title: Effects of social support, regular physician and health-related attitudes on cervical cancer screening in an Asian population.
abstract: OBJECTIVE
  Out primary objective was to examine sociodemographic and attitudinal factors that affect uptake of the Pap smear in a multi-ethnic Asian population.
  
  
  METHODS
  We conducted a prevalence survey among women aged 50-64 years living in Singapore and ascertained by means of an in-person questionnaire interview their Pap screening history, demographic characteristics, informal social support and attitudes towards early detection.
  
  
  RESULTS
  We found that, after adjusting for demographic variables known to be predictors of Pap screening, women who reported ever having a Pap smear were more likely to have close friends with whom they could discuss health (adjusted odds ratio (OR) 2.1, 95% confidence intervals (CI) 1.2-3.6), and have a regular physician (adjusted OR 2.3 (1.3-4.1)). Based on responses to four indices measuring health attitudes, they were significantly less likely to express a fatalistic viewpoint towards health and illness (adjusted OR for highest vs. lowest tertile 0.3 (95% CI 0.1-0.7)), and more likely to believe that early detection could improve the outcome (adjusted OR 3.3 (95% CI 1.4-7.8)). The nature of the test itself was a significant barrier to having a Pap smear, but only among women with fewer years of education.
  
  
  CONCLUSIONS
  Our results suggest that, within this Asian population, a multi-pronged approach is required to reach unscreened women. The role of physicians and close friends should be emphasized, and health messages should be formulated to address specific, relevant attitudinal barriers to Pap screening.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, National University of Singapore, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Seow
authors.forename: J
authors.initials: J
authors.lastname: Huang
authors.forename: P T
authors.initials: PT
authors.lastname: Straughan
mesh_terms: D000368:Aged; D044466:Asian People; D001294:Attitude to Health; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D065006:Papanicolaou Test; D012846:Singapore; D012944:Social Support; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data; D016387:Women's Health