Health beliefs mediate the effects of a cervical cancer screening intervention on uptake of the Pap smear among Vietnamese American women

Background:  As evidence-based approaches to enhancing cervical cancer screening are evaluated, it is critical to identify mediators of behavioral change for the optimization of future intervention strategies.

             

Objective: The effects of a psychoeducational intervention, based on the Health Belief Model (HBM), on Vietnamese American women’s cervical cancer screening behavior were evaluated.  The objective of the present study was to identify potential HBM factors that may mediate the effects of the intervention on women’s uptake of screening.

 

Methods:  In a community-based, randomized controlled intervention study, participants (n=1,365) were recruited from 30 Vietnamese community organizations.  The intervention addressed women’s knowledge and awareness of cervical cancer, health beliefs about cervical cancer and screening (perceived risk, perceived severity of cervical cancer, perceived benefits of and barriers to screening), and self-efficacy in obtaining screening.  Screening behavior was assessed 12-months post-intervention.

Results: Screening rates were significantly higher in the intervention compared to the control group.  The intervention group reported significant increases in perceived severity, benefits, knowledge, and self-efficacy; and decreases in perceived barriers from pre- to post-program. Perceived severity contributed 12% of the total intervention effect on behavior, and decreases in barriers contributed 10% of the total intervention effect.  Finally, knowledge contributed about 16% of the total intervention effect.  Thus, the intervention positively influenced screening behavior by increasing knowledge and perceived severity and reducing perceived barriers.

Conclusion: Future interventions to enhance screening behavior in this population should address women’s knowledge and severity beliefs, while reducing barriers to screening.