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Gynecol Oncol. 2007 Apr;105(1):74-80. Epub 2006 Dec 8.

What predicts adherence to follow-up recommendations for abnormal Pap tests among older women?

Author information

1
University of Texas Health Science Center, School of Public Health, 1200 Herman Pressler Dr., Houston, TX 77030, USA. Ann.L.Coker@uth.tmc.edu

Abstract

OBJECTIVE:

To address socio-demographic factors associated with adherence to follow-up recommendations in a high-risk population of women referred for follow-up care after an abnormal Pap test.

METHODS:

486 women aged 46-64 served by BCCEDP in two southeastern states between 1999-2002 and referred for follow-up care after an abnormal Pap test were the sampling frame for this cross-sectional study; 204 women completed a phone-based interview in 2004. Cox proportional hazards modeling was used to determine the association of various risk factors with time to adherence.

RESULTS:

Among those completing the phone interview (interview rate=61.4%) the mean age was 53.3 years, 64.7% were African-American women, 81.9% had low-grade cervical lesions, and all were either uninsured or under insured. Over 95% received follow-up care for an abnormal Pap test within 365 days of referral. When the BCCEDP criteria of follow-up within 60 days were applied, 52.9% were adherent. Rates of self-reported and program documented adherence differed significantly by state. After adjusting for state of residence, women who reported having symptoms of a chronic disease were more likely to be adherent within 365 days (aHR=1.42; 95% CI=1.00, 2.04). Neither age, race, lesion severity, education, number of dependent adults or children, self-perceived physical health, nor smoking status was associated with time to adherence.

CONCLUSIONS:

Findings suggest that institutional factors may be more important than individual factors in predicting time to adherence for an abnormal Pap test.

PMID:
17157363
DOI:
10.1016/j.ygyno.2006.10.046
[Indexed for MEDLINE]
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