DESCRIPTION: Increasing the regular use of Pap testing by underserved
populations has been identified as a national priority. Southeast Asian
immigrants to the United States are socially disadvantaged, have high rates
of invasive cervical cancer, and demonstrate low use of Pap testing compared
to other groups. However, little information concerning the control of
cancer in Southeast Asian populations is available. The overall goal of the
proposed research is to increase the uptake of cervical cancer screening by
women from Cambodia. Specific study objectives are to obtain qualitative
and quantitative information about the Pap testing behavior of Cambodian
refugees; develop, implement and evaluate the effect of a culturally
appropriate, neighborhood-based, cervical cancer control intervention
program; and assess the feasibility and costs of the intervention
components. Study participants will be Cambodian women aged 18 years and
older who reside in Seattle.
The PRECEDE framework and ethnographic methods will be used to develop
educational materials, intervention components, and a quantitative survey
instrument. The project will emphasize community involvement in all aspects
of intervention development and implementation. Delivery of the
intervention program will be guided by the Indigenous Model, and all
interventions will be provided by bicultural outreach workers. Program
components will include home visits and small group meetings, logistics
assistance, and the use of videotapes and print materials. Methods for
intervention development and implementation would be applicable to other
non-acculturated immigrant groups.
A randomized controlled trial will be employed to evaluate the effect of the
intervention program. Forty South Seattle "small neighborhood areas" will
be randomized to experimental or control groups. A total of 400 women will
participate in the trial. The outcome variable of interest will be Pap
testing during the 12-month intervention period. Pre- and post-intervention
surveys will be conducted in the experimental and control areas. In
addition, self-reported Pap testing will be verified by medical record
review. Process measures will be examined, and the costs of the
intervention program systematically assessed.
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