Graduation Year

2005

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Public Health

Major Professor

Robert J. McDermott, Ph.D.

Committee Member

Thomas J. Mason, Ph.D.

Committee Member

Karen M. Perrin, Ph.D.

Committee Member

Ellen M. Daley, Ph.D.

Committee Member

Richard G. Roetzheim, M.D.

Keywords

American cancer society, Centers for disease control and prevention, Compliance with, Ethnic origin, Preventive health model, Primary care provider advice, Public health research, Self-reported data

Abstract

Black American women have the highest screening rates for cervical cancer among all the ethnic groups in the United States. Even though evidence from the literature suggests that the number of deaths from cervical cancer in the United States could be reduced by preventive screening, this particular minority population still suffers disproportionately higher mortality from the disease than the other minority and majority populations in the United States. This study was proposed to investigate cancer screening disparities among different subpopulations of women residing in the United States during 1999, and to recommend public health interventions that could potentially increase cervical cancer screening rates, thereby decreasing differential mortality rates for cervical cancer among these subpopulations. The Preventive Health Model in conjunction with data from the 1999 Behavioral Risk Factor Surveillance System was used to identify the covariates of cervical cancer screening behavior in an ethnically diverse population of American women residing in the United States during the specified timeframe. Univariate, bivariate and multivariable logistic regression procedures were used to evaluate the association between each one of the independent variables and the dependent variable (compliance with the 1999 cervical screening guidelines of the American Cancer Society).

One of the major findings of this study was that Black, White and Hispanic American women were more similar in their screening behavior than dissimilar. The study also showed that the disparity in cervical cancer screening behavior in this population is in age, rather than in ethnic origin. Black, White and Hispanic American women of child-bearing age (18-44 years) were more likely to be compliant with the 1999 cervical cancer screening guidelines of the American Cancer Society, than Black, White and Hispanic American women who were not of child-bearing age (45 to 64 years). Implications for public health intervention studies are discussed, and recommendations made for future research in this area of cervical cancer screening behavior.

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