Department of Family and Community, Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX.
Department of Biostatistics and Epidemiology, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX.
J Low Genit Tract Dis. 2018 Oct;22(4):295-301. doi: 10.1097/LGT.0000000000000424.
The aims of the study were to evaluate the effect of a community outreach worker (promotora)-led high-intensity educational intervention compared with control without promotora-led intervention on cervical cancer screening preference (Pap smear vs self-sampling) and to determine the effect of this preference on subsequent screening completion.
This randomized controlled trial compared the effect of educational intervention on women's preferences for self-sampling for human papillomavirus. Inclusion criteria were women aged 30 to 65 years and no cervical cancer screening in 3 years or more. Community-based study with intervention group receiving culturally tailored education by promotora vs control group who received written education pamphlet. We evaluated participants' test preference, knowledge, and Pap completion at 12-months postintervention.
Two hundred one predominantly Hispanic women were randomly assigned to high-intensity (n = 100) education vs low-intensity education (n = 101). The mean age was 46.4 years (SD = 8.2 years). There was no difference in test preference between high- and low-intensity groups (49% vs 41%, both tests equally; 28.6% vs 35.1%, self-sampling; and 22% vs 23%, Pap, p = .536). High-intensity intervention resulted in a significantly higher self-sampling acceptability score (25.02 vs 24.06, p = .039).Testing preference did not significantly affect Pap completion (Pap vs self-sampling vs unsure/both equally, 60.0% vs 43.6% vs 48.9%, p = 0.24). Human papillomavirus knowledge was found to be significantly associated with completion of Pap at 12 months. Human papillomavirus-positive result on self-sampling trended toward increased likelihood of screening completion (16.3% vs 7.8%, p = .058).
We found a high level of acceptability of self-sampling regardless of intensity of education in a largely Hispanic female population living on the US-Mexico border and a trend toward increased Pap smear follow-up in participants who tested positive.
本研究旨在评估社区外展工作者（ promotora ）主导的高强度教育干预与无 promotora 主导干预相比，对宫颈癌筛查偏好（巴氏涂片与自我采样）的影响，并确定这种偏好对后续筛查完成的影响。
这项随机对照试验比较了教育干预对女性人乳头瘤病毒自我采样偏好的影响。纳入标准为年龄 30 至 65 岁且 3 年以上未进行宫颈癌筛查的女性。以社区为基础的研究，干预组接受 promotora 进行的文化适应教育，对照组接受书面教育手册。我们在干预后 12 个月评估了参与者的检测偏好、知识和巴氏涂片完成情况。
201 名主要为西班牙裔的女性被随机分配到高强度（ n = 100 ）教育组和低强度（ n = 101 ）教育组。平均年龄为 46.4 岁（标准差= 8.2 岁）。高强度组和低强度组之间的检测偏好无差异（巴氏涂片和自我采样各占 49%和 41%；自我采样和巴氏涂片各占 28.6%和 35.1%；不确定和两者各占 22%和 23%， p =.536 ）。高强度干预显著提高了自我采样的可接受性评分（ 25.02 比 24.06 ， p =.039 ）。检测偏好并未显著影响巴氏涂片完成率（巴氏涂片、自我采样、不确定和两者各占 60.0%、43.6%、48.9%， p = 0.24 ）。12 个月时，人乳头瘤病毒知识与巴氏涂片完成情况显著相关。自我采样 HPV 阳性结果与增加筛查完成率呈趋势相关（ 16.3%比 7.8% ， p =.058 ）。
我们在居住在美国-墨西哥边境的西班牙裔女性人群中发现，无论教育强度如何，自我采样的接受度都很高，且 HPV 检测阳性的参与者更倾向于进行巴氏涂片检查。
