Acculturation and healthcare access are associated with screening self-efficacy among Korean American women

Background: Korean American (KA) women have a higher incidence of cervical cancer and lower Papanicolaou (Pap) test rates than non-Hispanic white women.  Because self-efficacy (i.e. perceived ability to receive a Pap test) is generally associated with screening uptake, the present study sought to identify factors associated with screening self-efficacy among KA women.

Methods:  KA (n=721) women completed measures of screening self-efficacy, demographics, health care access, and acculturation.  Associations between screening self-efficacy and participant factors were evaluated using chi-square and logistic regression analyses.

Results:  Participants were on average 53.81 years of age (SD=11.06, range: 21-87) and lived in the U.S. for an average of 17.97 years (SD=10.93, range: 1-88). Approximately 53% (n= 659) of the women were planning to have a Pap test within the upcoming year. A significantly larger proportion of women with higher screening self-efficacy indicated an intention toward screening compared to those with lower self-efficacy. Age, education, household income, regular use of a physician, language spoken at home, and English (speaking) proficiency were significantly associated with a perceived ability to get a Pap test. In adjusted analyses, women with less than high school education, without a regular physician, and those who spoke only their native Asian language at home had lower screening self-efficacy (p=.021; p=.003; p=.054, respectively).

Conclusion:  Findings note the importance of acculturation and access to a physician in contributing to a greater perceived ability to receive a Pap test. Strategies for addressing identified needs among KA women will be discussed.