Onl women who are planning to have a famil need to have a ...
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® Normal Cell Division dividing cells cell migration dead cells healthy normal cells No or low knowledge of cervical cancer Negative beliefs and attitudes Increase likelihood of getting a pap smear at age 18 Low likelihood of getting a Pap smear at age 18 Increase: • Knowledge • Positive beliefs and attitudes Cervical cancer curriculum 0 1 2 3 4 5 Post-test Pre-test I H G F E D C B A 0 1 2 3 4 5 Post-test Pre-test I H G F E D C B A Figure 4: Mean differences between the pre- and post-tests in belief & attitude statements about cervical cancer and screening for the control group. Beliefs about screening and risk factors A. You can only get cancer if someone in your family has had it B. Women need a Pap smear only when they experience vaginal bleeding other than menstruation C. A Pap smear is only for women who are sexually active D. Only women who are planning to have a family need to have a Pap smear Attitudes about the Pap smear E. I am scared of having a Pap smear F. I would be embarrassed to get an exam from a male doctor G. A Pap smear is painful H. I would mind if my parents knew that I had a Pap smear Attitudes about cancer I. I would rather not know if I had cancer * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. Statement coding: (1 = strongly agree; 2 = agree; 3 = not sure; 4 = disagree; 5 = strongly disagree). * 0 20 40 60 80 100 Post-test Pre-test F E D C B A Figure 2: Percentage correct in knowledge questions for the control group. A. A Pap smear involves an “internal” examination B. The Pap smear tests for cervical cancer C. The Pap smear identifies abnormal cells D. A woman should be 18 years old or younger when she has her first Pap smear E. A woman should have a Pap smear every year F. Cervical cancer be treated * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. * * * * * Figure 3: Mean differences between the pre- and post-tests in belief & attitude statements about cervical cancer and screening for the intervention group. * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. Statement coding: (1 = strongly agree; 2 = agree; 3 = not sure; 4 = disagree; 5 = strongly disagree). Beliefs about screening and risk factors A. You can only get cancer if someone in your family has had it B. Women need a Pap smear only when they experience vaginal bleeding other than menstruation C. A Pap smear is only for women who are sexually active D. Only women who are planning to have a family need to have a Pap smear Attitudes about the Pap smear E. I am scared of having a Pap smear F. I would be embarrassed to get an exam from a male doctor G. A Pap smear is painful H. I would mind if my parents knew that I had a Pap smear Attitudes about cancer I. I would rather not know if I had cancer * * * * * 0 1 2 3 4 5 Post-test Pre-test E D C B A 0 1 2 3 4 5 Post-test Pre-test E D C B A Figure 6: Mean differences between the pre- and post-tests in belief and atti- tude statements about cervical cancer and screening for the control group. * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. Statement coding: (5 = strongly agree; 4 = agree; 3 = not sure; 2 = disagree; 1 = strongly disagree). Beliefs about screening and risk factors A. Smoking has been linked to cervical cancer Beliefs about cancer prevention B. You can prevent yourself from getting cervical cancer C. There is treatment for cervical cancer D. Early detection means cervical cancer can be cured Attitudes about cancer E. Screening for cervical cancer is a good way to help prevent cervical cancer * * Figure 5: Mean differences between the pre- and post-tests in belief and atti- tude statements about cervical cancer and screening for the intervention group. * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. Statement coding: (5 = strongly agree; 4 = agree; 3 = not sure; 2 = disagree; 1 = strongly disagree). Beliefs about screening and risk factors A. Smoking has been linked to cervical cancer Beliefs about cancer prevention B. You can prevent yourself from getting cervical cancer C. There is treatment for cervical cancer D. Early detection means cervical cancer can be cured Attitudes about cancer E. Screening for cervical cancer is a good way to help prevent cervical cancer * * * * Anatomy cervix vagina uterus 0 20 40 60 80 100 Post-test Pre-test F E D C B A Figure 1: Percentage correct in knowledge questions for the intervention group. A. A Pap smear involves an “internal” examination B. The Pap smear tests for cervical cancer C. The Pap smear identifies abnormal cells D. A woman should be 18 years old or younger when she has her first Pap smear