Cervical Cancer Prevention Behaviors Research Articles

Abstract A058: "That’s our culture...”: A qualitative study on factors that influence cervical cancer stigma in the Caribbean

Abstract Background: Cancer stigma, which encompasses the negative responses of nations, communities, families, and individuals towards those affected by cancer, presents a growing challenge in low-resourced societies and various parts of the world. In particular, cervical cancer (CCA) stigma has become increasingly prevalent in numerous cultures and societies. This stigma is fueled by the fact that nearly 99% of CCA cases and pre-cancerous cervical lesions are attributed to infection with the sexually transmitted human papillomavirus (HPV). Despite the substantial burden CCA stigma and the availability of widely accessible, cost-effective services, Caribbean women exhibit alarmingly low rates of appropriate CCA screening practices and HPV vaccination for their children, both in the U.S. and the Caribbean. To enhance the effectiveness of CCA prevention efforts in the U.S, it is imperative to include studies involving Caribbean nations with significant immigration to the U.S. Objective: This study aimed to explore the manifestations of cancer stigma among men and women aged 18-85 in Grenada, Jamaica, and Trinidad & Tobago, and its potential impact on CCA prevention behaviors. Design and Methods: Employing a community-based participatory research approach, academic institutions collaborated with community leaders in each country to conduct a cross-sectional qualitative study using focus groups. Thematic analysis was performed using MAXQDA data analysis software to examine the role of stigma in CCA prevention behaviors. Results: Three focus groups were conducted in each country, with a total of 69 participants. Major themes emerged regarding the influence of stigma on CCA cancer prevention efforts, including fatalism, cultural views, and confidentiality. Participants demonstrated knowledge of the sexually transmitted nature of HPV, which causes CCA, contributing to the stigmatization of the disease. Stigma was associated with unwarranted assumptions of female promiscuity. The stigmatization of CCA was characterized by blame and the belief that women with the disease should feel ashamed, creating significant barriers to HPV vaccination and pap testing. Cancer was often regarded as a death sentence and rarely discussed among family and friends, further deterring women from seeking screening, early detection, and support. Fear and misinformation surrounding the pap testing procedure, as well as concerns about medical confidentiality, also hindered screening. Conclusion: Generalized cancer stigma (viewing cancer as a death sentence) and specific CCA cancer stigma (shame and blame) have adverse effects on CCA prevention efforts. Further research is needed to assess the multifaceted dimensions of cancer stigma and inform interventions aimed at improving CCA cancer screening and HPV vaccination in the Caribbean. Investigating and addressing the various dimensions of cancer stigma within the non-patient population are required to inform strategies to reduce stigma’s influence; and thus improve CCA screening and HPV vaccination to prevent cancer and save lives. Citation Format: Kamilah B. Thomas-Purcell, Diadrey-Ann Sealy, Althea Bailey, Sherry-Ann Joseph, Kimlin Ashing. "That’s our culture...”: A qualitative study on factors that influence cervical cancer stigma in the Caribbean [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A058.

PENGARUH PENDIDIKAN KESEHATAN DENGAN METODE GUIDANCE AND COUNSELING TERHADAP PENGETAHUAN WANITA USIA SUBUR UNTUK PENCEGAHAN KANKER SERVIKS

