Carruth Ann K, Browning Steven, Reed Deborah B, Skarke Lana, Sealey Lorinda
School of Nursing, Southeastern Louisiana University, Hammond 70402, USA.
Nurs Res. 2006 Mar-Apr;55(2):121-7. doi: 10.1097/00006199-200603000-00007.
Rural residence, access to healthcare facilities, and multiple roles of farmwomen may pose barriers to cervical cancer screening among women living in southern farm states.
To compare the proportion of women failing to obtain cervical cancer screening in three Southern states to state-level Behavioral Risk Factor Surveillance System (BRFSS) data and to identify factors contributing to cervical cancer screening and detection behaviors.
A cross-sectional study design was used. Data were collected using several Farm Family Health and Injury Prevention surveys via telephone interviews in three southern states. Farmwomen (N = 2,324) from three states comprised the sample on Pap testing. Data were used from summary reports of the BRFSS for each state to compare the proportion of farmwomen >or=18 years of age who had failed to obtain a Pap test within the past 3 years to failure to obtain Pap tests statewide. Multiple logistic regression analyses were conducted to examine the predictors of failure to obtain early screening.
Pap testing did not meet Healthy People 2010 target goal of 90%. Farm lifestyle predicting failure to obtain cervical cancer screening included having a house on the farm and engaging in no off-farm work and minimal involvement in farm tasks. The risk of failing to obtain Pap testing increased with age and decreased with education. The only health access variable contributing to failure to obtain Pap testing was women with no insurance. Positive preventive risk factors contributing to compliance with up-to-date status were previous mammogram and previous breast exam. Being married was a positive risk factor.
Although the failure to obtain Pap testing in Texas was comparable to state BRFSS rates, failure to obtain Pap testing rates in Kentucky and Louisiana were at least 6% greater for farmwomen than women living in the state. Farmwomen, a subgroup of the rural population, have unique barriers to obtaining screening services. Geographical isolation and minimal role involvement on the farm may contribute to the likelihood that women are not seeking cervical cancer screening.
农村居住环境、医疗保健设施的可及性以及农村女性的多种角色，可能对生活在南部农业州的女性进行宫颈癌筛查构成障碍。
将三个南部州未进行宫颈癌筛查的女性比例与州级行为危险因素监测系统（BRFSS）数据进行比较，并确定影响宫颈癌筛查和检测行为的因素。
采用横断面研究设计。通过对三个南部州进行电话访谈，利用多项农场家庭健康与伤害预防调查收集数据。来自三个州的2324名农村女性构成了巴氏试验样本。使用每个州BRFSS的总结报告数据，比较年龄≥18岁的农村女性在过去3年内未进行巴氏试验的比例与全州未进行巴氏试验的比例。进行多项逻辑回归分析，以检验未能获得早期筛查的预测因素。
巴氏试验未达到《健康人民2010》设定的90%的目标。预测未能进行宫颈癌筛查的农场生活方式包括在农场有住房、不从事农场外工作且极少参与农场任务。未进行巴氏试验的风险随年龄增加而上升，随受教育程度提高而下降。导致未进行巴氏试验的唯一健康可及性变量是没有保险的女性。有助于遵守最新筛查状况的积极预防风险因素是既往乳房X光检查和既往乳房检查。已婚是一个积极的风险因素。
尽管德克萨斯州未进行巴氏试验的比例与州BRFSS数据相当，但肯塔基州和路易斯安那州农村女性未进行巴氏试验的比例比该州其他女性至少高6%。农村女性作为农村人口的一个亚群体，在获得筛查服务方面存在独特障碍。地理隔离和在农场中角色参与度低，可能导致女性不寻求宫颈癌筛查。
