Eggleston Katherine S, Coker Ann L, Luchok Kathryn J, Meyer Tamra E
University of Texas Health Science Center, School of Public Health, Houston, Texas 77025, USA.
Obstet Gynecol. 2007 Jun;109(6):1332-41. doi: 10.1097/01.AOG.0000266396.25244.68.
To evaluate whether timely adherence rates differ by race among women with abnormal Pap tests participating in a cost-free or reduced-cost program.
Eligible subjects included women aged 47-64 years who received a referral for follow-up care after an abnormal Pap test from 1999 to 2002 in South Carolina (n=330). Adherence was measured as days to receipt of follow-up care after an abnormal Pap test. Cox proportional hazards modeling was used to estimate risk factors associated with time to adherence within 60 and 365 days by race.
African-American and non-Hispanic white women had similar adherence to follow-up. Among white women, those with high-grade lesions were less likely to adhere in a timely manner relative to those with low-grade lesions (hazard ratio 0.6, 95% confidence interval [CI] 0.4-1.0). For African-American women, rural residence (hazard ratio: 0.5, 95% CI 0.2-0.9) and history of abnormal Pap tests (hazard ratio 0.6, 95% CI 0.3-1.0) were associated with decreased adherence, whereas less education (hazard ratio 2.3, 95% CI 1.3-3.9) was associated with increased adherence.
Adherence rates do not differ by race. However, risk factors for adherence within race are variable. Interventions tailored to the differential needs of racial and ethnic groups may prove effective toward increasing timely adherence rates.
II.
评估参与免费或低成本项目的巴氏试验异常女性中，种族因素是否会导致及时依从率存在差异。
符合条件的受试者为1999年至2002年在南卡罗来纳州巴氏试验异常后接受后续护理转诊的47至64岁女性（n = 330）。依从性通过巴氏试验异常后接受后续护理的天数来衡量。采用Cox比例风险模型按种族估计60天和365天内与依从时间相关的风险因素。
非裔美国女性和非西班牙裔白人女性对后续护理的依从性相似。在白人女性中，高级别病变者相对于低级别病变者及时依从的可能性较小（风险比0.6，95%置信区间[CI] 0.4 - 1.0）。对于非裔美国女性，农村居住（风险比：0.5，95% CI 0.2 - 0.9）和巴氏试验异常史（风险比0.6，95% CI 0.3 - 1.0）与依从性降低相关，而受教育程度较低（风险比2.3，95% CI 1.3 - 3.9）与依从性增加相关。
依从率不存在种族差异。然而，种族内部的依从风险因素各不相同。针对不同种族和族裔群体的不同需求制定的干预措施可能对提高及时依从率有效。
II级。
