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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
Grant Details

Grant Number: 5R01CA107015-06 Interpret this number
Primary Investigator: Radecki Breitkopf, Carmen
Organization: University Of Texas Medical Br Galveston
Project Title: Intervention to Improve Follow-Up of Abnormal Pap Test
Fiscal Year: 2010
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Abstract

Over 90 percent of deaths due to cervical cancer could be prevented with appropriate screening and treatment of precursor lesions. However, 20 percent to 70 percent of women in the United States who are told that their Papanicolaou (Pap) test was abnormal do not adhere to recommendations for follow-up care. This is a problem especially among minorities and women of lower socioeconomic status. The proposed study will address this problem by investigating an intervention based in the unified theory of behavior that has been designed to improve follow-up rates after notification of an abnormal Pap test. A total of 600 women of white, black, or Hispanic race/ethnicity between 18 and 55 years of age who experience an abnormal Pap test will be randomized to one of three groups: (1) matched belief + knowledge + importance (intervention), (2) mismatched belief + knowledge + importance (active control), or (3) standard care (passive control). All groups will be notified by telephone of their abnormal results and provided instructions for follow-up. Women assigned to the intervention will receive a semi-structured message addressing three core determinants of behavior identified in our previous work. Specifically, the message will target beliefs about the consequences of follow-up that were isolated for each racial/ethnic group (matched beliefs). In addition, the message will provide detailed information regarding the procedures and timeline associated with follow-up care. Finally, the importance of follow-up, particularly for "low-grade" abnormalities, will be emphasized. Women assigned to the active control group will receive the same knowledge and importance message; however, the belief component will have been designed for a race/ethnicity different from their own (mismatched). Multiple behavioral and psychological outcomes including adherence to initial follow-up, anxiety, and patient satisfaction will be evaluated between groups. In addition, delay in care and completeness of care will be assessed over an 18- month interval. Finally, we will examine the grade of Pap abnormality (low versus high) as an effect modifier. If the proposed intervention is supported by the data, it will significantly increase adherence to follow-up recommendations and consequently decrease the number of women who develop invasive cervical cancer.

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Publications

Intervention to improve follow-up for abnormal Papanicolaou tests: a randomized clinical trial.
Authors: Breitkopf C.R. , Dawson L. , Grady J.J. , Breitkopf D.M. , Nelson-Becker C. , Snyder R.R. .
Source: Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2014 Apr; 33(4), p. 307-16.
EPub date: 2013-06-03.
PMID: 23730719
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Recycling attitudes and behavior among a clinic-based sample of low-income Hispanic women in southeast Texas.
Authors: Pearson H.C. , Dawson L.N. , Radecki Breitkopf C. .
Source: PloS one, 2012; 7(4), p. e34469.
EPub date: 2012-04-06.
PMID: 22493693
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Predictors of sleep characteristics among women in southeast Texas.
Authors: Kachikis A.B. , Breitkopf C.R. .
Source: Women's health issues : official publication of the Jacobs Institute of Women's Health, 2012 Jan-Feb; 22(1), p. e99-109.
EPub date: 2011-08-27.
PMID: 21875813
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Who is counseled to lose weight? Survey results and anthropometric data from 3,149 lower socioeconomic women.
Authors: Breitkopf C.R. , Egginton J.S. , Naessens J.M. , Montori V.M. , Jatoi A. .
Source: Journal of community health, 2012 Feb; 37(1), p. 202-7.
PMID: 21744160
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Is Spanish language a barrier to domestic violence assessment?
Authors: Jatoi A. , Breitkopf C.R. .
Source: Journal of women's health (2002), 2011 Jul; 20(7), p. 1111-6.
EPub date: 2011-06-01.
PMID: 21631373
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Passive smoke exposure and abnormal cervical cytology in a predominantly Hispanic population.
Authors: Ward K.K. , Berenson A.B. , Breitkopf C.R. .
Source: American journal of obstetrics and gynecology, 2011 Mar; 204(3), p. 213.e1-6.
EPub date: 2011-01-17.
PMID: 21247553
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The influence of cultural adaptation and sexual risk behaviors on cervical cytology in a Hispanic population.
Authors: Ward K.K. , Roncancio A.M. , Breitkopf C.R. .
Source: American journal of obstetrics and gynecology, 2010 Dec; 203(6), p. 549.e1-7.
EPub date: 2010-09-22.
PMID: 20864073
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Attitudes, beliefs and behaviors surrounding organ donation among Hispanic women.
Authors: Breitkopf C.R. .
Source: Current opinion in organ transplantation, 2009 Apr; 14(2), p. 191-5.
PMID: 19469039
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The Body Image Concern Inventory: validation in a multiethnic sample and initial development of a Spanish language version.
Authors: Littleton H. , Breitkopf C.R. .
Source: Body image, 2008 Dec; 5(4), p. 381-8.
EPub date: 2008-08-26.
PMID: 18753021
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