title: Barriers to cervical cancer screening among middle-aged and older rural Appalachian women.
abstract: Although cervical cancer rates in the United States have declined sharply in recent decades, certain groups of women remain at elevated risk, including middle-aged and older women in central Appalachia. Cross-sectional baseline data from a community-based randomized controlled trial were examined to identify barriers to cervical cancer screening. Questionnaires assessing barriers were administered to 345 Appalachian women aged 40-64, years when Papanicolaou (Pap) testing declines and cervical cancer rates increase. Consistent with the PRECEDE/PROCEED framework, participants identified barriers included predisposing, enabling, and reinforcing factors. Descriptive and bivariate analyses are reported, identifying (a) the most frequently endorsed barriers to screening, and (b) significant associations of barriers with sociodemographic characteristics in the sample. Recommendations are provided to decrease these barriers and, ultimately, improve rates of Pap tests among this traditionally underserved and disproportionately affected group.
authors.affiliation: Department of Behavioral Science, College of Medicine, University of Kentucky, 101 Medical Behavioral Science Building, Lexington, KY 40536-0086, USA. tina.studts@uky.edu
authors.forename: Christina R
authors.initials: CR
authors.lastname: Studts
authors.forename: Yelena N
authors.initials: YN
authors.lastname: Tarasenko
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
mesh_terms: D000328:Adult; D000367:Age Factors; D001061:Appalachian Region / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*