title: In my own words: misunderstanding of Pap smears and colposcopy among Appalachian women.
abstract: OBJECTIVE
  To evaluate knowledge of Pap smear screening and colposcopy among Appalachian women.
  
  
  METHODS
  English-speaking women (18 years or older) referred for colposcopy after abnormal Pap testing at a teaching hospital in the southeastern United States were studied. Structured interviews were conducted to assess demographic characteristics, health literacy skills using the Rapid Estimate of Adult Literacy in Medicine, understanding of the Pap smear and colposcopy, state anxiety, and cervical intraepithelial neoplasia distress.
  
  
  RESULTS
  The mean age of women was 29.6 +/- 10.94, 93.2% white, 50.2% high school graduates or had an equivalency diploma, and 55.3% current cigarette use. Approximately one fifth (n = 22) of women had limited health literacy skills. Overall, womens' understanding of the Pap test, meaning of abnormal Pap test results, identification of risk factors contributing to abnormal Pap test results, and understanding of colposcopy was limited. Health literacy skills was the lone characteristic to significantly predict overall understanding of the Pap smear and colposcopy (unstandardized beta coefficient [SE] = 0.68 [0.02], p < .05).
  
  
  CONCLUSIONS
  These findings demonstrate that Pap smear and colposcopy knowledge is associated with health literacy skills. Health care providers should be aware that many women lack sufficient knowledge of the Pap smear and colposcopy and tailor counseling during the clinical encounter accordingly.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA.
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Fortner
authors.forename: Nikki B
authors.initials: NB
authors.lastname: Zite
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Wallace
mesh_terms: D000328:Adult; D003127:Colposcopy; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D065006:Papanicolaou Test; D012959:Socioeconomic Factors; D013714:Tennessee; D014626:Vaginal Smears