Winkler J, Bingham A, Coffey P, Handwerker W Penn
PATH, 1455 NW Leary Way, Seattle, WA 98107-5136, USA.
Health Educ Res. 2008 Feb;23(1):10-24. doi: 10.1093/her/cyl156. Epub 2007 Jan 17.
Cervical cancer is often the most common cancer among women in developing countries, yet current screening efforts have not been effective in reducing incidence and mortality rates in these settings. In an effort to increase knowledge about screening participation in low-resource settings, this study sought to identify key factors affecting women's participation in a cervical screening program in north central Peru. We studied women who were exposed to various health promotion educational activities and compared a total of 156 women who sought screening between July 2001 and October 2003 with 155 women who did not. Results from logistic regression identified four significant predictors of screening: higher relative wealth, knowing other screened women, seeking care from a health facility when sick and satisfaction with services at the health facility. When we restricted our analysis to women who had experienced screening in the past, two additional predictors emerged: having a husband who was supportive of screening participation and attending an awareness-raising session. These results have important programmatic value for tailoring outreach efforts for women and indicate that different strategies may be required to best reach women who have never been screened.
宫颈癌往往是发展中国家女性中最常见的癌症，但目前的筛查工作在这些地区并未有效降低发病率和死亡率。为了增加对资源匮乏地区筛查参与情况的了解，本研究旨在确定影响秘鲁中北部女性参与宫颈癌筛查项目的关键因素。我们研究了参与各种健康促进教育活动的女性，并将2001年7月至2003年10月期间寻求筛查的156名女性与155名未寻求筛查的女性进行了比较。逻辑回归结果确定了筛查的四个重要预测因素：相对较高的财富水平、认识其他接受筛查的女性、生病时到医疗机构就诊以及对医疗机构服务的满意度。当我们将分析限制在过去接受过筛查的女性时，又出现了另外两个预测因素：有支持筛查参与的丈夫以及参加提高认识活动。这些结果对于为女性量身定制外展工作具有重要的项目价值，并表明可能需要不同的策略来最好地覆盖从未接受过筛查的女性。
