English proficiency and physicians' recommendation of Pap smears among Hispanics.
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.
De Alba
Israel
I
Department of Medicine, Division of General Internal Medicine and Primary Care, University of California, Irvine, CA 92697-5800, USA.
Sweningson
Jamie M
JM
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*