title: Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention.
abstract: Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants' intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7%) screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates.
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA. Evelyn.Interis@dshs.state.tx.us.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Coronado Interis
authors.affiliation: School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA. chidi89@uab.edu.
authors.forename: Chidinma P
authors.initials: CP
authors.lastname: Anakwenze
authors.affiliation: Epidemiology and Research Unit, Western Regional Health Authority, Montego Bay, Jamaica. maung.aung@wrha.gov.jm.
authors.forename: Maug
authors.initials: M
authors.lastname: Aung
authors.affiliation: School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA. jollyp@uab.edu.
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007563:Jamaica; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D055815:Young Adult
keywords: cervical cancer; disease control; health behavior; health promotion; intervention; prevention; risk; screening