Cervical Cancer Beliefs and Pap Test Screening Practices Among Chinese American Immigrants

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Abstract
Purpose/Objectives: To examine beliefs and Pap test utilization among Chinese American women, the largest Asian female population in the United States. Research Approach: Cross-sectional descriptive, correlational study. Setting: Metropolitan areas of Portland, OR. Participants: 100 foreign-born Chinese women aged 40 years and older. Methodologic Approach: Three questionnaires were modified, translated, combined, and pretested. Participants completed the self-administered questionnaire in a group setting. Main Research Variables: Utilization of Pap test screening, health beliefs, and cultural and sociodemographic variables. Findings: Sixty-eight percent reported having a Pap test within the prior three years (adherence), and 84% reported ever having a Pap test. The odds of Pap test use and adherence decreased with increasing age. Women with insurance or a regular healthcare provider had better odds of Pap test use and adherence. Older age, older age when a participant moved to the United States, and increased modesty were negatively associated with ever having had a Pap test. Conclusions: Age and cultural beliefs influence Pap test use and adherence. The strength of provider recommendation and healthcare access as predictors suggest areas for interventions designed to increase screening for cervical cancer. Interpretation: Nurses play a vital role in preventive health care, especially with the growing number of advanced practice nurses delivering primary care. Primary healthcare providers should be reminded of their influential role in increasing adherence to cancer screening. Further health policy action is necessary to extend screening coverage to those who do not have adequate health insurance.