E. A woman should have a Pap smear every year F. Cervical cancer be treated * signifies that there was a statistically significant change between the pre- and post-test at p < 0.05. * * * * * * MOTIVATION • Underutilization of screening services is thought to be a key factor related to the higher incidence of cervical cancer among Hispanic women. • In-depth interviews with Hispanics in the Yakima Valley, Washington suggested that fewer Hispanics than non-Hispanics had ever received a screening test for cervical cancer. • Classroom-based interventions on cervical cancer may be valuable for promoting cervical cancer screening among young women for several reasons: – They capture women who are eligible to receive initial screening tests. – They provide education to all economic segments of women, including those who may underutilize health care systems. OBJECTIVE • Examine whether a one-hour cervical cancer curriculum results in changes in adolescents’ knowledge, beliefs, and attitudes toward cervical cancer and screening, and affects their stated likelihood of having a Pap smear by age 18. METHODS • A one-hour cervical cancer curriculum was developed for high school students which included: – A presentation about how cancer develops and what are the risk factors and prevention strategies for cervical cancer, a video graphic of the Pap test procedure, and a section addressing barriers to screening called “concerns among adolescents” were included. – A role-play section allowing groups of students to work together to create a skit about cervical cancer and screening. – A question and answer session for discussing students’ written questions after the presentation. • Students from health classes at two high schools in the Lower Yakima Valley, Washington were assigned to the intervention or control group. • Students in the intervention group received the cervical cancer curriculum; those in the control received a breast cancer curriculum. • Pre- and post-tests were administered, containing questions related to knowledge, beliefs, attitudes about cervical cancer and screening and the likelihood of getting a Pap test by the age of 18. Knowledge, Beliefs, Attitudes, and Intentions Regarding Risk and Prevention of Cervical Cancer Among Hispanic Adolescents Silvia Tejeda, 1,2,3 Gloria Coronado, 1 Ilda Islas, 1 Jane Rees, 2, 3 and Beti Thompson 1,3 1 Fred Hutchinson Cancer Research Center • 2 Maternal and Child Health Program and 3 School of Public Health and Community Medicine, University of Washington, Seattle RESULTS Sample Characteristics • Data from 142 female participants were included. • The mean age was 15 years and 71% of the students were Hispanic. • In the pre-test, low percentages of women had heard of a Pap test: 17 (25.4%) said that they had heard of the Pap smear in the intervention group vs. 27 (38.0%) in the control group. • Also a low percentage had had a Pap smear: 4 (5.6%) in the intervention group compared to 2 (2.8%) in the control group. Only half of students (50%) in both groups answered this question. Likelihood of Getting a Pap Smear • Students who received the curriculum were significantly more likely to report that they would have a Pap test by the age of 18 [a 0.4 point difference in the mean, from the pre- and post-test was noted in the intervention group compared to a 0.1 difference in the mean of the control group on a 5 point scale (5 = very likely; 4 = likely; 3 = not sure; 2 = unlikely; 1 = very unlikely)] CONCLUSIONS • A one-hour instructional curriculum on cervical cancer prevention improved knowledge and led to more positive changes in beliefs and attitudes among predominantly Hispanic adolescent females in two high schools located in a rural setting. • This study demonstrated that the self-reported likelihood of obtaining a Pap smear by age 18 significantly increased after students participated in the curriculum. • This study provides information for related curriculum development aimed at Hispanics adolescents. • Future research should focus on understanding the long-term changes in knowledge, beliefs, and attitudes related to cervical cancer screening among adolescents and how their intentions affect future screening practices. IMPLICATIONS FOR PUBLIC HEALTH It is important to reach diverse populations in order to increase over- all health of women in this country, particularly those known to have greater barriers to accessing preventive health services. This study demonstrates that a one-hour curriculum can inform young women about screening as a lifetime behavior while eliminating barriers related to beliefs and attitudes.
Transcript of Onl women who are planning to have a famil need to have a ...
