Grant Number:	1R01CA107015-01A1 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:	2005

DESCRIPTION (provided by applicant): 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 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) culturally targeted belief + knowledge + importance (intervention), (2) non-targeted 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 (standard care). Women randomized to the intervention will receive a semi-structured message during the phone call addressing core determinants of behavior identified in our previous work. Specifically, the message will address culturally targeted beliefs about the consequences of follow-up that were isolated for each racial/ethnic group (targeted beliefs). The message also will include beliefs delivered to the active control group so that only the presentation of targeted beliefs differs between these groups. 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 contain only those beliefs previously identified across race/ethnicity (non-targeted). 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 grade of Pap abnormality (low versus high) as an effect modifier. The intervention strategy is generalizable and may ultimately decrease the number of low income and minority women who develop invasive cervical cancer.




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.
PMID: 23730719
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Who is counseled to lose weight? Survey results and anthropometric data from 3,149 lower socioeconomic women.
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Predictors of sleep characteristics among women in southeast Texas.
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Recycling attitudes and behavior among a clinic-based sample of low-income Hispanic women in southeast Texas.
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Is Spanish language a barrier to domestic violence assessment?
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Passive smoke exposure and abnormal cervical cytology in a predominantly Hispanic population.
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The influence of cultural adaptation and sexual risk behaviors on cervical cytology in a Hispanic population.
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Attitudes, beliefs and behaviors surrounding organ donation among Hispanic women.
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The Body Image Concern Inventory: validation in a multiethnic sample and initial development of a Spanish language version.
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