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A mixed-methods approach to assessing barriers to cervical screening exams among indigent high-risk women in substance abuse programs

Tuesday, November 5, 2013 : 5:30 PM - 5:50 PM

Saritha Bangara, MPH , Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
Monique Shuler, MS , School of Public Health, Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
Raquel Y. Qualls-Hampton, PhD, MS , Department of Obstetrics & Gynecology, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX
Martha Felini, DC, PhD , Department of Ob/Gyn, College of Osteopathic Medicine, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX
Background: Our preliminary evaluation of the Dallas Prostitute Diversion Initiative, where women destined for incarceration are diverted to substance abuse treatment centers (SATC), uncovered an exceptional window of opportunity to provide well women exams to this indigent high risk subgroup. Few studies to date have examined whether past traumatic experiences are a barrier to utilizing Pap smears in this vulnerable population.

Objectives: The objective of this study was to determine baseline knowledge of cervical cancer and explore the experiences of previous screenings, among women participating in substance abuse and mental health treatment programs at the Nexus Recovery Center, Dallas's largest women-only SATC.

Methodology: Six focus groups (N=48 women) were conducted among women undergoing treatment at the Nexus Recovery Center. A separate focus group was conducted among members of our project advisory board (medical professionals, social workers, and recovering addicts) who guided the research. A mixed methods approach was used to analyze the data and identify themes from participants' responses.

Results: In assessing the participants' utilization of and knowledge regarding cervical cancer screening, 30 (63%) had a Pap smear in the last two years, and 35 (73%) had heard of HPV, a risk factor for cervical cancer. Preliminary analysis is currently underway to uncover the impact of past trauma in utilizing cervical cancer screening in this population.

Conclusion: Our findings will be used to develop a trauma-informed, culturally sensitive cervical cancer education program specific to the needs and experiences of this population that can be integrated into SATC's.

Learning Areas:
Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify barriers to engaging in well women’s cancer screening programs among a high risk subset of women with substance abuse issues Differentiate between our project advisory board’s perception and participants’ actual citing of barriers to utilizing cervical screening exams

Keywords: Women's Health, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The confluence of my research experiences in cancer epidemiology will stand me in good stead with regard to my current presentation. I have been a project manager on a cancer epidemiology study for five years investigating occupational-related cancers and have successfully co-authored three publications. I have also been involved in gastric cancer research among indigent populations and presented at the prestigious Digestive Disease Week conference.
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.

Back to: 4430.0: Reaching subgroups: Learning from cervical cancer prevention and control
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