Congress Abstracts 2004

36

FACTORS INFLUENCING FOLLOW-UP CERVICAL CANCER SCREENING AMONG LOW-INCOME MINORITY WOMEN. Miok Lee, EdD, RN, CS, ANP, School of Nursing, Hunter-Belleview School of Nursing, Hunter College, CUNY, New York, NY, and Shuquan Chen, PhD, Institute for Cancer Prevention, New York, NY.

Advance practice nurses have important roles in preventing and reducing health risks associated with cervical cancer by identifying major barriers and motivators in cervical cancer screening and by implementing ethno-culturally appropriate interventions in the community.

Cervical cancer is preventable and curable with the five-year relative survival rate of nearly 100% if diagnosed in pre-cancer stage with a Pap test. Korean American women showed low rates of initial screenings using Pap test and a substantial number not returning for annual follow up. The purpose of the study is to explore influencing factors in these women’s decision process of not returning for follow-up as well as returning for follow-up.

The conceptual framework is derived from the Health Belief Model (HBM). The HBM hypothesizes that health-related actions depend on the simultaneous occurrence of a few factors including the existence of sufficient motivation. It emphasizes that one needs to believe the benefits of the preventive action to be greater than overcoming important barriers.

The qualitative design using focus group approach with purposeful sampling method was used. The sample was drawn from the Korean women who participated in either the annual Korean Health Fair or the Cervical Cancer Early Detection Program during 2000. Seven focus groups—four non-follow-ups (n = 20) and three follow-ups (n = 9) were conducted by a Korean facilitator using 12 guiding questions based on HBM. All sessions were taped after obtaining the consents.

The seven taped sessions were transcribed, translated, and analyzed thematically using Nudist Vivo software, and triangulated by another consultant making conceptual maps.

All participants were immigrants, age 40 or older, have low income, and no health insurance. The findings revealed that the major barriers were service quality at clinics—long waits and crowds, humility, embarrassment, no time and money, lack of knowledge, and low concern for preventive health. Motivators were free cost, reminder card, illness experiences of self or others, peer involvements, and high concern for health. The findings will help advance practice nurses to design and implement appropriate interventions for these women to participate in annual cervical cancer screening, thus leading to maintaining good health and better quality of life.