Differences in perceptions of benefits and barriers by stage of Pap smear screening in Vietnamese Immigrants

Background. Low levels of Papanicolaou (Pap) screening participation in Vietnamese-American women remain a significant public health problem. The transtheoretical model (TTM) suggests that individuals adopt Pap smear behavior move through a series of stages of readiness to change. This model also suggests that individuals in the maintenance stage of the TTM exhibit higher levels of perceived benefits and lower levels of perceived barriers than people in precontemplation. Because women engage in different stages of cervical cancer screening practices, identifications of the difference in specific benefits and barriers associated with stages of Pap smear use may give insight to design future interventions tailored to specific needs and characteristics of this population.

Aim. The aim of this study was to explore differences in perceived benefits of and barriers to obtaining Pap smears by the TTM stages.

Methods. A descriptive, cross-sectional design with snowball sampling method was used to recruit participants. A total of 80 Vietnamese-American women (36.4 % response rate) completed the self-administered questionnaire, including Demographic Questionnaire, Cervical Cancer Screening Stage Questionnaire, and Benefits/Barriers Scale.

Results. Respondents in maintenance perceived more benefits from Pap smears in relation to detecting abnormalities of the cervix early and increasing their treatment chances than those in precontemplation, F (3, 76) = 3.57, p = .02. Precontemplators had higher levels of perceived barriers to getting Pap tests than those in maintenance in (a) availability of Pap test, F (3, 71) = 8.80, p = .00; (b) lack of female physicians, F (3, 71) = 3.73, p = .02; and (c) fear of Pap test results, F (3, 73) = 6.08, p = .00.

Conclusions. Female physicians, knowledge of cervical cancer, and awareness of screening programs appear to play an important role in transitions between precontemplation and maintenance. Educational interventions should be targeted at private doctor's clinics that serve Vietnamese women. Continued research is needed to identify the most effective theory-based interventions for evidence-based nursing practice in this population. As culture and acculturation may impact the screening of the Vietnamese-Americans, future research could explore how these variables affect Pap screening behaviors.