Skip to main content

Advertisement

SpringerLink
Log in

Pap Screening Goals and Perceptions of Pain among Black, Latina, and Arab Women: Steps Toward Breaking down Psychological Barriers

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Understanding women’s psychological barriers to getting Papanicolaou (Pap) screening has potential to impact cancer disparities. This study examined pain perceptions of Pap testing among black, Latina, and Arab women and goal setting to receive Pap tests. Data on 420 women, in a longitudinal study, were analyzed using Chi-square tests of differences and generalized linear mixed models. At baseline, 30.3 % of black and 35.5 % of Latina women perceived Pap tests to be very painful compared to 24.2 % of Arab women. Perceptions of pain influenced goal settings, such as scheduling a first ever Pap test (odds ratio = 0.58, 95 % confidence interval 0.14–0.94). Immediately following the intervention, women’s perception that Pap tests are very painful significantly declined (P value <0.001) with Arab and black women registering the greatest improvements (20.3 and 17.3 % reduction, respectively, compared to 8.4 % for Latina). Having the perception that the Pap test is very painful significantly reduces the likelihood of black, Latina, and Arab women setting the goal to schedule their first ever Pap test. Latina women are the least likely to improve their perception that the Pap test is very painful, though national statistics show they have the highest rates of morbidity and mortality from cervical cancer. These findings are instructive for designing tailored interventions to break down psychological barriers to Pap screening among underserved women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96. doi:10.3322/CA.2007.0010

    Article  PubMed  Google Scholar 

  2. Jemal A, Thun M, Ries L et al (2008) Annual report to the nation on the status of cancer, 1975–2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Cancer Inst 100(23):1672–1694

    Article  PubMed  Google Scholar 

  3. American Cancer Society (2011). Cancer Facts & Figures 2011. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-029771.pdf

  4. Agency for Healthcare Research and Quality. 2008. Cancer screening and treatment in women: recent findings. http://www.ahrq.gov/research/cancerwom.htm#intro

  5. Hakama M, Miller AB, Day NE (eds) (1986) Screening for cancer of the uterine cervix: from the IARC working group on cervical cancer screening and the UICC project group on the evaluation of screening programmes for cancer. Oxford University Press, New York

    Google Scholar 

  6. Jemal A, Thomas A, Murray T et al (2002) Cancer statistics, 2002. CA Cancer J Clin 52:23–47. doi:10.3322/canjclin.52.1.23

    Article  PubMed  Google Scholar 

  7. Hoyo C, Yarnall KSH, Skinner CS et al (2005) Pain predicts non-adherence to pap smear screening among middle-aged African American women. Preventive Medicine 41:439–445

    Article  PubMed  Google Scholar 

  8. Morbidity and Mortality Weekly Report (MMWR). Cancer Screening—United States, 2010. Center for Disease Control and Prevention. December 2012, Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6103a1.htm?s_cid=mm6103a1_w

  9. Watson M, Saraiya M, Benard V et al (2008) Burden of cervical cancer in the United States, 1998–2003. Cancer 113:2855–2864. doi:10.1002/cncr.23756

    Article  PubMed  Google Scholar 

  10. National Cancer Institute (2009). SEER cancer statistics review 1975–2007. Bethesda, MD Retrieved from http://seer.cancer.gov

  11. Jennings-Dozier K (1999) Predicting intentions to obtain a Pap smear among African American and Latina Women: Testing the theory of planned behavior. Nurs Res 48(4):198–205

    Article  PubMed  CAS  Google Scholar 

  12. de la Cruz GP, Brittingham A. The Arab population: census 2000 brief. December 2003, US Census Bureau

  13. American Community Survey. 2008. Selected population characteristics & interactive map. Demographics data from the Arab American Institute. December 2012, Retrieved from http://www.aaiusa.org/pages/demographics/

  14. Matin M, LeBaron S (2004) Attitudes toward cervical cancer screening among Muslim women: a pilot study. Women & Health 39(3):63–77

    Article  Google Scholar 

  15. Salman K (2012) Health beliefs and practices related to cancer screening among Arab Muslim women in an urban community. Health Care for Women International 33(1):45–74

    Article  PubMed  Google Scholar 

  16. Michigan Department of Community Health and Michigan Public Health Institute. Special cancer behavioral risk factor survey, 2008. www.michigancancer.org/PDFs/MCCReports/SCBRFS_2008-042910.pdf.

  17. Williams KP, Mullan PB, Todem D (2009) Moving from theory to practice: implementing the Kin KeeperSM Cancer Prevention model. Health Educ Res 24:343–56

    Article  PubMed  CAS  Google Scholar 

  18. Williams KP, Reiter P, Mabiso A, Maurer J, Paskett E (2009) Family History of cancer predicts Papanicolaou screening behavior for African American and White women. Cancer 115(1):179–189

    Article  PubMed  Google Scholar 

  19. Mandelblatt JS, Gold K, O'Malley AS et al (1999) Breast and Cervix cancer screening among multiethnic women: role of age, health, and source of care. Preventive Medicine 28(4):418–425

    Article  PubMed  CAS  Google Scholar 

  20. Harlan LC, Bernstein AB, Kessler LG (1991) Cervical cancer screening: who is not screened and why? Am J Public Health 81(7):885–890

    Article  PubMed  CAS  Google Scholar 

  21. Skrondal A, Rabe-Hesketh S (2009) Prediction in multilevel generalized linear models. Journal of the Royal Statistical Society, Series A 172:659–687

    Google Scholar 

  22. Skrondal A, Rabe-Hesketh S (2004) Generalized latent variable modeling: multilevel, longitudinal, and structural equation models. Chapman & Hall/CRC, Boca Raton, FL

    Book  Google Scholar 

  23. Raudenbush SW, Bryk AS (2002) Hierarchical linear models: applications and data analysis methods, 2nd edn. Sage, Newbury Park, CA

    Google Scholar 

  24. SAS Institute Inc., 2008. SAS/STAT® 9.2 User's guide. Cary, NC: SAS Institute Inc.

  25. Percac-Lima S, Aldrich LS, Gamba MA et al (2011) Barriers to follow-up of an abnormal Pap smear in Latina women referred for colposcopy. J Gen Intern Med 25(11):1198–1204

    Article  Google Scholar 

Download references

Acknowledgments

This project has been funded by the National Institutes of Health National Institute of Nursing Research R21NR010366. Each of the authors has contributed writing this manuscript and given their permission for their names to be used. We would like to thank Justice Wilson for formatting this manuscript.

Conflict of Interest

No financial disclosures were reported by the authors of this paper.

Author information

Authors and Affiliations

  1. College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA

    Julie W. Gauss

  2. Development Strategy and Governance Division, International Food Policy Research Institute, Washington, DC, USA

    Athur Mabiso

  3. Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, 626 E. Fee Hall, East Lansing, MI, 48824, USA

    Karen Patricia Williams

Authors
  1. Julie W. Gauss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Athur Mabiso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen Patricia Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen Patricia Williams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gauss, J.W., Mabiso, A. & Williams, K.P. Pap Screening Goals and Perceptions of Pain among Black, Latina, and Arab Women: Steps Toward Breaking down Psychological Barriers. J Canc Educ 28, 367–374 (2013). https://doi.org/10.1007/s13187-012-0441-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-012-0441-1

Keywords

Search

Navigation