Abstract Although cervical cancer rates in the United
States have declined sharply in recent decades, certain
groups of women remain at elevated risk, including
middle-aged and older women in central Appalachia. Crosssectional
baseline data from a community-based randomized
controlled trial were examined to identify barriers to
cervical cancer screening. Questionnaires assessing barriers
were administered to 345 Appalachian women aged 40–64,
years when Papanicolaou (Pap) testing declines and cervical
cancer rates increase. Consistent with the PRECEDE/
PROCEED framework, participants identified barriers
included predisposing, enabling, and reinforcing factors.
Descriptive and bivariate analyses are reported, identifying
(a) the most frequently endorsed barriers to screening, and
(b) significant associations of barriers with sociodemographic
characteristics in the sample. Recommendations are
provided to decrease these barriers and, ultimately, improve
rates of Pap tests among this traditionally underserved and
disproportionately affected group.
Abstract Although cervical cancer rates in the United
States have declined sharply in recent decades, certain
groups of women remain at elevated risk, including
middle-aged and older women in central Appalachia. Crosssectional
baseline data from a community-based randomized
controlled trial were examined to identify barriers to
cervical cancer screening. Questionnaires assessing barriers
were administered to 345 Appalachian women aged 40–64,
years when Papanicolaou (Pap) testing declines and cervical
cancer rates increase. Consistent with the PRECEDE/
PROCEED framework, participants identified barriers
included predisposing, enabling, and reinforcing factors.
Descriptive and bivariate analyses are reported, identifying
(a) the most frequently endorsed barriers to screening, and
(b) significant associations of barriers with sociodemographic
characteristics in the sample. Recommendations are
provided to decrease these barriers and, ultimately, improve
rates of Pap tests among this traditionally underserved and
disproportionately affected group.
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