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Grant Details

Grant Number: 5R01CA181047-05 Interpret this number
Primary Investigator: Ramaswamy, Megha
Organization: University Of Kansas Medical Center
Project Title: Sexual Health Empowerment for Cervical Health Literacy and Cancer Prevention
Fiscal Year: 2018


DESCRIPTION (provided by applicant): Women in the criminal justice system are four-five times as likely to have cervical cancer compared to non- incarcerated women. In our previous research, we found that the most important contributor to cervical cancer risk, and perhaps lack of follow-up, is incarcerated women's low health literacy about broader reproductive health issues. Until we effectively address incarcerated women's unique reproductive health literacy needs, the cervical cancer health disparity between incarcerated and non-incarcerated women will persist. The objective of this study is to assess the effectiveness of a sexual health empowerment (SHE Project) intervention to improve cervical health knowledge, reduce barriers to screening that are related to beliefs about cervical cancer, improve self-efficacy for navigatin providers and health care systems, and ultimately work towards preventing cervical cancer. This objective is responsive to PAR-10-133 in that it develops an intervention strategy to address health literacy and broader health outcomes in a vulnerable population. To meet the objectives of this study, we propose to assess the impact of a sexual health empowerment intervention (SHE Project) on cervical health knowledge; barriers to screening that are related to beliefs about cervical cancer, and self-efficacy for screening and follow-up among women leaving jail. More specifically, we will conduct a pre- and post-intervention assessment from baseline to the end of a weeklong intervention using a wait-list control design. Next, we will use a three-year observational study design employing both survey and ethnographic methods for follow-up, to understand how knowledge, beliefs, self-efficacy, and other factors change post-release cervical health prevention behaviors over time. This approach will allow us to observe the extent to which women translate, if at all, increased knowledge, reduced barriers, and increased self-efficacy into practice during clinical encounters, or if other factors explain health behaviors ove time. The public health impact of this study is its potential to reduce cervical cancer morbidity and mortality for this high risk and vulnerable group of women. Our development of an effective and easily disseminated health literacy intervention that can be adapted to many health conditions and broader cancer prevention efforts in institutionalized populations (jails, prisons, community corrections, military institutions) will have an impact on public health, and also on the science of developing effective health literacy interventions.


