Po Justine, Bookstein Arthur, Lee Woori, Barahona Rosa, Baezconde-Garbanati Lourdes
Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, United States.
Georgetown University School of Medicine, Washington DC 20007, United States.
JNCI Cancer Spectr. 2025 Jan 3;9(1). doi: 10.1093/jncics/pkaf006.
Screening represents a cornerstone of cervical cancer control strategy. However, disparities in social determinants of health have perpetuated gaps in screening among racial and ethnic minorities. Social determinants of health including cultural stigma and lack of insurance have contributed to decreased screening among Hispanic women. To increase cancer screening in this population, community-academic partnerships and culturally tailored media have emerged as promising strategies.
This study assessed the impact of a culturally tailored cervical cancer screening campaign implemented through academic-community-government partnerships. Intercept surveys, conducted from 2015 to 2018 in eastern neighborhoods of Los Angeles, assessed campaign recall, interpretation, and screening intention among Hispanic women aged 21-65 years after exposure to the campaign. Screening intention was evaluated using χ2 and logistic regression by participant characteristics, with thematic analysis for campaign interpretation.
Of 673 participants, 26.1% were uninsured, and 85.9% primarily spoke Spanish at home. Campaign recall was 25.1%, with 64.5% interpreting the campaign's message as cervical cancer screening or health checkups. The campaign's most liked aspect was emphasis on family (cited by 37.1% of participants). Postcampaign, 89.5% of participants overall were likely or extremely likely to schedule a Pap test, including 83.5% of women who had not had a Pap test in the past 3 years.
Our findings underscore several important strategies to reduce cervical cancer disparities: (1) associating positive cultural values with screening to decrease stigma, (2) combining culturally tailored outreach with interventions that target other known screening barriers, (3) facilitating long-term community relationships, and (4) leveraging academic-community-government partnerships.
筛查是宫颈癌防控策略的基石。然而,健康社会决定因素的差异使种族和少数族裔在筛查方面的差距长期存在。包括文化耻辱感和缺乏保险在内的健康社会决定因素导致西班牙裔女性的筛查率下降。为了提高这一人群的癌症筛查率,社区与学术机构的合作以及针对特定文化的媒体宣传已成为颇具前景的策略。
本研究评估了通过学术机构、社区和政府合作实施的针对特定文化的宫颈癌筛查活动的影响。2015年至2018年在洛杉矶东部社区进行的拦截式调查,评估了21至65岁的西班牙裔女性在接触该活动后对活动的回忆、理解以及筛查意愿。通过卡方检验和逻辑回归,根据参与者特征评估筛查意愿,并对活动理解进行主题分析。
在673名参与者中,26.1%没有保险,85.9%在家中主要说西班牙语。活动回忆率为25.1%,64.5%的人将活动信息理解为宫颈癌筛查或健康检查。活动最受欢迎的方面是对家庭的强调(37.1%的参与者提到)。活动后,总体上89.5%的参与者可能或极有可能安排巴氏试验,包括在过去3年中未进行过巴氏试验的女性中的83.5%。
我们的研究结果强调了几个减少宫颈癌差异的重要策略:(1)将积极的文化价值观与筛查联系起来以减少耻辱感;(2)将针对特定文化的外展活动与针对其他已知筛查障碍的干预措施相结合;(3)促进长期的社区关系;(4)利用学术机构、社区和政府的合作。