Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA.
Cancer Causes Control. 2022 Jun;33(6):861-873. doi: 10.1007/s10552-022-01573-y. Epub 2022 Mar 25.
Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women.
Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews.
Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate.
The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.
尽管宫颈癌是少数几种如果早期发现可以预防的癌症之一，但服务不足的黑人和西班牙裔/拉丁裔女性在异常巴氏试验后进行后续护理的比例较低。然而，现有的文献在增加这一人群的后续护理方面缺乏有效的干预措施。一项同时进行的混合方法研究旨在评估基于短信的干预措施的可接受性，并确定服务不足的主要为黑人和西班牙裔/拉丁裔女性在异常巴氏试验后进行后续护理的感知障碍和促进因素。
完成异常巴氏试验随访的患者被招募来完成横断面调查、定性访谈评估后续护理的障碍和促进因素，以及短信内容评估（N=28）。描述性统计用于描述背景变量并评估短信的可接受性。对定性访谈进行了有针对性的内容分析。
参与者对基于短信的干预措施表现出增加异常巴氏试验随访的兴趣。在定性访谈中，对宫颈癌风险的知识水平低和对阴道镜检查/结果的负面情绪被确定为后续护理的障碍。后续护理的促进因素包括阴道镜检查后的放松和足够的社会支持。参与者认为短信易于理解、与个人相关且具有文化适宜性。
研究结果表明，服务不足的黑人和西班牙裔/拉丁裔女性经历认知和情感障碍，这削弱了她们获得后续护理的能力，而基于短信的干预措施可能有助于女性克服这些障碍。未来的研究应开发和评估基于短信的干预措施，以增强异常巴氏试验后的后续护理。
