Online Program

Assessment of client & provider acceptability of VIA & cryotherapy to screen & treat cervical cancer in Cambodia

Wednesday, November 6, 2013 : 10:30 a.m. - 10:45 a.m.

Jessamyn Bowling, MPH, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
Karen Heckert, PhD, MPH, MSW, Health Promotion Sciences Division and Global Health Institute, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
Sichheng Ma, BS, Reproductive Health Association of Cambodia, Phnom Penh, Cambodia
Var Chivorn, MD, MPH, Reproductive Health Association of Cambodia, Phnom Penh, Cambodia
Ping Chutema, MD, Reproductive Health Association of Cambodia, Phnom Penh, Cambodia
Francisco Garcia, MD, MPH, Pima County Health Department, Pima County Health Dept and The University of Arizona, Mel & Enid Zuckerman College of Public Health, Tucson, AZ
Significance: Cancer of the cervix, one of few preventable cancers, is the second most common cancer in women worldwide and a leading cause of cancer-related death in women in developing countries. Cervical cancer incidence and mortality rates are the highest of all cancers in Cambodia. These statistics are alarming since the Reproductive Health Association of Cambodia (RHAC) offers the highly sensitive and specific one-stop visual inspection with acetic acid (VIA) screening method in 15 of the country's 23 provinces. Objective: This assessment qualitatively examined women's perceptions and experiences and provider practices with VIA to explain the low uptake of cryotherapy for treating precancerous cervical lesions to recommend improvements in provider practices and client education. Methods: Focus group discussions were conducted with 51 women ages 21-45 in Kampong Speu province (rural) and in Phnom Penh (urban). Interviews were conducted with 15 cervical cancer screening clients of RHAC clinics in Phnom Penh. Clinic providers were also interviewed. Thematic analysis was conducted of focus group and interview results. Results: Themes emanating from the analysis included; factors that influence the women's health care decisions, knowledge and beliefs about cervical cancer and screening, experiences with providers, and perceived barriers to health care. Recommendations based on these results included: adult learning methods for clinic education sessions (e.g. participator games), culturally appropriate cervical cancer education video for clinic waiting rooms using novella story-telling, resources for rural health volunteers (e.g. flyer illustrating prevention, detection, and treatment), and posters for providers to aide in cervical cancer screening counseling.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Discuss the importance of cervical cancer prevention in Cambodia Describe 5 barriers to cervical cancer screening and treatment for Cambodian women Identify 3 routes of information for learning about cervical cancer for Cambodian women Analyze the challenges of sexual health research in the current Cambodian context

Keyword(s): Cervical Cancer, Culture

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have designed and led research teams in the U.S. context for needs assessments using qualitative methods. I have been trained in focus group facilitation and interview techniques for sensitive topics such as sexual assault, traumatic experiences, and life history. After living and working abroad for many years, I have skills in cross-cultural communication and cultural sensitivity. I have been in the field of reproductive health advocacy for over 8 years.
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.

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