Cervical cancer is a malignant disease of the female reproductive organs. One of the interventions that can be done to prevent cervical cancer is to increase the knowledge of women of childbearing age with guidance and counseling methods. The guidance and counseling method can empower clients and develop their potential optimally so as to create awareness for cervical cancer prevention behavior. This study aims to determine the effect of health education about cervical cancer with guidance and counseling methods on the knowledge of women of childbearing age for the prevention of cervical cancer. This study used a pre-experimental design with a one group pre-test post-test design. This study was conducted in the work area of Puskesmas Simpang Baru with a total sample of 55 respondents who were members of one group with purposive sampling technique. The measuring instrument used was a cervical cancer knowledge questionnaire that had been tested for validity and reliability. Data analysis used was univariate and bivariate analysis using Wilcoxon test. The results showed that from demographic data, the majority of respondents were in late adulthood (36-46 years) with a percentage of (49,1%), Minang ethnicity (49,1%), multiparous parity (80%) with a high school / equivalent education level (50,9%) and the majority of respondents' jobs were not working / housewife (72,7%). There was a change in the minimum and maximum values during the pre-test 7-21 which increased during the post-test to 16-22, a change in the mean value during the pre-test and post-test with an increase of 4,13. The results of the Wilcoxon statistical test obtained a p value (0,000) < ? (0,05). This shows that health education about cervical cancer with the guidance and counseling method affects the knowledge of women of childbearing age for the prevention of cervical cancer.

The Effect of Cervical Cancer Counseling on Cervical Cancer Prevention Behavior in Women of Childbearing Age: A Literature Study

Background: : According to World Health Organization (WHO) data, cervical cancer is the second leading cause of death worldwide . In 2020 the worldwide burden of cervical cancer is significant, there are an estimated 604,000 new infections and 342,000 deaths in 2020. Based on Riskesdas data, the prevalence of tumor/cancer, especially cervical cancer, in Indonesia ranks second with 36,633 cases, accounting for 9.2% of all cancer cases. Effective interventions at various life stages could significantly reduce global mortality from cervical cancer. Objective: This study was conducted to examine the impact of cervical cancer counseling on cervical cancer prevention behavior in women of reproductive age. Methods: Conducting a literature review of previous journal articles related to the effects of cervical cancer counseling on cervical cancer prevention behavior in women of childbearing age. Results: The results of this study indicate that cervical cancer is a significant reproductive health issue in Indonesia due to low screening coverage and lack of knowledge, resulting in late diagnosis. However, education and counseling can play a vital role in increasing awareness and promoting preventive behavior towards cervical cancer. Conclusion: Education and counseling interventions can effectively increase awareness and promote preventive behavior, this promotive and preventive behavior greatly reduces the burden of cervical cancer.

Exploring Factors Influencing Cervical Cancer Prevention Behaviors: Unveiling Perspectives of Conservative Muslim American Women in Virginia.

Understanding the complexities surrounding cervical cancer prevention methods and hesitancy among conservative Muslim American women is crucial in addressing health disparities. This qualitative study aimed to delve into the religious, behavioral, and socio-cultural factors influencing Muslim women's decisions regarding cervical cancer screening (CC-S) and HPV vaccination (HPV-V) in Virginia, USA. Through interviews with 10 Muslim women residing in Virginia, qualitative data were collected as part of a mixed-method cross-sectional study conducted between August and September 2021. Findings revealed that participants had limited knowledge about cervical cancer, CC-S, and HPV-V, with notable themes emerging, such as cultural influences, misconceptions, language barriers, and challenges posed by the intricate US healthcare system. Future research should focus on exploring these barriers to mitigate the impact of cervical cancer within the Muslim population.

Factors associated with Pap test screening among South Korean women aged 20 to 39 years.

The number of hospital visits with cervical cancer as the chief complaint among South Korean women aged 20 to 39 has increased by 1.2 times between 2016 and 2020, indicating a need for active screening for the disease. This study aimed to investigate the status of the Papanicolaou (Pap) test and identify factors influencing Pap test experience among South Korean women aged 20 to 39 years. An online questionnaire survey was conducted over 5 days starting from November 19, 2021. A total of 338 participants who were randomly sampled by age completed the survey. Data were analyzed using descriptive statistics, t test, χ2 test, and logistic regression. The mean age of the participants was 29.9 years, and participants with and without Pap test experience accounted for 60.7% and 39.3% of the total, respectively. There were significant differences in age, marital status, employment status, smoking status, experience of coitus, awareness of the National Cancer Screening Program, and human papillomavirus (HPV) vaccination status according to the Pap test experience (P < .05) of the participants. Pap test attitude, Pap test self-efficacy, cervical cancer knowledge, HPV knowledge, and cancer prevention behavior scores were significantly higher in the Pap test experience group than in the no Pap test experience group (P < .05). Logistic regression analysis showed that experience of coitus (odds ratio [OR] = 10.46, 95% confidence interval [CI]: 4.54-24.11), marital status (OR = 5.96, 95% CI: 2.25-15.77), awareness of the National Cancer Screening Program (OR = 4.39, 95% CI: 1.66-11.58), HPV vaccination (OR = 2.62, 95% CI: 1.35-5.09), employment status (OR = 2.22, 95% CI: 1.08-4.59), and self-efficacy (OR = 1.09, 95% CI: 1.01-1.19) were the influencing factors in the Pap test experience group. To improve the Pap test screening rate among South Korean women aged 20 to 39, reinforcement strategies and intervention programs that involve age-specific approaches must be established.

