title: Factors influencing cancer screening practices of underserved women.
abstract: OBJECTIVE
  This integrated review was conducted to evaluate the factors that inhibit or promote decisions by African American and Hispanic women to obtain cervical cancer screening.
  
  
  METHODS
  Research articles were identified using MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health literature, published between 1999 and 2005.
  
  
  CONCLUSIONS
  Cervical cancer screening practices of African American and Hispanic women were influenced by extrinsic motivators including lack of insurance, no usual source of health care, acculturation, and socioeconomic factors. Intrinsic motivators were related to beliefs and perceptions of vulnerability, such as ignoring cervical cancer screening when no symptoms were present; believing that not knowing if one had cervical cancer was better; and thinking that only women who engage in sexual risk-taking behaviors need to obtain Papanicolaou (Pap) smear testing.
  
  
  CONCLUSIONS
  Nurse practitioners (NPs) have an opportunity to impact the incidence and mortality of cervical cancer by improving screening practices of minority women. They can emphasize the importance of obtaining Pap smears regularly, teach patients the risks for and signs and symptoms of cervical cancer, and provide recommendations for obtaining screening at low cost or no cost to the patient. To improve cancer screening practices, NPs need to address minority women's beliefs about cervical cancer and provide information and services in a culturally sensitive manner at an appropriate level of learning.
authors.affiliation: University of Michigan School of Nursing, Ann Arbor, Michigan, USA. kellya@umich.edu
authors.forename: Kelly
authors.initials: K
authors.lastname: Ackerson
authors.forename: Kimberlee
authors.initials: K
authors.lastname: Gretebeck
mesh_terms: D000069:Acculturation; D001741:Black or African American / Q000193:education / Q000208:ethnology / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino / Q000193:education / Q000208:ethnology / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D009042:Motivation; D009369:Neoplasms / Q000175:diagnosis*; D009722:Nurse Practitioners / Q000458:organization & administration; D024802:Nurse's Role; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D012107:Research Design; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology; D012959:Socioeconomic Factors; D014930:Women / Q000193:education / Q000523:psychology*