Issues of access: Examining psychosocial predictors of cervical cancer prevention through Pap test screening among college-age Vietnamese-American women in Los Angeles

BACKGROUND: Vietnamese-American (VA) women have the highest age-adjusted incidence rate of cervical cancer (CCa) (43/100,00), and are five times more likely to develop CCa than non-Hispanic White women (8.7/100,000). Population-based studies completed in California have found that Vietnamese women report lower levels of Pap testing (62.3%) than any other racial/ethnic group. Studies have shown that increased acculturation is linked to higher rates of CCa screening. Although college-age VA women are generally more acculturated than less-educated VA women, they still exhibit the same high-risk screening behaviors as their counterparts. METHODS: In this formative study about CCa screening, three initial focus groups comprised of 16 non-HPV-vaccinated, college-age VA women (ages 18-24) who resided in the greater Los Angeles area were convened. Qualitative research is used to explore the range and sources of knowledge, attitudes, beliefs, barriers, motivators, and psychosocial predictors regarding CCa screening. Specifically, interviews were conducted to identify factors that would increase the effectiveness of community-based educational messages and materials in order to 1) increase the proportion of college-age VA women who obtain Pap tests on a regular basis and 2) ultimately reduce mortality from CCa among VA women. RESULTS: Findings from this study indicate that higher education, knowledge about CCa, and access to health insurance do not necessarily lead to adherence to recommended screening practices. Social and cultural factors proved critical in determining the attitudes and behaviors of the women. CONCLUSION: Future research on the generalizability of these preliminary findings is necessary to develop interventions for this often overlooked population.