Dignan M B, Michielutte R, Wells H B, Sharp P, Blinson K, Case L D, Bell R, Konen J, Davis S, McQuellon R P
AMC Cancer Research Center, Denver, CO 80214, USA.
Health Educ Res. 1998 Dec;13(4):545-56. doi: 10.1093/her/13.4.545.
Although age-adjusted mortality rates from cancer among Native-Americans are generally lower than for the US population as a whole, cervical cancer mortality rates are higher. This report presents results from a National Cancer Institute-funded health education program conducted among the Lumbee tribe in North Carolina that was designed to increase the proportion of women, age 18 and older, who receive Pap smears to screen for cervical cancer. The Solomon Four Group research design was used for this project. Participants were selected at random from the enrollment records of the Lumbee tribe and data collection was carried out during face-to-face interviews. The health education program was provided one-on-one in women's homes by a trained lay health educator and included verbal, print and videotape information. A total of 979 women were enrolled in the study, and 125 were lost to follow-up between the pre-test and post-test. Women who received the education program were found to be more likely to have knowledge of the Pap smear and to report a Pap smear in the past year at the post-test than those in the control group, regardless of whether they received the pre-test interview, P < 0.05. Women most likely to respond to the education program were also likely to have reported that they receive an annual physical examination. Women with better knowledge of the Pap smear tended to have more education, higher income and greater identification with Native-American culture than those with less knowledge. We conclude that the health education program was associated with greater knowledge about cervical cancer prevention and higher proportions of Lumbee women obtaining Pap smears in the past year.
尽管美国原住民经年龄调整后的癌症死亡率总体低于美国总人口，但宫颈癌死亡率却更高。本报告展示了美国国立癌症研究所资助的一项健康教育项目的结果，该项目在北卡罗来纳州的伦拜族部落开展，旨在提高18岁及以上接受巴氏涂片检查以筛查宫颈癌的女性比例。本项目采用了所罗门四组研究设计。参与者从伦拜族部落的登记记录中随机选取，数据收集在面对面访谈期间进行。健康教育项目由一名经过培训的非专业健康教育家在女性家中一对一提供，内容包括口头、印刷品和录像带信息。共有979名女性参与了该研究，125名在预测试和后测试之间失访。结果发现，接受教育项目的女性在接受后测试时，比对照组更有可能了解巴氏涂片检查，并且在过去一年进行过巴氏涂片检查，无论她们是否接受了预测试访谈，P<0.05。最有可能对教育项目做出反应的女性也更有可能报告她们每年进行一次体检。与知识较少的女性相比，对巴氏涂片检查了解较多的女性往往受教育程度更高、收入更高，并且对美国原住民文化的认同感更强。我们得出结论，健康教育项目与对宫颈癌预防的更多了解以及过去一年中伦拜族女性进行巴氏涂片检查的比例更高有关。
