A community-based randomized trial of a faith-placed intervention to reduce cervical cancer burden in Appalachia

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• 作者：Christina R. Studts^a ; ^{tina.studts@uky.edu} ; Yelena N. Tarasenko^a ; ¹ ; ^{YTarasenko@cdc.gov} ; Nancy E. Schoenberg^a ; ^{nesch@uky.edu} ; Brent J. Shelton^b ; ^{bshelton@kcp.uky.edu} ; Jennifer Hatcher-Keller^c ; ^{jennifer.hatcher@uky.edu} ; Mark B. Dignan^d ; ^{mbdign2@email.uky.edu}
• 关键词：Cervical cancer screening ; Randomized controlled trial ; Faith-placed ; Appalachia
• 刊名：Preventive Medicine
• 出版年：2012
• 期刊代码：306_00917435
• 类别：med
• 出版时间：June, 2012
• 卷：54
• 期：6
• 页码：408-414
• 文件大小：577 K

摘要

Objective

Faith Moves Mountains assessed the effectiveness of a faith-placed lay health advisor (LHA) intervention to increase Papanicolaou (Pap) test use among middle-aged and older women in a region disproportionately affected by cervical cancer and low screening rates (regionally, only 68%screened in prior 3 years).

Method

This community-based RCT was conducted in four Appalachian Kentucky counties (December 2005-June 2008). Women aged 40-64 and overdue for screening were recruited from churches and individually randomized to treatment (n = 176) or wait-list control (n = 169). The intervention provided LHA home visits and newsletters addressing barriers to screening. Self-reported Pap test receipt was the primary outcome.

Results

Intention-to-treat analyses revealed that treatment group participants (17.6%screened) had over twice the odds of wait-list controls (11.2%screened) of reporting Pap test receipt post-intervention, OR = 2.56, 95%CI: 1.03-6.38, p = 0.04. Independent of group, recently screened participants (last Pap > 1 but < 5 years ago) had significantly higher odds of obtaining screening during the study than rarely or never screened participants (last Pap 鈮?#xA0;5 years ago), OR = 2.50, 95%CI: 1.48-4.25, p = 0.001.

Conclusions

The intervention was associated with increased cervical cancer screening. The faith-placed LHA addressing barriers comprises a novel approach to reducing cervical cancer disparities among Appalachian women.