title: English proficiency and physicians' recommendation of Pap smears among Hispanics.
abstract: BACKGROUND
  Hispanics have one of the highest incidence rates of cervical cancer. Physician recommendation is one of the most important cues to cancer screening; however, low English proficiency among Hispanics may hinder health providers' recommendation of Pap smears.
  
  
  METHODS
  Analysis of data from the 2000 National Health Interview Survey. All Hispanic women, age > or =18, without a Pap smear in the past 3 years or ever and who visited a health care provider in the past year were included. The main outcome was receipt of Pap smear recommendation by a health care provider.
  
  
  RESULTS
  A total of 314 Hispanic women were included in the analysis, 44.9% were highly English proficient. Only 7.7% of low English proficient Hispanics not up-to-date in cancer screening reported a recommendation for a Pap smear as compared to 14.3% of highly proficient Hispanics. After adjusting for sociodemographics and health access and utilization factors, highly English proficient Hispanics were more than two times as likely to report receiving a recommendation for a Pap smear as compared to the less proficient (aOR 2.2, 95% CI 1.1-4.5).
  
  
  CONCLUSIONS
  Low English language proficiency is a barrier to receive a recommendation for Pap smear among Hispanic women not up-to-date with cervical cancer screening. Further research is needed to explore specific mechanisms responsible for the low recommendation rates and to assess the impact of interpreters or Spanish-speaking providers on Pap smear recommendation rates.
authors.affiliation: Department of Medicine, Division of General Internal Medicine and Primary Care, University of California, Irvine, CA 92697-5800, USA.
authors.forename: Israel
authors.initials: I
authors.lastname: De Alba
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Sweningson
mesh_terms: D000328:Adult; D003144:Communication Barriers; D003581:Cytodiagnosis / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008403:Mass Screening; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D014626:Vaginal Smears / Q000706:statistics & numerical data*