181071 Socioeconomic Barriers to Pap smear utilization among Ohio Appalachian women

Tuesday, October 28, 2008: 12:45 PM

Electra D. Paskett, PhD , College of Public Health, The Ohio State University, Columbus, OH
Mira Katz, PhD , College of Public Health, The Ohio State University, Columbus, OH
Paul L. Reiter, PhD , Gillings School of Global Public Heatlh, University of North Carolina, Chapel Hill, NC
Jill M. Oliveri, MPH, DrPH , Comprehensive Cancer Center, The Ohio State University, Columbus, OH
Amy Lehman , Center for Biostatistics, The Ohio State University, Columbus, OH
Dale Rhoda , Battelle Centers for Public Health Research & Evaluation, Battelle, Columbus, OH
Douglas Post, PhD , Department of Family Medicine, The Ohio State University, Columbus, OH
Mack Ruffin, MD , Department of Family Practice, University of Michigan, Ann Arbor, MI
Background: While cervical cancer rates have decreased in many developed countries, certain population groups experience higher rates of this cancer. Appalachia, a region defined by geographic proximity to the Appalachian Mountains and lower socio-economic status, (SES) is one of these areas that suffers a disproportionate burden from this cancer.

Objective/Purpose: Lack of appropriate use of Pap smears is one of the risk factors for cervical cancer. The objective of this paper is to examine how the SES profile of this region impacts whether women in Ohio Appalachia are within recommended guidelines for Pap smear testing.

Methods: Cross-sectional survey was conducted among 571 randomly selected women who were patients at 14 clinics in Ohio Appalachia. Multivariate random effects models were constructed to assess the variables associated with being within risk-appropriate guidelines for Pap Smear testing, including demographic, SES, psychological and knowledge variables.

Results: Marital status, lower SES, and increased number of major life events were all significant (p<0.05) predictors of being outside of Pap testing guidelines. In addition, there was a significant interaction between the respondent's perception of their current financial situation and their parents' and whether the respondent had sex before age 18 (p=0.01)

Discussion/Conclusions: Among women in Ohio Appalachia, demographic, SES, psychological, and sexual behavior variables were associated with being within guidelines for Pap testing. These results could be used to target resources to identifying and eliminating barriers to receiving Pap testing among women in these sub-groups in order to reduce high cervical cancer rates in Appalachia.

Learning Objectives:
By the end of the session, participants will be able to: 1. Describe the SES profile of women in Ohio Appalachia. 2. Discuss how SES variables correlate with being within recommended guidelines for Pap smear testing in Ohio Appalachian women.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.