to all eligible women are needed to improve national screening rates.

Background: In Canada, the prevalence of cervical cancer in Aboriginal women continues to increase with a significantly higher mortality rate than women of non-Aboriginal ancestry. Despite that invasive cervical cancer is highly preventable with regular cervical cancer screening, participation in screening remains lower among Aboriginal women. Since limited information exists on the way cervical cancer screening is perceived and experienced, the purpose of this study was to gain an understanding of Saskatchewan Aboriginal womens perceptions related to and experiences with cervical cancer screening.<p> Methodology: This qualitative exploratory study used an interpretive descriptive approach. Perceptions related to and experiences with cervical cancer screening were elicited through individual interviews with eleven Dakota First Nation women. Women were recruited through purposive sampling techniques. Initially direct quotes from individual transcripts were coded, and then organized with other participant quotes that reflected thematic similarities.<p> Findings: Shared insights reflected a main theme that described perceptions of, experiences with, and factors influencing cervical cancer screening participation among Saskatchewan Aboriginal women. This theme, transitioning from experiencing the negatives of cervical cancer screening participation to living healthier, consisted of the womens mind-set (attitudes and cultural beliefs), knowledge, encounters with the health care system, and sharing information across the generations, which included patterns of communication and a community oriented approach.<p> Discussion: Findings of this study suggest that improving knowledge about cervical cancer screening and cervical cancer may increase screening utilization. Emphasis on health promotion and prevention should be considered when designing education programs. Interventions designed to improve screening rates are more effective when community members are involved in each phase, ensuring cultural relevance. Improving knowledge about, experiences with, and stories shared regarding cervical cancer screening among Aboriginal women may increase screening rates.

Background: In Canada, the prevalence of cervical cancer in Aboriginal women continues to increase with a significantly higher mortality rate than women of non-Aboriginal ancestry. Despite that invasive cervical cancer is highly preventable with regular cervical cancer screening, participation in screening remains lower among Aboriginal women. Since limited information exists on the way cervical cancer screening is perceived and experienced, the purpose of this study was to gain an understanding of Saskatchewan Aboriginal womens perceptions related to and experiences with cervical cancer screening.<p> Methodology: This qualitative exploratory study used an interpretive descriptive approach. Perceptions related to and experiences with cervical cancer screening were elicited through individual interviews with eleven Dakota First Nation women. Women were recruited through purposive sampling techniques. Initially direct quotes from individual transcripts were coded, and then organized with other participant quotes that reflected thematic similarities.<p> Findings: Shared insights reflected a main theme that described perceptions of, experiences with, and factors influencing cervical cancer screening participation among Saskatchewan Aboriginal women. This theme, transitioning from experiencing the negatives of cervical cancer screening participation to living healthier, consisted of the womens mind-set (attitudes and cultural beliefs), knowledge, encounters with the health care system, and sharing information across the generations, which included patterns of communication and a community oriented approach.<p> Discussion: Findings of this study suggest that improving knowledge about cervical cancer screening and cervical cancer may increase screening utilization. Emphasis on health promotion and prevention should be considered when designing education programs. Interventions designed to improve screening rates are more effective when community members are involved in each phase, ensuring cultural relevance. Improving knowledge about, experiences with, and stories shared regarding cervical cancer screening among Aboriginal women may increase screening rates.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Pathology / Doctoral / Doctor of Philosophy