title: Self-efficacy scale for Pap smear screening participation in sheltered women.
abstract: BACKGROUND
  Sheltered, homeless women disproportionately experience cervical dysplasia and cervical cancer. Low rates of Pap smear screening contribute to late diagnosis with accompanying increased morbidity and mortality. Self-efficacy (SE) has been demonstrated to be predictive of several health behaviors, but limited evidence about SE for Pap smear screening exists.
  
  
  OBJECTIVE
  To develop, test, and refine the conceptually based Self-Efficacy Scale for Pap Smear Screening Participation (SES-PSSP).
  
  
  METHODS
  This correlational, descriptive study included a purposive sampling of sheltered women (N = 161).
  
  
  RESULTS
  The 20-item SES-PSSP demonstrated acceptable initial validity and reliability. Reliability estimates of stability (>or=84%) and internal consistency (alpha = .95) exceeded criteria. Content validity and construct validity were supported (e.g., common factor analysis and predictive model testing that included SE, decisional balance, knowledge regarding Pap smear screening, demographics, health-related behaviors, health status, and personal beliefs about risks for cervical cancer and dysplasia). Self-efficacy, decisional balance, illicit drug usage, and age predicted 28% of the variance in stages of change (precontemplation, contemplation, preparation, action, and maintenance) for Pap smear screening participation.
  
  
  CONCLUSIONS
  The SES-PSSP provides a new scale for measuring SE pertinent to Pap smear screening participation in a vulnerable, ethnically diverse sample of sheltered, inner-city women. Validity testing demonstrated that the SE concept was predictive of Pap smear screening behavior, suggesting that SE-based interventions tailored to the SES-PSSP subscale or total scores could increase screening. A 10-minute completion time supports feasibility for use in the clinic setting.
authors.affiliation: Health, Innovation, and Research, 8687 Tranquility Loop, Ft. Calhoun, NE 68023, USA. jette@jetteh.us
authors.forename: Jette R
authors.initials: JR
authors.lastname: Hogenmiller
authors.forename: Jan R
authors.initials: JR
authors.lastname: Atwood
authors.forename: Ada M
authors.initials: AM
authors.lastname: Lindsey
authors.forename: David R
authors.initials: DR
authors.lastname: Johnson
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Scott
mesh_terms: D000328:Adult; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011581:Psychological Tests; D015203:Reproducibility of Results; D020377:Self Efficacy; D014481:United States; D014504:Urban Health; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears / Q000523:psychology* / Q000706:statistics & numerical data