Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
Inova Health System, 8110 Gatehouse Road Suite 200W, Falls Church, VA, 22042, USA.
J Cancer Educ. 2021 Jun;36(3):441-451. doi: 10.1007/s13187-020-01755-9.
African immigrant (AI) women have low rates of Pap testing. Health literacy plays a pivotal role in health behaviors. Sources and types of health information could shape health literacy and inform the Pap testing behaviors of AI women. However, the influences of health literacy, sources, and types of health information along with cultural and psychosocial correlates on the Pap testing behaviors of AI women are poorly understood. To examine how sources and types of health information impact health literacy, and in turn, how health literacy and cultural and psychosocial factors influence the Pap testing behaviors of AI women. An adapted Health Literacy Skills Framework guided the selection of variables for this cross-sectional study. Convenience sampling was used to recruit 167 AI women, 21-65 years. Multivariate logistic regression was used to assess correlates of Pap testing after adjusting for covariates (age, education, English proficiency, employment, income, health insurance, access to primary care, marital status, and healthcare provider recommendation). Most participants (71%) had received a Pap test in the past and used multiple (two or more) sources (65%) and types (57%) of health information. Using multiple sources of health information (aOR 0.11, p < 0.01) but not types of health information was associated with Pap testing. Having negative cultural beliefs (aOR 0.17, p = 0.01) and having high self-efficacy (aOR 9.38, p < 0.01) were significantly associated with Pap testing after adjusting for covariates. High health literacy (OR 3.23, p < 0.05) and high decisional balance (OR 5.28, p < 0.001) were associated with Pap testing in bivariate models but did not remain significant after controlling for covariates. Cultural beliefs was a significant correlate of AI women's Pap testing behaviors regardless of other known social determinants of health (education, English proficiency, age, access to primary care). Disseminating health information through various sources has the potential to promote Pap testing among AI women. Larger studies which utilize a robust sampling strategy and include a diverse group of AI women are needed in order to optimize health interventions aimed at improving Pap test screening behaviors among AI women.
非洲移民（AI）女性进行巴氏涂片检查的比例较低。健康素养在健康行为中起着关键作用。健康信息的来源和类型可能会影响健康素养，并影响 AI 女性的巴氏涂片检查行为。然而，健康素养、健康信息的来源和类型以及文化和心理社会因素对 AI 女性巴氏涂片检查行为的影响还知之甚少。为了研究健康信息的来源和类型如何影响健康素养，以及健康素养和文化心理社会因素如何反过来影响 AI 女性的巴氏涂片检查行为。一个经过改编的健康素养技能框架指导了本横断面研究的变量选择。使用方便抽样招募了 167 名年龄在 21-65 岁的 AI 女性。使用多元逻辑回归在调整协变量（年龄、教育程度、英语水平、就业、收入、医疗保险、获得初级保健、婚姻状况和医疗保健提供者的建议）后评估巴氏涂片检查的相关性。大多数参与者（71%）过去曾接受过巴氏涂片检查，使用了多种（两种或更多种）来源（65%）和类型（57%）的健康信息。使用多种健康信息来源（比值比 0.11，p<0.01）而不是健康信息类型与巴氏涂片检查有关。具有消极的文化信念（比值比 0.17，p=0.01）和具有高自我效能感（比值比 9.38，p<0.01）在调整协变量后与巴氏涂片检查显著相关。高健康素养（比值比 3.23，p<0.05）和高决策平衡（比值比 5.28，p<0.001）与巴氏涂片检查有关，但在控制协变量后不再显著。文化信念是 AI 女性巴氏涂片检查行为的重要相关因素，无论其他已知的健康决定因素（教育、英语水平、年龄、获得初级保健）如何。通过各种来源传播健康信息有可能促进 AI 女性进行巴氏涂片检查。需要更大规模的研究，采用稳健的抽样策略并包括更多不同的 AI 女性，以便优化旨在改善 AI 女性巴氏涂片检查行为的健康干预措施。