®
Normal Cell Division
dividing cells
cell migration
dead cells
healthy
normal cells
Anatomy
cervix
vagina
uterus
No or low knowledge of
cervical cancer
Negative beliefs and attitudes
Increase likelihood of getting a pap smear at age 18
Low likelihood of getting a Pap smear
at age 18
Increase:• Knowledge
• Positive beliefs and attitudes
Cervical cancer curriculum
Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Figure 4: Mean differences between the pre- and post-tests in belief & attitude statements about cervical cancer and screening for the control group.
Beliefs about screeningand risk factors
A. You can only get cancer if someone in your family has had it
B. Women need a Pap smear only when they experience vaginal bleeding other than menstruation
C. A Pap smear is only for women who are sexually active
D. Only women who are planning to have a family need to have a Pap smear
Attitudes about the Pap smear
E. I am scared of having a Pap smear
F. I would be embarrassed to get an exam from a male doctor
G. A Pap smear is painful
H. I would mind if my parents knew that I had a Pap smear
Attitudes about cancer
I. I would rather not know if I had cancer
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.Statement coding: (1 = strongly agree; 2 = agree; 3 = not sure; 4 = disagree; 5 = strongly disagree).
*
Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Figure 2: Percentage correct in knowledge questions for the control group.
A. A Pap smear involves an “internal” examination
B. The Pap smear tests for cervical cancer
C. The Pap smear identifi es abnormal cells
D. A woman should be 18 years old or younger when she has her fi rst Pap smear
E. A woman should have a Pap smear every year
F. Cervical cancer be treated
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.
*
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Figure 3: Mean differences between the pre- and post-tests in belief & attitude statements about cervical cancer and screening for the intervention group.
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.Statement coding: (1 = strongly agree; 2 = agree; 3 = not sure; 4 = disagree; 5 = strongly disagree).
Beliefs about screeningand risk factors
A. You can only get cancer if someone in your family has had it
B. Women need a Pap smear only when they experience vaginal bleeding other than menstruation
C. A Pap smear is only for women who are sexually active
D. Only women who are planning to have a family need to have a Pap smear
Attitudes about the Pap smear
E. I am scared of having a Pap smear
F. I would be embarrassed to get an exam from a male doctor
G. A Pap smear is painful
H. I would mind if my parents knew that I had a Pap smear
Attitudes about cancer
I. I would rather not know if I had cancer
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Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Figure 6: Mean differences between the pre- and post-tests in belief and atti-tude statements about cervical cancer and screening for the control group.
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.Statement coding: (5 = strongly agree; 4 = agree; 3 = not sure; 2 = disagree; 1 = strongly disagree).
Beliefs about screeningand risk factors
A. Smoking has been linked to cervical cancer
Beliefs about cancer prevention
B. You can prevent yourself from getting cervical cancer
C. There is treatment for cervical cancer
D. Early detection means cervical cancer can be cured
Attitudes about cancer
E. Screening for cervical cancer is a good way to help prevent cervical cancer
**
Figure 5: Mean differences between the pre- and post-tests in belief and atti-tude statements about cervical cancer and screening for the intervention group.
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.Statement coding: (5 = strongly agree; 4 = agree; 3 = not sure; 2 = disagree; 1 = strongly disagree).
Beliefs about screeningand risk factors
A. Smoking has been linked to cervical cancer
Beliefs about cancer prevention
B. You can prevent yourself from getting cervical cancer
C. There is treatment for cervical cancer
D. Early detection means cervical cancer can be cured
Attitudes about cancer
E. Screening for cervical cancer is a good way to help prevent cervical cancer
****
dermisNormal Cell Division
dividing cellsdermis
cell migration
dead cells
healthy normal cells
Anatomy
cervix
vagina
uterus
Beliefs about screening and risk factorsYou can only get cancer if someone in your family has had itWomen need a Pap smear only when they experience vaginal bleeding other than menstruationA Pap smear is only for women who are sexually activeOnly women who are planning to have a family need to have a Pap smearI am scared of having a Pap smearI would be embarrassed to get an exam from a male doctorA Pap smear is painfulI would mind if my parents knew that I had a Pap smearI would rather not know if I had cancer
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Figure 1: Percentage correct in knowledge questions for the intervention group.