Peer Group Method Can Improve Adolescent Behavior in Prevention of Cervical Cancer

Cervical cancer is a disease that often attacks women's reproductive health. So we need a communityempowerment in the form of training of trainers to improve cervical cancer prevention behavior inadolescents with a peer group method approach. Facilitation activities include counseling on peer group learning methods, conducting training on improving behavior in preventing cervical cancer with the peer group method for adolescents. Activities carried out for one month, starting from planning, preparation, implementation and evaluation. This training was able to increase knowledge, attitudes and behavior in preventing cervical cancer in adolescents. It is recommended that participants who have been trained to be tutors are able to train their peers at school and in their neighborhood.

Perceptions, Knowledge, Attitudes, and Cervical Cancer Prevention Behavior Among Health and Non-Health Scholar

Background: Cervical cancer is still a leading cause of death fourth in women in the world and in Indonesia it is the second leading cause of death in women after breast cancer, including in the adolescent group. This study aimed to explore distinguish perception, knowledge, attitude, and cervical cancer prevention among health and non-health scholars in Indonesia. Method: Used an analytical observational design with a cross-sectional approach. The sample in this study were 364 students, consisting of 168 health students and 196 non-health scholars. Data analysis used univariate and bivariate analysis using independent t tests. Results: there are differences in perceptions of cervical cancer prevention between health and non-health students with an average value of 17.34 (2.11) for health students, while for non-health students 16.80 (1.94) with p_value 0.012, including variables knowledge and attitude differences in cervical cancer prevention (in health students the average knowledge = 11.95, 0.95; the average attitude = 21.57, 2.08, while in non-health students the average knowledge = 10.81, 1.06; the average attitude = 20.62, 2.25). The p value for the attitude variable is 0.000 and the knowledge variable is 0.001. Conclusion: there are differences in perceptions, knowledge, and attitudes towards cervical cancer prevention in health and non-health scholars, Indonesia.&#x0D;

Abstract A097: Examining differences based on gender and sexual orientation for cervical cancer screening and prevention behaviors