COVID-19 vaccine hesitancy among women leaving jails: A qualitative study.
Authors: Geana M.V. , Anderson S. , Ramaswamy M. .
Source: Public health nursing (Boston, Mass.), 2021-05-11; , .
EPub date: 2021-05-11.
PMID: 33973268
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A Systematic Evaluation of Barriers and Facilitators to the Provision of Services for Justice-Involved Women.
Authors: Smith S. , Wickliffe J. , Rivera-Newberry I. , Redmond M. , Kelly P.J. , Ramaswamy M. .
Source: Journal of community health, 2020 12; 45(6), p. 1252-1258.
PMID: 32737745
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Correlates of sexually transmitted infection testing following women's release from jail.
Authors: Pickett M.L. , Lee J. , Brousseau D.C. , Satterwhite C. , Ramaswamy M. .
Source: Women & health, 2020 Nov-Dec; 60(10), p. 1109-1117.
EPub date: 2020-08-05.
PMID: 32757716
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Developing a Cancer Prevention Health Education Resource: a Primer of Process and Evaluation.
Authors: Kelly P.J. , Driscoll D. , Lipnicky A. , Anderson S. , Glenn J. , Ramaswamy M. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2020-06-25; , .
EPub date: 2020-06-25.
PMID: 32583352
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Voter Registration and Jail-Incarcerated Women: Are Justice-Involved Women Civically Engaged?
Authors: Emerson A. , Allison M. , Ramaswamy M. .
Source: Women & criminal justice, 2020; 30(3), p. 172-187.
EPub date: 2019-04-11.
PMID: 32742078
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Effectiveness of a Kansas City, Jail-Based Intervention to Improve Cervical Health Literacy and Screening, One-Year Post-Intervention.
Authors: Emerson A.M. , Smith S. , Lee J. , Kelly P.J. , Ramaswamy M. .
Source: American journal of health promotion : AJHP, 2020 01; 34(1), p. 87-90.
EPub date: 2019-07-17.
PMID: 31315420
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A Research Agenda for Emergency Medicine-based Adolescent Sexual and Reproductive Health.
Authors: Miller M.K. , Chernick L.S. , Goyal M.K. , Reed J.L. , Ahmad F.A. , Hoehn E.F. , Pickett M.S. , Stukus K. , Mollen C.J. .
Source: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2019 12; 26(12), p. 1357-1368.
EPub date: 2019-07-26.
PMID: 31148339
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Justice-involved women's preferences for an internet-based Sexual Health Empowerment curriculum.
Authors: Pickett M.L. , Wickliffe J. , Emerson A. , Smith S. , Ramaswamy M. .
Source: International journal of prisoner health, 2019-08-20; 16(1), p. 38-44.
PMID: 32040270
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Retention Strategies in Working With Justice-Involved Women.
Authors: Wickliffe J. , Kelly P.J. , Allison M. , Emerson A. , Ramaswamy M. .
Source: Journal of correctional health care : the official journal of the National Commission on Correctional Health Care, 2019 07; 25(3), p. 231-237.
EPub date: 2019-06-26.
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The role of the community health delivery system in the health and well-being of justice-involved women: a narrative review.
Authors: Smith S.A. , Mays G.P. , Collins T.C. , Ramaswamy M. .
Source: Health & justice, 2019-06-28; 7(1), p. 12.
EPub date: 2019-06-28.
PMID: 31254119
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Feminism and Bourdieusian Social Theory in a Sexual Health Empowerment Project with Incarcerated and Recently Released Women.
Authors: Emerson A.M. , Wickliffe J. , Kelly P.J. , Ramaswamy M. .
Source: Social theory & health : STH, 2019 Mar; 17(1), p. 57-74.
EPub date: 2018-05-03.
PMID: 30853856
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Validating self-reported cervical cancer screening among women leaving jails.
Authors: Webb S. , Kelly P.J. , Wickliffe J. , Ault K. , Ramaswamy M. .
Source: PloS one, 2019; 14(7), p. e0219178.
EPub date: 2019-07-01.
PMID: 31260465
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Assessing fidelity: balancing methodology and reality in jail interventions.
Authors: Kelly P.J. , Emerson A. , Fair C. , Ramaswamy M. .
Source: BMC women's health, 2018-07-23; 18(1), p. 127.
EPub date: 2018-07-23.
PMID: 30037333
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Strategizing and Fatalizing: Self and Other in the Trauma Narratives of Justice-Involved Women.
Authors: Emerson A.M. .
Source: Qualitative health research, 2018 05; 28(6), p. 873-887.
EPub date: 2018-02-24.
PMID: 29478403
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Breast Cancer Risk Among Women in Jail.
Authors: Pickett M.L. , Allison M. , Twist K. , Klemp J.R. , Ramaswamy M. .
Source: BioResearch open access, 2018; 7(1), p. 139-144.
EPub date: 2018-09-20.
PMID: 30250761
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Cervical cancer screening among incarcerated women.
Authors: Kelly P.J. , Allison M. , Ramaswamy M. .
Source: PloS one, 2018; 13(6), p. e0199220.
EPub date: 2018-06-26.
PMID: 29944694
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Impact of a brief intervention on cervical health literacy: A waitlist control study with jailed women.
Authors: Ramaswamy M. , Lee J. , Wickliffe J. , Allison M. , Emerson A. , Kelly P.J. .
Source: Preventive medicine reports, 2017 Jun; 6, p. 314-321.
EPub date: 2017-04-05.
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Closing the cervical cancer disparity gap.
Authors: Kelly P.J. , Ramaswamy M. .
Source: Public health nursing (Boston, Mass.), 2017 05; 34(3), p. 195-196.
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Challenges to Pap Smear Follow-up among Women in the Criminal Justice System.
Authors: Kelly P.J. , Hunter J. , Daily E.B. , Ramaswamy M. .
Source: Journal of community health, 2017 Feb; 42(1), p. 15-20.
PMID: 27449030
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"The Vagina is a Very Tricky Little Thing Down There": Cervical Health Literacy among Incarcerated Women.
Authors: Ramaswamy M. , Kelly P.J. .
Source: Journal of health care for the poor and underserved, 2015 11; 26(4), p. 1265-85.
PMID: 26548678
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The development of a brief jail-based cervical health promotion intervention.
Authors: Ramaswamy M. , Simmons R. , Kelly P.J. .
Source: Health promotion practice, 2015 May; 16(3), p. 432-42.
EPub date: 2014-07-25.
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Narrative Inquiry Into Shelter-Seeking by Women With a History of Repeated Incarceration: Research and Nursing Practice Implications.
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Source: ANS. Advances in nursing science, 2018 Jul/Sep; 41(3), p. 260-274.
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