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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Ann L Coker, PhD, Department of Epidemiology and Biostatistics, University of South Carolina, Norman J. Arnold School of Public Health, Health Sciences Building, Columbia, SC 29208, 803-777-6647, acoker@sph.sc.edu, Sharon M Bond, CNM, MSN, College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., PO Box 250160, Charleston, SC 29425, and Heather M. Brandt, MSPH, CHES, Norman J. Arnold School of Public Health, University of South Carolina, Department of Health Promotion and Education, 800 Sumter, Columbia, SC 29208.
Data from the Cervical Cancer Education and Prevention Project in South Carolina was used to explore reasons why some women discontinue free follow-up care for a low-grade cervical lesion. Follow-up care included free colposcopy, Pap smears, cervigrams, and biopsies as needed. 602 women receiving family planning services through the state health department were found to have a low grade cervical lesion and recruited into the follow-up study. All women were low-income and without health insurance. Of the 556 women recruited and interviewed between 1995-2001, 53 were referred out due to higher grade SIL, 17 were pregnant , 7 women had another health condition precluding follow-up, and 9 women moved out of the area before the 2nd visit. 470 women began follow-up and 175 women (37.2%) dropped out of the study before three completed visits (15 months). Younger women were significantly more likely to dropout (relative risk [RR]=0.95; 95% CI=0.93, 0.98). Women who dropped out were significantly more likely to report more recent (<3 years) stressful life events (age-adjusted RR=1.10 95% CI=1.01). Specific recent events most strongly associated with dropping out were being homeless (aRR=7.4), beaten by a partner (aRR=2.3)and having to move back in with parents (aRR=1.6). Neither race, educational status, smoking, alcohol use nor high risk HPV positivity was significantly associated with dropping out after adjusting for age. These findings indicate that specific life stressors may be important predictors of follow-up. Interventions can be developed to help women effectively cope with stress and continue to receive needed care.
Learning Objectives:
Keywords: Access and Services, Cervical Cancer
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.