title: A multifaceted intervention to increase cervical cancer screening among underserved Korean women.
abstract: OBJECTIVE
  Despite the proven survival benefits associated with cervical cancer screening, use of the Pap test continues to be suboptimal in some population subgroups, such as among Korean-American women who face considerable barriers to screening. Therefore, we evaluated a multifaceted intervention that combined psychoeducational counseling with patient navigation to address both psychosocial and access barriers to screening.
  
  
  METHODS
  Women (n = 102) were recruited from Korean community centers and assigned to the intervention or control condition. The intervention group received cervical cancer education and patient navigation delivered by bilingual Korean health educators. The control group received general health education, including information about cervical cancer and screening. Assessments were obtained at baseline and postintervention. Screening behavior was assessed at 6 months postintervention.
  
  
  RESULTS
  At baseline, 17% of participants reported having had a Pap test in the previous year. At 6 months postintervention, 83% of women in the intervention group had obtained screening compared with 22% in the control group, chi2(1) = 41.22, P < 0.001. Multivariate logistic regression analyses indicated that participation in the intervention was associated with screening (P < 0.001). Fewer psychosocial barriers (e.g., discomfort at having a stranger perform Pap) and greater self-efficacy were also associated with screening (P < 0.05).
  
  
  CONCLUSIONS
  A combined modality intervention that delivers education with patient navigation training and assistance resulted in increased screening rates. Multifaceted approaches may be effective in reducing the psychosocial, access, and language barriers that contribute to cancer health disparities in underserved populations.
authors.affiliation: Division of Population Science, Fox Chase Cancer Center, Cheltenham, PA 19012, USA. carolyn.fang@fccc.edu
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Fang
authors.forename: Grace X
authors.initials: GX
authors.lastname: Ma
authors.forename: Yin
authors.initials: Y
authors.lastname: Tan
authors.forename: Nungja
authors.initials: N
authors.lastname: Chi
mesh_terms: D003153:Community Health Services; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007723:Korea; D008403:Mass Screening; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*