Abstract Background Population-based studies to examine cervical cancer screening and prevention among sexual and gender diverse (SGD) individuals have been limited. We conducted a state-wide survey in New Mexico (NM) to examine differences in cervical cancer screening and HPV vaccination uptake based on gender and sexual orientation. Methods The survey was advertised using mailed flyers, social media, and targeted internet ads across the state. We received a total of 2534 responses, of which 797 respondents were cervical cancer screening eligible (i.e., between 21-65 years old, had a cervix, and did not have a prior cervical cancer diagnosis) and provided information about cervical cancer screening and were included in this analysis. Descriptive statistics were conducted using SAS 9.4. Results Of the 797 respondents, 83% were 21 - 40 years old, 44% were white, 34% reported an annual household income below $50,000, 83% were employed, 81% had health insurance, and 73% reported having a primary care provider. Fourteen percent were transgender men or nonbinary, 86% were cisgender women, 34% were bisexual, 48% were lesbian, and 18% were queer. While there were no statistical differences in self-reported cervical cancer screening based on gender identity, 31% of cisgender women and 25% of transgender men and nonbinary individuals reported never receiving a Pap test. The top reason for never receiving a Pap test among cisgender women was that their healthcare provider told them they did not need it (17%) and for transgender men and nonbinary individuals the top reasons were that they had an HPV vaccine (21%) or that it was too painful, unpleasant, or embarrassing (21%). There were significant statistical differences based on sexual orientation for receiving a Pap test (p&amp;lt;0.001) and for being up to date on screening (Pap test in the past 3 years, a co-test, or primary HPV test in the past 5 years) (p=0.03). Among lesbians, 39% reported never having a Pap test, compared with 17% of bisexuals and 30% of queer individuals. For lesbians, the top reason for not receiving a Pap test was not knowing that Pap tests existed (19%), while the top reason for both bisexual and queer individuals was that their healthcare provider told them they did not need it (17% and 19%, respectively). No significant differences were noted in HPV vaccination uptake among respondents. Conclusions In order to address sexual orientation differences noted in our study, future research is needed to explore mechanisms through which these differences operate using community-based approaches. Additionally, educational interventions inclusive of different gender identities and sexual orientations are needed to improve motivations for screening uptake among SGD individuals. Finally, specific considerations for SGD individuals should be incorporated into screening recommendations and guidelines and clearly communicated to providers, further enabling them to make recommendations for these populations. Citation Format: Prajakta Adsul, Deborah Kanda, Emily Wu, Molly McClain, Vernon Shane Pankratz, Shiraz Mishra, Bernard Tawfik, Uma Nair, Tamara Stimatze, Purnima Madhivanan, Miria Kano. Examining differences based on gender and sexual orientation for cervical cancer screening and prevention behaviors [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A097.

Relationship Husband Support With Cervic Cancer Prevention Behavior To Women Of Young Married Age In The Village Tuntungan I Pancur Batu In 2022

Cervical cancer prevention behavior is an action taken to prevent cervical cancer by avoiding risk factors. The behavior of women in conducting the examination is influenced by the husband's support which shows the husband's understanding of his wife providing motivation, support, and increasing feelings of security in a relationship. This study aims to determine the relationship between husband's support and cervical cancer prevention behavior on young married women in Tuntungan Pancur Batu Village in 2022. The research design is a cross sectional population in this study as many as 85 people. The sampling technique is purposive sampling. The results of the study obtain bad husband support (95.3%) and bad cervical cancer prevention behavior as much as (84.7%). The results of the Chi Square statistical test obtain a P-value = 0.048 (p&gt;0.05) so it is concluded that there is a significant relationship between husband's support and cervical cancer prevention behavior in young married women at Tuntungan Village I Pancur Batu. It is hoped that women can improve cervical cancer prevention behavior by increasing knowledge and self-awareness.

Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial

BackgroundApplications of mobile technologies (mHealth) have the potential to reduce health inequalities, give patients more control over their health, and improve health care’s cost-effectiveness. The widespread use of mobile phones offers us a new way to prevent cervical cancer. The objective of the study was to design and develop a mobile phone application (app) that aims to conduct a behavioral intervention for women and to evaluate the efficacy of the app-based intervention.MethodsThis study involves 5 phases. In the first phase, understanding women’s perspectives will be identified using a qualitative approach based on the I-Change model. In phase 2, the results from the qualitative approach and requirement prioritization through providing experts’ perspectives will be done. The main outputs of this phase will be resulted in prioritizing the main measurable effective variables of the I-Change model. Phase 3 will be processed for the development and psychometric of an assessment tool regarding selected constructs. In phase 4, the App framework and content development will be performed. In phase 5, a three-armed, parallel-design randomized controlled trial will be conducted on women. Two hundred ten women will be randomly assigned to three groups including two intervention groups and one control group. The intervention groups included the following: (1) a mobile application and (2) a digital book. The data will be evaluated using tools designed and constructed in phase 3 of the study at baseline in 3-month follow-up assessments. The impact of the two interventions on cervical cancer prevention behaviors through mobile-based educational intervention will then be evaluated.DiscussionA theory-based health education program using a mobile app to improve cervical cancer-preventive behaviors will be implemented for the first time in Iran. With an effective health mobile-based educational design, it is very important to determine whether Iranian women will be motivated to adhere to preventive behavior related to CC.Trial registrationIranian Clinical Trial Register IRCT20181205041861N3. Registered V2.0 on 26 October 2021.