A. A Pap smear involves an “internal” examination
B. The Pap smear tests for cervical cancer
C. The Pap smear identifi es abnormal cells
D. A woman should be 18 years old or younger when she has her fi rst Pap smear
E. A woman should have a Pap smear every year
F. Cervical cancer be treated
* signifi es that there was a statistically signifi cant change between the pre- and post-test at p < 0.05.
* * * * * *
MOTIVATION• Underutilization of screening services is thought to be a key factor
related to the higher incidence of cervical cancer among Hispanic women.
• In-depth interviews with Hispanics in the Yakima Valley, Washington suggested that fewer Hispanics than non-Hispanics had ever received a screening test for cervical cancer.
• Classroom-based interventions on cervical cancer may be valuable for promoting cervical cancer screening among young women for several reasons:
– They capture women who are eligible to receive initial screening tests.
– They provide education to all economic segments of women, including those who may underutilize health care systems.
OBJECTIVE• Examine whether a one-hour cervical cancer curriculum results
in changes in adolescents’ knowledge, beliefs, and attitudes toward cervical cancer and screening, and affects their stated likelihood of having a Pap smear by age 18.
METHODS• A one-hour cervical cancer curriculum was developed for high school
students which included:
– A presentation about how cancer develops and what are the risk factors and prevention strategies for cervical cancer, a video graphic of the Pap test procedure, and a section addressing barriers to screening called “concerns among adolescents” were included.
– A role-play section allowing groups of students to work together to create a skit about cervical cancer and screening.
– A question and answer session for discussing students’ written questions after the presentation.
• Students from health classes at two high schools in the Lower Yakima Valley, Washington were assigned to the intervention or control group.
• Students in the intervention group received the cervical cancer curriculum; those in the control received a breast cancer curriculum.
• Pre- and post-tests were administered, containing questions related to knowledge, beliefs, attitudes about cervical cancer and screening and the likelihood of getting a Pap test by the age of 18.
Knowledge, Beliefs, Attitudes, and Intentions Regarding Riskand Prevention of Cervical Cancer Among Hispanic Adolescents
Silvia Tejeda,1,2,3 Gloria Coronado,1 Ilda Islas,1 Jane Rees,2, 3 and Beti Thompson1,3 1Fred Hutchinson Cancer Research Center • 2Maternal and Child Health Program and 3School of Public Health and Community Medicine, University of Washington, Seattle
RESULTSSample Characteristics
• Data from 142 female participants were included.
• The mean age was 15 years and 71% of the students were Hispanic.
• In the pre-test, low percentages of women had heard of a Pap test: 17 (25.4%) said that they had heard of the Pap smear in the intervention group vs. 27 (38.0%) in the control group.
• Also a low percentage had had a Pap smear: 4 (5.6%) in the intervention group compared to 2 (2.8%) in the control group. Only half of students (50%) in both groups answered this question.
Likelihood of Getting a Pap Smear
• Students who received the curriculum were signifi cantly more likely to report that they would have a Pap test by the age of 18 [a 0.4 point difference in the mean, from the pre- and post-test was noted in the intervention group compared to a 0.1 difference in the mean of the control group on a 5 point scale (5 = very likely; 4 = likely; 3 = not sure; 2 = unlikely; 1 = very unlikely)]
CONCLUSIONS• A one-hour instructional curriculum on cervical cancer prevention
improved knowledge and led to more positive changes in beliefs and attitudes among predominantly Hispanic adolescent females in two high schools located in a rural setting.
• This study demonstrated that the self-reported likelihood of obtaining a Pap smear by age 18 signifi cantly increased after students participated in the curriculum.
• This study provides information for related curriculum development aimed at Hispanics adolescents.
• Future research should focus on understanding the long-term changes in knowledge, beliefs, and attitudes related to cervical cancer screening among adolescents and how their intentions affect future screening practices.
IMPLICATIONS FOR PUBLIC HEALTHIt is important to reach diverse populations in order to increase over-all health of women in this country, particularly those known to have greater barriers to accessing preventive health services. This study demonstrates that a one-hour curriculum can inform young women about screening as a lifetime behavior while eliminating barriers related to beliefs and attitudes.
