Applying the transtheoretical model to cervical cancer screening in Vietnamese‐American women

Abstract

Low levels of Papanicolaou (Pap) screening participation in Vietnamese-American women remain a significant public health problem. The transtheoretical model (TTM) suggests that individuals adopting Pap smear behaviour move through a series of stages of readiness to change. Determining a woman's level of readiness for regular Pap testing and identifying the screening behaviour that an individual already performs is important in the development of successful intervention programmes that address the specific needs of Vietnamese-American women in different stages. To describe Pap smear screening behaviours of Vietnamese-American women, and to examine whether constructs (stages of change, self-efficacy and perceived benefits/barriers) from the TTM are applicable to Vietnamese-American women relative to Pap testing. A descriptive, cross-sectional design with snowball sampling was used to recruit participants. A total of 80 Vietnamese-American women completed the self-administered questionnaire. Most respondents (62.5%) reported previous Pap testing and only 46.3% receiving regular Pap testing. Compared with those in the pre-contemplation stage of the TTM, participants in maintenance reported significantly less self-efficacy (F (3, 73) = 4.85, P = 0.00), a lower level of perceived barriers (F (3, 75) = 5.99, P = 0.00) and a higher level of perceived benefits (F (3, 76) = 3.91, P = 0.01) relative to Pap smear. The results support some of the assumptions of the TTM but raise questions about the predicted relationships between stages of change and self-efficacy. Continued research is needed to identify the most effective theory-based interventions for evidence-based nursing practice in this population.