Department of Behavioral Science, University of Kentucky, Lexington, KY 40536-0086, USA.
Prev Med. 2012 Jun;54(6):408-14. doi: 10.1016/j.ypmed.2012.03.019. Epub 2012 Apr 3.
Faith Moves Mountains assessed the effectiveness of a faith-placed lay health advisor (LHA) intervention to increase Papanicolaou (Pap) test use among middle-aged and older women in a region disproportionately affected by cervical cancer and low screening rates (regionally, only 68% screened in prior 3 years).
This community-based RCT was conducted in four Appalachian Kentucky counties (December 2005-June 2008). Women aged 40-64 and overdue for screening were recruited from churches and individually randomized to treatment (n=176) or wait-list control (n=169). The intervention provided LHA home visits and newsletters addressing barriers to screening. Self-reported Pap test receipt was the primary outcome.
Intention-to-treat analyses revealed that treatment group participants (17.6% screened) had over twice the odds of wait-list controls (11.2% screened) of reporting Pap test receipt post-intervention, OR=2.56, 95% CI: 1.03-6.38, p=0.04. Independent of group, recently screened participants (last Pap >1 but <5 years ago) had significantly higher odds of obtaining screening during the study than rarely or never screened participants (last Pap ≥5 years ago), OR=2.50, 95% CI: 1.48-4.25, p=0.001.
The intervention was associated with increased cervical cancer screening. The faith-placed LHA addressing barriers comprises a novel approach to reducing cervical cancer disparities among Appalachian women.
“信仰移山”评估了信仰引导员（LHA）干预对增加中年和老年女性巴氏涂片（Pap）检测使用的效果，这些女性所在的地区受宫颈癌和低筛查率的影响不成比例（在该地区，只有 68%的女性在过去 3 年内接受过筛查）。
这是一项基于社区的 RCT，在肯塔基州的四个阿巴拉契亚县进行（2005 年 12 月至 2008 年 6 月）。从教堂招募年龄在 40-64 岁且筛查过期的女性，并对其进行个体随机分组，分别接受治疗（n=176）或候补名单对照（n=169）。干预措施提供了 LHA 家访和解决筛查障碍的通讯。自我报告的 Pap 检测结果是主要结局。
意向治疗分析显示，治疗组参与者（17.6%接受筛查）在报告 Pap 检测结果方面的可能性是候补名单对照组（11.2%接受筛查）的两倍以上，OR=2.56，95%CI：1.03-6.38，p=0.04。无论分组如何，最近接受筛查的参与者（上次 Pap 检查>1 年但<5 年前）在研究期间获得筛查的可能性明显高于很少或从未接受过筛查的参与者（上次 Pap 检查≥5 年前），OR=2.50，95%CI：1.48-4.25，p=0.001。
该干预措施与增加宫颈癌筛查相关。针对障碍的信仰引导员干预构成了减少阿巴拉契亚妇女宫颈癌差异的一种新方法。
