title: Tailored telephone counseling to improve adherence to follow-up regimens after an abnormal pap smear among minority, underserved women.
abstract: OBJECTIVE
  The present study explored the impact of a tailored telephone counseling intervention on increasing follow-up adherence after an abnormal Pap smear result among low-income, minority women, which may reduce cervical cancer disparity.
  
  
  METHODS
  Participants (N=211) were randomly assigned to receive: (1) a telephone reminder that included an assessment of barriers to adherence, as well as counseling tailored to the barriers elicited; (2) telephone reminder and barriers assessment, followed by a mailed home tailored barriers print brochure; or (3) enhanced standard care comprising telephone reminder and barriers assessment. Assessments were obtained at initial contact and 1-week later, as well as at 6- and 12-months after the initial colposcopy.
  
  
  RESULTS
  The telephone counseling group showed greater adherence to follow-up recommendations than did the combined other two groups (p<0.05). For the initial colposcopy, tailored telephone barriers counseling was more effective among women with a high school education or less.
  
  
  CONCLUSIONS
  Tailored telephone barriers counseling improves adherence to initial colposcopy, as well as to longer-term medical follow-up, among low-income, inner-city women.
  
  
  CONCLUSIONS
  Dissemination of barriers counseling into ongoing telephone reminder calls and contacts may decrease disparities in cancer outcomes, especially among women with less than post-secondary education.
authors.affiliation: Department of Psychosocial and Behavioral Medicine, Fox Chase Cancer Center/Temple University Health System, USA. Electronic address: Suzanne.Miller@fccc.edu.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: Siu-kuen Azor
authors.initials: SK
authors.lastname: Hui
authors.forename: Kuang-Yi
authors.initials: KY
authors.lastname: Wen
authors.forename: John
authors.initials: J
authors.lastname: Scarpato
authors.forename: Fang
authors.initials: F
authors.lastname: Zhu
authors.forename: Joanne
authors.initials: J
authors.lastname: Buzaglo
authors.forename: Enrique E
authors.initials: EE
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D003127:Colposcopy; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D008507:Medically Underserved Area; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D010174:Pamphlets; D065006:Papanicolaou Test; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D010414:Pennsylvania; D011204:Poverty Areas; D017010:Reminder Systems; D012959:Socioeconomic Factors; D013689:Telephone; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears
keywords: Cervical cancer screening; Follow up adherence; Tailored counseling