Sexual health empowerment project: Description and preliminary analysis of a jail-based cervical health literacy promotion intervention

Background: Women with a criminal justice history are 4-5 times more likely to develop cervical cancer than women without such a history.   An important contributor to cervical cancer risk is low health literacy about broader reproductive health issues.

Objective: To describe a novel jail-based cervical health literacy promotion intervention, the Sexual Health Empowerment Project, and provide preliminary results from outcomes analysis.

Methods:  Participants were recruited using a wait-list control design from 2 Kansas City jails. All participants completed a survey to measure baseline cervical health literacy.  At the end of the 5-day intervention, which included content on knowledge, beliefs, and self-efficacy related to screening and follow-up specific to the needs of incarcerated women, another survey was administered to compare pre- and post-intervention measures within and between the intervention and control groups.  After the intervention group completed their 5-day assessment, the wait-list control group received the intervention. 

Results:   Preliminary analysis (N=23) showed an increase in knowledge (p=0.02), decreased barriers to screening (p<0.01), reduced fear (p=0.03), increased self-efficacy (p<0.01) and increased confidence navigating health systems (p<0.01). The intervention group had greater changes in knowledge (d=0.94 vs 0.41), fear of screening (d=1.03 vs 0.44), and self-efficacy for screening (d=1.33 vs 0.80) compared to the control group.  Outcomes analysis for 125 participants will be completed in 6 months.

Conclusions:  This potentially effective and easily disseminated cervical health literacy promotion intervention could narrow the cervical cancer health gap between women with and without criminal justice histories.