title: Race and ethnic disparities in cervical cancer screening in a safety-net system.
abstract: OBJECTIVE
  The three objectives of this research were: 1) to examine the use of Pap smear tests among low-income women, including minority and immigrant women who were patients in a safety-net healthcare system; 2) to identify policy relevant variables that could lead to changes in use of Pap smear screening services for these women; and 3) to contribute to the literature on use of Pap smear screening, especially among minorities and immigrants. The Behavioral Model for Vulnerable Populations was used as the theoretical framework.
  
  
  METHODS
  Pap smear screening predictors were examined using telephone interviews with a random sample of women aged 18-60, including 465 Non-Hispanic Whites, 285 African Americans, 164 Hispanic Americans, and 256 Hispanic immigrants, enrolled in a safety-net healthcare system in Texas in Fall 2000. Binary logistic regression analysis was used.
  
  
  RESULTS
  The research revealed that Non-Hispanic Whites were most likely to have been screened ever and in the past 3 years, followed by African Americans, Hispanic immigrants, and Hispanic Americans. Among Hispanics, immigrants were most likely to have had Pap smear screening, supporting the "healthy immigrant hypothesis." Older women were most likely to have ever been screened, with younger women, most likely in the past year. Having a usual source of healthcare and a checkup for current pregnancy increased screening, while competing needs (food, clothing, housing) affected screening negatively.
  
  
  CONCLUSIONS
  Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.
authors.affiliation: Department of Sociology, University of North Texas, Denton, Texas, 76203, USA.
authors.forename: Gertrude A
authors.initials: GA
authors.lastname: Owusu
authors.forename: Susan Brown
authors.initials: SB
authors.lastname: Eve
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Cready
authors.forename: Kenneth
authors.initials: K
authors.lastname: Koelln
authors.forename: Fernando
authors.initials: F
authors.lastname: Trevino
authors.forename: Ximena
authors.initials: X
authors.lastname: Urrutia-Rojas
authors.forename: Joanne
authors.initials: J
authors.lastname: Baumer
mesh_terms: D000293:Adolescent; D000328:Adult; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test; D011203:Poverty; D044469:Racial Groups; D013781:Texas; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data