Effects of a church-based intervention on Korean American women's health beliefs and intentions to undergo cervical cancer screening

Background: Despite the survival benefits associated with cervical cancer screening, utilization of the Pap test among Korean American women remains relatively low. Guided by the Health Belief Model, we implemented a church-based program to address beliefs regarding the benefits of screening and to reduce screening barriers.

Objective: The purpose of this study was to evaluate whether the church-based program resulted in changes in women's beliefs and screening intentions.

Methods: Korean American women (N= 498) who were non-adherent to screening guidelines were randomly assigned to the intervention program or an attention control condition. The intervention group received education designed to increase knowledge and address psychosocial beliefs and barriers to screening. The control group received general health education including information about cervical cancer screening. Participants completed measures of health beliefs at baseline and post-intervention. Participants also completed an item assessing intention to undergo screening in the next 12 months.

Results: The intervention group reported greater perceived benefits of screening (p=0.01), fewer barriers (p=0.01), and greater confidence regarding their ability to obtain screening (p<0.001) at post-intervention compared to the control group. Importantly, a greater proportion of intervention participants (74.8%) reported that they intended to obtain a Pap test over the next 12 months compared to control participants (43.0%), χ2(1)=48.5, p < 0.001.

Conclusion: A culturally-adapted psychoeducational intervention yielded more positive attitudes, reduced perceived barriers, and increased intentions to undergo screening. When delivered within a church setting, this multifaceted program may be effective in promoting cervical cancer screening in this underserved population.