Thinking you can: Self-efficacy and barriers to cervical cancer screening among Latinas

Background: Compared to white women, Latinas are at higher risk for cervical cancer. Risk is particularly high for Latinas with less than a high school education (currently over half of Latinas living in Los Angeles). Thus, determining barriers to cervical cancer screening among Latinas is crucial to reducing cervical cancer health disparities. Method: Latinas aged 21-50 were recruited for a face-to-face survey in Los Angeles clinics and community sites. Participants were categorized as compliant with current Pap test screening guidelines (N = 500) or not (never had a Pap test or no Pap test within the previous 3 years; N = 250). The survey included questions about barriers to medical care, self-efficacy to be screened, descriptive norms about how commonly other Latinas get cervical cancer screenings, and intentions to be screened in future. Results: Hierarchical regression and logistic regression were used to analyze the data. After controlling for age, education, and insurance status, the relationship between descriptive norms and current Pap test screening behaviors was moderated by specific barriers to care, including inability to pay and feeling too busy. In contrast, behavioral intent to have regular Pap tests in the future was moderated by self-efficacy, but not specific barriers to care. Conclusion: Findings indicate that interventions to increase rates of cervical cancer screening will need to focus both structural and psychosocial barriers to care. In addition, to encourage regular cervical cancer screening, different interventions may be required for Latinas who already follow Pap test guidelines and those who do not.