Evidence-based intervention to reduce access barriers to cervical cancer screening among underserved Chinese American women

Background: Current data suggest that Chinese women have high rates of cervical cancer but low incidence rates due to low screening rates. Objectives: The purpose was to evaluate the effects of a community-based intervention that combined cervical cancer education with patient navigation among Chinese American women residing in New York City. Methods: Chinese women (n = 134) who had not had a Pap test within the past year were recruited from four Asian community-based organizations (CBOs). Women from two CBOs received the intervention program (n= 80) consisting of education, interaction with a Chinese physician, and navigation assistance. Women in the control program (n = 54) received education and written materials on general health and cancer screening, and information about sites that provided free services. Assessment was conducted in-person at baseline and post-intervention. Screening behavior was self-reported at 12-month post-intervention and verified by medical staff. Data was analyzed by the chi square test, odds ratios, and 95% confidence intervals with hierarchical logistic regression analyses. Results: At 12-month follow-up, screening rates were significantly higher in the intervention(70%) compared to the control group (11.1%). Hierarchical logistic regression analyses indicated that screening behavior was associated with older age. In addition, women with poorer English language, and those who lacked health insurance were less likely to obtain screening. Also, greater perceived severity of disease was positively associated with screening behavior. Discussion: Community-based programs providing combined education and patient navigation are effective in overcoming linguistic and access barriers to screening faced by Chinese American women.