Behaviour of cervical cancer prevention among fertile age woman: health promotion approach

Cervical cancer incidences have tremendous effects on patients' quality of life and their families and affect government health expenditure. Prevention and early detection action are urgently needed. This study aimed to analyze the prevention behavior of cervical cancer of fertile ages women based on the Health Promotion Model. This study involved 196 samples taken by cluster sampling. Independent variables included personal factors, including ages, perceived health status and culture, perceived benefits, perceived barriers, self-efficacy and attitudes related to activities, husband's support, and situational influences. The dependent variable was the behavior of cervical cancer prevention. Data were collected using a questionnaire then analyzed by logistic regression with α&amp;lt;0.05. There was a relationship between perceived barriers (p=0.004) and situational influences (p=0.021) with cervical cancer prevention behavior. However, there is no relationship between personal factors, perceived benefits, self-efficacy, attitudes related to activity, and husband's support. Further research can be conducted through a qualitative framework to explore cervical cancer prevention of fertile age’s women.

Examining differences based on gender and sexual orientation for cervical cancer screening and prevention behaviors.

5533 Background: Population-based studies to examine cervical cancer screening (CCS) and prevention among sexual and gender diverse (SGD) individuals have been limited. We conducted a state-wide survey in New Mexico to examine differences in CCS and HPV vaccination uptake based on gender and sexual orientation. Methods: The survey was advertised using mailed flyers, social media, and targeted internet ads across the state. We received a total of 2534 responses, of which 797 respondents were CCS eligible (i.e., between 21-65 years old, had a cervix, and did not have a prior cervical cancer diagnosis) and provided information about CCS and were included in this analysis. Descriptive statistics were conducted using SAS 9.4. Results: Of the 797 respondents, 83% were 21 - 40 years old, 44% were white, 34% reported an annual household income below $50,000, 83% were employed, 81% had health insurance, and 73% reported having a primary care provider. Fourteen percent were transgender men or nonbinary, 86% were cisgender women, 34% were bisexual, 48% were lesbian, and 18% were queer. While there were no statistical differences in self-reported CCS based on gender identity, 31% of cisgender women and 25% of transgender men and nonbinary individuals reported never receiving a Pap test. The top reason for never receiving a Pap test among cisgender women was that their healthcare provider told them they did not need it (17%) and for transgender men and nonbinary individuals the top reasons were that they had an HPV vaccine (21%) or that it was too painful, unpleasant, or embarrassing (21%). There were significant statistical differences based on sexual orientation for receiving a Pap test (p &lt; 0.001) and for being up to date on screening (Pap test in the past 3 years, a co-test, or primary HPV test in the past 5 years) (p = 0.03). Among lesbians, 39% reported never having a Pap test, compared with 17% of bisexuals and 30% of queer individuals. For lesbians, the top reason for not receiving a Pap test was not knowing that Pap tests existed (19%), while the top reason for both bisexual and queer individuals was that their healthcare provider told them they did not need it (17% and 19%, respectively). No significant differences were noted in HPV vaccination uptake among respondents. Conclusions: In order to address sexual orientation differences noted in our study, future research is needed to explore mechanisms through which these differences operate using community-based approaches. Additionally, educational interventions inclusive of different gender identities and sexual orientations are needed to improve motivations for screening uptake among SGD individuals. Finally, specific considerations for SGD individuals should be incorporated into screening recommendations and guidelines and clearly communicated to providers, further enabling them to make recommendations for these populations.

