title: Pap testing adherence among Vietnamese American women.
abstract: OBJECTIVE
  Vietnamese American women are five times more likely to be diagnosed with cervical cancer than their White counterparts. Previous research has demonstrated low levels of Papanicolaou (Pap) testing among Vietnamese. Our study objective was to examine factors associated with interval Pap testing adherence.
  
  
  METHODS
  A population-based, in-person survey of Vietnamese women aged 18-64 years was conducted. Questionnaire content was guided by the Health Behavior Framework (HBF). The study sample was randomly selected from 1639 south Seattle households. Statistical methods included chi(2) tests and logistic regression.
  
  
  RESULTS
  The response rate among eligible households was 82%, and the study included 352 women. Sixty-eight percent of the participants had been screened during the preceding 3 years. The following HBF factors were associated (P < 0.05) with interval Pap testing in bivariate comparisons: believing Pap tests decrease the risk of cervical cancer and believing cervical cancer is curable if detected early (perceived effectiveness); knowing testing is necessary for women who are asymptomatic, sexually inactive, or postmenopausal (knowledge); reporting concern about pain/discomfort as a barrier to screening (barriers); family member(s) and friend(s) had suggested testing (social support); doctor(s) had recommended testing; and had asked doctor(s) for testing (communication with provider). In a multivariate analysis, being married, knowing Pap testing is necessary for asymptomatic women, doctor(s) had recommended testing, and had asked doctor(s) for testing were independently associated (P < 0.05) with screening participation.
  
  
  CONCLUSIONS
  Our results confirm low levels of Pap testing among Vietnamese women and demonstrate the importance of physician-patient communication in increasing screening adherence. Health education efforts should target unmarried women and reinforce the importance of Pap testing for all Vietnamese women.
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, PO Box 19024, Seattle, WA 98109-1024, USA. vtaylor@fhcrc.org
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Nancy
authors.initials: N
authors.lastname: Burke
authors.forename: Tung
authors.initials: T
authors.lastname: Nguyen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Acorda
authors.forename: Hue
authors.initials: H
authors.lastname: Thai
authors.forename: Pingping
authors.initials: P
authors.lastname: Qu
authors.forename: J Carey
authors.initials: JC
authors.lastname: Jackson
mesh_terms: D000293:Adolescent; D000328:Adult; D001213:Asian / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D010349:Patient Compliance / Q000208:ethnology*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D014744:Vietnam / Q000208:ethnology; D014861:Washington / Q000453:epidemiology