268899 Reducing Pap Smears among young women in Title X Family Planning clinics

Tuesday, October 30, 2012 : 4:50 PM - 5:10 PM

Sarah Goldenkranz, MPH , Cardea Services, Seattle, WA
David Fine, PhD , Cardea Services, Seattle, WA
Ginny Cassidy-Brinn, ARNP-DNP , Cardea Services, Seattle, WA
Karen Dluhosh, MC , Cardea Services, Seattle, WA
Background: In 2009, the American College of Obstetricians and Gynecologists revised recommendations for cervical cancer screening, delaying Pap Smear (PS) initiation to age 21. 285 Title X clinics in Region X (AK, ID, OR, WA) provide family planning services to 250,000 women annually and collect data at all clinic visits. Objective: Describe activities to promote awareness and adherence to recommendations in Region X and evaluate outcomes; examine temporal trends in and patient characteristics associated with PS in Region X Title X clinics. Methods: We compiled demographic and service data for all female patients under age 22 during 2008-2011 (n=305,655 patients), calculated the percentage of women receiving PS by age and year, and used multivariate analyses to assess associations between PS and client characteristics. Results: From 2008-2011, the percentage of women receiving PS declined from 18.8% to 1.6%; stratified by age—PS declined from 1.9% to 0.1% among patients 10-14 years; 8.6% to 0.4% among patients 15-17 years; 25.2% to 2.3% among patients 18-20 years. PS was least common in ID and most common in AK. PS was also significantly associated with patients' state, race/ethnicity, and insurance. PS was less common among American Indian, black, and Hispanic patients than white patients (AOR=.65, .70, .90, respectively). Compared to publically insured patients, PS was more common among uninsured (AOR=1.20) and privately insured (AOR=1.17) patients. Conclusions: Title X clinics adopted new recommendations and substantially decreased PS among women under age 21. Patients of certain demographic and insurance characteristics are still more likely to be tested.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe new Pap smear recommendations according to 2009 American College of Obstetricians and Gynecologists (ACOG) Discuss extent of adherence to new guidelines in Region X Title X Family Planning clinics and patient characteristics associated with Pap smears.

Keywords: Cervical Cancer, Children and Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Cardea Services performs Data Management and program evaluation for the Region X Title X Family Planning program.
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.