title: [Factors associated with the use of the Papanicolaou smear screening among older women in the interior of Brazil].
abstract: OBJECTIVE
  To verify the coverage, by Pap testing, of older women and the associated factors.
  
  
  METHODS
  A population-based study was conducted by home interviews. The inclusion criteria were women aged 60 and over, living on the north side of the city of Juiz de Fora, Minas Gerais, Brazil, self-sufficient to answer the questionnaire or having someone to answer on their behalf. The interview consisted of sociodemographic questions, regarding the general health of the older women, and preventive practices in women's health. The selection was made by random sampling, stratified and clustered in multiple stages. To analyze associated factors, a theoretical model was formulated with three hierarchical blocks of variables, adjusted to each other in each block. The variables that had a level of significance of 0.2 or less were included in the Poisson regression model and adjusted to their next highest level (p<0.1).
  
  
  RESULTS
  Pap testing occurred in 84.1% of cases (95%CI 79.0-88.4). Based on multivariate regression analysis, three variables remained significantly associated with access to Pap testing: the marital status "without partner" (older women who were single, widowed, separated or divorced), self-sufficiency to perform Instrumental Activities of Daily Living (IADLs) and adherence to mammography. In the interblock analysis these variables remained significantly associated with the outcome variable, and self-sufficiency for IADLs had the highest association.
  
  
  CONCLUSIONS
  Among the older women comprising the study sample, was observed variation in the use of Pap testing. An adjustment of public health policies towards the formulation of policies giving priority to universal preventive care may be an alternative to solve the disparities observed.
authors.affiliation: Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
authors.forename: Mônica Cristina Marzullo de
authors.initials: MC
authors.lastname: Freitas
authors.forename: Luiz Cláudio
authors.initials: LC
authors.lastname: Ribeiro
authors.forename: Marcel de Toledo
authors.initials: Mde T
authors.lastname: Vieira
authors.forename: Maria Teresa Bustamante
authors.initials: MT
authors.lastname: Teixeira
authors.forename: Ronaldo Rocha
authors.initials: RR
authors.lastname: Bastos
authors.forename: Isabel Cristina Gonçalves
authors.initials: IC
authors.lastname: Leite
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*