Intervention to improve follow-up for abnormal Papanicolaou tests

A randomized clinical trial

Carmen Radecki Breitkopf, Lauren Dawson, James J. Grady, Daniel M. Breitkopf, Carolyn Nelson-Becker, Russell Snyder

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To evaluate the effect of a theory-based, culturally targeted intervention on adherence to follow-up among low-income and minority women who experience an abnormal Pap test. Method: 5,049 women were enrolled and underwent Pap testing. Of these, 378 had an abnormal result and 341 (90%) were randomized to one of three groups to receive their results: Intervention (I): culturally targeted behavioral and normative beliefs + knowledge/skills + salience + environmental constraints/barriers counseling; Active Control (AC): nontargeted behavioral and normative beliefs + knowledge/skills + salience + environmental constraints/ barriers counseling; or Standard Care Only (SCO). The primary outcome was attendance at the initial follow-up appointment. Secondary outcomes included delay in care, completion of care at 18 months, state anxiety (STAI Y-6), depressive symptoms (CES-D), and distress (CDDQ). Anxiety was assessed at enrollment, notification of results, and 7-14 days later with the CDDQ and CES-D. Results: 299 women were included in intent-to-treat analyses. Adherence rates were 60% (I), 54% (AC), and 58% (SCO), p =.73. Completion rates were 39% (I) and 35% in the AC and SCO groups, p =.77. Delay in care (in days) was (M ± SD): 58 ± 75 (I), 69 ± 72 (AC), and 54 ± 75 (SCO), p =.75. Adherence was associated with higher anxiety at notification, p <.01 and delay < 90 days (vs. 90+) was associated with greater perceived personal responsibility, p <.05. Women not completing their care (vs. those who did) had higher CES-D scores at enrollment, p <.05. Conclusions: A theory-based, culturally targeted message was not more effective than a nontargeted message or standard care in improving behavior.

Original languageEnglish (US)
Pages (from-to)307-316
Number of pages10
JournalHealth Psychology
Volume33
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Papanicolaou Test
Randomized Controlled Trials
Anxiety
Counseling
Appointments and Schedules
Depression

Keywords

  • Behavior theory
  • Cervical dysplasia
  • Intervention
  • Minority
  • Randomized controlled trial

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

Cite this

Breitkopf, C. R., Dawson, L., Grady, J. J., Breitkopf, D. M., Nelson-Becker, C., & Snyder, R. (2014). Intervention to improve follow-up for abnormal Papanicolaou tests: A randomized clinical trial. Health Psychology, 33(4), 307-316. https://doi.org/10.1037/a0032722

Intervention to improve follow-up for abnormal Papanicolaou tests : A randomized clinical trial. / Breitkopf, Carmen Radecki; Dawson, Lauren; Grady, James J.; Breitkopf, Daniel M.; Nelson-Becker, Carolyn; Snyder, Russell.

In: Health Psychology, Vol. 33, No. 4, 2014, p. 307-316.

Research output: Contribution to journalArticle

Breitkopf, CR, Dawson, L, Grady, JJ, Breitkopf, DM, Nelson-Becker, C & Snyder, R 2014, 'Intervention to improve follow-up for abnormal Papanicolaou tests: A randomized clinical trial', Health Psychology, vol. 33, no. 4, pp. 307-316. https://doi.org/10.1037/a0032722
Breitkopf, Carmen Radecki ; Dawson, Lauren ; Grady, James J. ; Breitkopf, Daniel M. ; Nelson-Becker, Carolyn ; Snyder, Russell. / Intervention to improve follow-up for abnormal Papanicolaou tests : A randomized clinical trial. In: Health Psychology. 2014 ; Vol. 33, No. 4. pp. 307-316.
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