title: Interactive model of client health behavior and cervical cancer screening of African-American women.
abstract: OBJECTIVE
  Explore inductively African American women's use of Pap smear screening services and consider how well the data did or did not affirm the usefulness of the interaction model of client health behavior (IMCHB).
  
  
  METHODS
  The IMCHB guided this qualitative study designed to explore women's social influence and previous health care experience and their influence on the women's cognitive appraisal associated with Pap smears and cervical cancer. Interviews were conducted with 24 women, resulting in 2 groups: routine-use (n = 11) (Pap smears every 1-3 years) and non-routine-use (n = 13).
  
  
  METHODS
  Content analysis approach to data analysis was used, where interview data were considered in relation to elements of IMCHB.
  
  
  RESULTS
  Analysis revealed that the IMCHB was useful for framing cervical cancer screening health behavior research. Both groups' data fit well onto the framework. The routine-use group fit the entire model, with iterative (repeat) behavior in cervical cancer screening. The non-routine-use group also fit the model, but their iterative behavior in cervical cancer screening was intermittent due to negative personal influences.
  
  
  CONCLUSIONS
  This model can provide a focus to the delivery of gynecological care based on a client's unique characteristics that can be addressed with individualized nursing interventions designed to promote positive health outcomes.
authors.affiliation: Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan 49008-5345, USA. kelly.ackerson@wmich.edu
authors.forename: Kelly
authors.initials: K
authors.lastname: Ackerson
mesh_terms: D000328:Adult; D001741:Black or African American; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D008962:Models, Theoretical; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D014626:Vaginal Smears; D055815:Young Adult