A Correlation level of knowledge about cervical cancer with cervical cancer prevention behavior in adolescent women class X &amp; XI AT SMK Muhammadiyah Berbah

Background : Cervical cancer is the second most common malignant tumor in women in women world and the most common types of cancer found in women in developing countries, including Indonesia. It is estimated that the number of people with this cancer will increase in the future due to lifestyle changes. The incidence of cervical cancer in Southeast Asia is 30-44.9 per 100,000 women each year. The estimated incidence of cervical cancer is 385,540 cases worldwide and in the last 3 years it has increased to 26.1 per 100,000 population.&#x0D; Purpose: to determine the level of knowledge with cervical cancer prevention behavior in adolescent girls in class X-XI SMK Muhammadiyah Brebah.&#x0D; Research method: this is a quantitative research with a non- experimental. The research was carried out at SMK Muhammadiyah Brebah. The sampling technique used is total sampling. With respondents as many as 93 young women class X and XI SMK Muhammadiyah Brebah. The instrument used is a questionnaire.&#x0D; Results: From the results of the level of knowledge with preventive behavior of adolescent girls in grades X and XI about cervical cancer, the correlation coefficient was 0.241 with a significance of 0.017.&#x0D; Conclusion: There is a relationship between the level of knowledge about cervical cancer and the behavior of preventing cervical cancer for female adolescents in class X and XI at SMK Muhammadiyah Berbah.

The Impact of Cultural Beliefs About Cervical Cancer Screening on Clinical Practice: A Qualitative Study of Asian Indian Women in Texas

Background: Asian Indians, primarily through immigration, are among the three fastest growing Asian minority populations in the United States. Sadly, Asian Indian Women did not meet the Health People 2020’s the 93% cervical cancer screening goal of 93%. Cervical cancer screening rates among Asian Indian Women were 70.5% compared to 82.7% among non-Hispanic Whites. A systematic review revealed the need for qualitative studies to explore influences of cultural beliefs on cervical cancer screening (pap smears) behaviors among Asian Indian Women applying symbolic interactionism theoretical framework. Purpose: To explore the influence of cultural beliefs on cervical cancer screening behaviors among Asian Indian Women. Method: A qualitative descriptive ethnographic design used descriptive ethosemantic semi-structured questions to investigate cultural impact on cervical cancer prevention behaviors among a purposive sample of 15 Asian Indian Women between the ages 21 to 49 years of age. Data analysis used inductive analytical methods. Findings: Five themes influenced cervical cancer screening: locus of control, concept of health, ‘no sex before marriage,’ awareness, and body image. A healthy internal locus of control, sense of being healthy, awareness, and positive body image supported cervical cancer screening behaviors. An external locus of control, belief that health is not a priority, “no sex before marriage,” and low body image were barriers to cervical cancer screening behaviors. Additionally, the concept of “no sex before marriage” influenced timing of the first pap smear. Notwithstanding their cultural beliefs, employment, health insurance, and recommendations from their providers had a positive impact on cervical cancer screening. Conclusion: Findings from this study have implications for both health policy and clinical practice. Health policy influences funding for basic screening and preventive services. Clinical practice implications encompass fostering partnerships within the community to promote prevention programs and cultural sensitivity training for providers. Future community-based participatory research should address interventional studies to increase compliance for cervical cancer screening and prevention behaviors among Asian Indian Women.

Cervical Cancer Knowledge as a Predictor of Latent Class Membership among African American and Hispanic Young Adult College Women

