Abstract
1. Kelly Ackerson[1][1] 2. Lisa Stines Doane[2][2] 3. Robert McNutt[1][1] 4. Yuanyuan Shao[1][1] 1. 1Western Michigan University, Kalamazoo, USA 2. 2Cleveland State University, OH, USA 1. Kelly Ackerson, Associate Professor, Bronson School of Nursing, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008-5345, USA. Email: kelly.ackerson{at}wmich.edu This study is a report on modifications and pilot testing of a measurement tool to predict Pap testing based on the Interaction Model of Client Health Behavior. Women have been found to avoid routine cervical cancer screening (CCS) due to personal influencing factors. For this study, the Pap Smear Belief Questionnaire (PSBQ) was modified by adding items and evaluated through content validity index (CVI = .89) and cognitive interviews (think-aloud protocol), resulting in a 31-item instrument with four subscales (Benefits, Barriers, Vulnerability, Experiences). Pilot testing the modified PSBQ was conducted at a local agency. Fifty-three women completed and returned the PSBQ, which had good internal consistency, with a Cronbach’s alpha coefficient of .81 (Benefits α = .51; Barriers α = .85; Vulnerability α = .78; Experiences α = .87). Test–retest reliability of the 31-item PSBQ was also good (.878). Univariate logistic regression indicated that the only significant predictor of seeking/avoiding routine screening by women’s background characteristics was social influence ( p = .04). Subscales found to be significant predictors in Pap testing were Barriers ( p = .003) and Gynecological Exam Experiences ( p = .04). The refined 31-item PSBQ has good psychometric data supporting its use in predicting CCS. However, this research should be replicated in a larger sample enabling further validity and reliability testing of the PSBQ. Understanding women’s attitudes toward CCS will help health care providers, who deal with gynecological health, develop more effective screening programs and interventions facilitating better experiences for women contributing to an increase in routine screening. [1]: #aff-1 [2]: #aff-2
Highlights
In 2010, a total of 11,818 women in the United States were newly diagnosed with cervical cancer and 3,939 women died from the disease (Centers for Disease Control and Prevention [CDC], 2012)
It is important that we gain a better understanding of the factors that contribute to avoidance of cancer screening (CCS) in women who have access to health care but avoid screening despite these resources
In previous qualitative research on attitudes toward CCS (Ackerson, 2010; Ackerson, Pohl, & Low, 2008), some participants chose not to get a Pap test even though they had available resources. In these small qualitative studies, personal barriers emerged as the most powerful factor related to avoidance of routine screening. We propose that these other barriers, those relating to personal history, will predict avoidance behavior in this sample of women with access to health care
Summary
In 2010, a total of 11,818 women in the United States were newly diagnosed with cervical cancer and 3,939 women died from the disease (Centers for Disease Control and Prevention [CDC], 2012). In previous qualitative research on attitudes toward CCS (Ackerson, 2010; Ackerson, Pohl, & Low, 2008), some participants chose not to get a Pap test even though they had available resources (i.e., access to care, insurance coverage) In these small qualitative studies, personal barriers (including negative emotions) emerged as the most powerful factor related to avoidance of routine screening. The client singularity element includes a range of dynamic variables, such as cognitive appraisal (beliefs about the benefits and barriers to CCS, perceptions of vulnerability to cervical cancer), affective response (emotional reactions to an event such as previous screening/health care interactions), and motivation (a process that causes action and involves social, emotional response and cognitive forces). The variables included in client singularity are believed to interact to produce a specific health behavior (i.e., seeking or avoiding Pap tests)
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