Background: Multiple studies have shown that African-American and Hispanic women have limited and inadequate knowledge about cervical cancer (CC) and CC screening, which contributes to morbidity and mortality disparities. Access to knowledge, education, and other socio-political factors are social determinants of health that serve to shape individual health behavior knowledge. Better CC knowledge has been shown to increase screening uptake. Methods: In the present study, we specified unique subgroups regarding CC prevention behaviors in a sample of African- American and Hispanic women (N = 328) recruited from a minority-serving higher education institution. Results: Latent class analysis identified 3 unique salient subgroups based on the indicators: CC Screening Adherers and Vaccinators (14%), CC Screening Adherers (48%), and CC Prevention Non-adherers (38%). We found probable variations within the classes regarding screening behavior, human papillomavirus (HPV) vaccination status, and race/ethnicity. Women reporting higher guideline knowledge were 11 times more likely to be classified as CC Screening Adherers and Vaccinators than CC Prevention Non-adherers. Additionally, women who specifically understood that HPV causes cervical cancer were 16 and 9 times more likely to be classified as CC Screening Adherers and Vaccinators and CC Screening Adherers than to be classified as CC Prevention Nonadherers. Conclusion: Addressing cervical cancer knowledge remains an important intervention strategy in these populations to increase CC screening uptake.

Cervical Cancer Prevention Behaviors Among Criminal-Legal Involved Women from Three U.S. Cities.

Background: This study aims to understand how criminal-legal involved women from three U.S. cities navigate different health resource environments to obtain cervical cancer screening and follow-up care. Methods: We conducted a cross-sectional study of women with criminal-legal histories from Kansas City KS/MO; Oakland, CA; and Birmingham, AL. Participants completed a survey that explored influences on cervical cancer prevention. Responses from all women with/without up-to-date cervical cancer screening and women with abnormal Pap testing who did/did not obtain follow-up care were compared. Proportions and associations were tested with chi-square or analysis of variance tests. Multivariable regression was performed to identify variables independently associated with up-to-date cervical cancer screening and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: There were n = 510 participants, including n = 164 Birmingham, n = 108 Kansas City, and n = 238 Oakland women. Criminal-legal involved women in Birmingham (71.3%) and Kansas City (68.9%) were less likely to have up-to-date cervical cancer screening than women in Oakland (84.5%, p = 0.01). More women in Birmingham (14.6%) and Kansas City (16.7%) needed follow-up for abnormal Pap than women in Oakland (6.7%, p = 0.003), but there were no differences in follow-up rates. Predictors for up-to-date cervical cancer screening included access to a primary care provider (OR: 3.3, 95% CI: 1.4-7.7), health literacy (OR: 0.3, 95% CI: 0.2-0.7), and health behaviors, including avoiding tobacco (OR: 0.4, 95% CI: 0.1-0.9) and HPV vaccination (OR: 3.4, 95% CI: 1.0-10.9). Conclusions: Cervical cancer screening and follow-up varied by study site. The results suggest that patient level factors coupled with the complexity of accessing care in different health resource environments impact criminal-legal involved women's cervical cancer prevention behaviors.

Determinant of Primary Preventive Behaviour Cervical Cancer in an Adolescent Girl

Cervical cancer is caused by infection with the human papilloma virus which can infect the genitals, anus,throat, mouth and cells on the surface of the skin. Cervical cancer is often late so that it can cause death,so efforts are needed to reduce the risk factors for cervical cancer, namely through primary preventionefforts. The purpose of this study was to determine the relationship between primary factors and cervicalcancer prevention behavior in adolescent girls. The sample in this study were 77 young women who weretaken by technique purposive sampling. The research design used was an observational analysis using across sectional approach and analyzed using chi-square. The results of this study illustrate that there is arelationship between knowledge, attitudes and social support with cervical cancer prevention behavior inadolescent girls. So we need efforts to reduce cervical cancer risk factors, namely through primary preventionefforts, by increasing outreach activities in the community to carry out a healthy lifestyle.

Cervical cancer screening and follow-up among women in the criminal-legal system

<h3>Objectives:</h3> The one million U.S. women under supervision of the criminal-legal (CL) system are a populuation with 4-5 times the rate of cervical cancer than the general population–a disparity that has persisted for over 50 years. CL-involved women include those who have recently left jails/prisons, are on probation, or are in community corrections but still under legal supervision. Up to 60% of CL-involved women have a history of an abnormal Papanicolaou (Pap) test due to sexual health risks, trauma histories, and tenuous life circumstances that increase their risk of cervical dysplasia and serve as barriers to preventative care. The purpose of this study is to understand how women with CL involvement navigate individual, social, and community level systems to maintain their cervical health in varied funding and healthcare access environments. <h3>Methods:</h3> Retrospective cross-sectional study that analyzed baseline data from an ongoing longitudinal (2019-2024) study with CL-involved women, the Tri-City study. Data was collected from January-June 2020 and includes 508 CL-involved women from Kansas City, KS/MO (KC); Oakland, California (Oak); and Birmingham, AL (Birm). Participants completed a 288-item survey that explored influences on health services use as guided by the behavioral model for vulnerable populations (BMVP). Categorical variables were reported using frequencies and continuous data was reported as means with standard deviations. Proportions and associations were tested with chi-square or fisher's exact test. Multivariate regression was performed after controlling for study site and reported as odds ratios (OR) with 95% confidence intervals (CI) and corresponding p-values. <h3>Results:</h3> CL-involved women in KC (68.9%) and Birm (71.3%) were less likely to have up-to-date Pap testing than women in Oak (84.5%, p=0.01). Of the CL-involved women who needed follow-up for abnormal Pap results, only 58% of Birm and 66% of KC women completed follow-up whereas 88% of women in Oak completed follow-up and other 5% had an appointment scheduled (p=0.1). Using a BMVP framework, predictors for up-to-date Pap test included lower belief score for barriers to screening (OR 0.3, 95% CI 0.2-0.7, p=0.003), personal doctor (OR 3.3, 95% CI 1.4-7.7, p=0.005), not using tobacco (OR 0.4, 95% CI 0.1-0.9, p=0.05), and HPV vaccination (OR 3.4, 95% CI 1.0-10.9, p=0.04). When comparing CL-involved women who did or did not obtain follow-up for an abnormal Pap result, factors associated with follow-up in the bivariate analysis included lower susceptibility score (2.4 follow-up vs 3.1 no follow-up, p=0.007), lower severity of disease scores (3.3 follow-up vs 4.0 no follow-up, p=0.008), using hormonal birth control (22.5% follow-up vs 11.1% no follow-up, p=0.05), and not using condoms (42.5% follow-up vs 11.1% no follow-up, p=0.05). However, none of these variables were significant predictors of abnormal Pap follow-up in the multivariate model. <h3>Conclusions:</h3> Pap testing and follow-up varied by study site with the highest rates observed in Oakland, which was the only city that offered health services through Medicaid expansion. The results of our baseline data suggest that patient level factors coupled with the complexity of navigating community health delivery systems impacts CL-involved women's cervical cancer prevention behaviors.

Cervical Cancer Prevention Education Program for Rural Korean Immigrant Women.

The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention (p = .001), behavioral attitude toward cervical cancer prevention (p = .029) and behavioral intention regarding cervical cancer prevention (p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased (p = .029), but the rate of change in the selection of primary care providers was not significant. The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

Examining Cervical Cancer Preventive Behaviors for Latinx Transmasculine Individuals among Medical Students.

Latinx transmasculine men (LTM) can be at a particularly high risk for cervical cancer as they lie at the intersection of two health disparity populations (gender and ethnic minorities). Previous research using self-report measures has documented how negative interactions with providers are a key barrier for cervical cancer screening among LTM. However, no research to date has examined, via direct observation, cervical cancer preventive behaviors in clinical interactions with LTM. Thus, the objective of this study was to examine cervical cancer preventive behaviors in clinical interactions between medical students and an LTM. The team implemented standardized patient simulations (simulations of clinical interactions with actors portraying the role of a patient), self-report measures, and observational techniques. A total of 37 medical students participated in the study. The results were mixed with some key behaviors neglected (i.e., asking if the patient preferred to collect the HPV test sample by himself), while others were enacted (i.e., checking family history of cervical cancer). Further research is needed to better understand behaviors in clinical interactions with LTM as well as how to improve them.