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Several barriers impede cancer prevention in the Mexican American population. This study identified sociocultural factors that could be used to increase screening rates for cervical cancer in women of reproductive age. A survey was conducted in 1991 of 366 Mexican American women ages 18 to 40 in Tucson, Arizona, to assess current compliance with cervical cancer screening guidelines and several psychological, social, and cultural variables. Women who had never been screened (13 percent of the sample) had a knowledge deficit, no gynecological care, and no sexual activity. Women not screened annually (16 percent) lacked preventive care, imperfectly understood the Pap test, had lower selfefficacy expectations for understanding physicians, experienced higher emotional stress about the test, and were older and less acculturated. Women who have never been screened require basic education on cancer and cancer screening and policy changes increasing access to care. For women with less routine screening, preventive care, supportive attitudes, and health care skills must be encouraged.

Afield investigation was completed surveying the communication practices of 754 adults. Questionnaire items were designed to tap the multidimensional nature of deception in patient-physician interactions. A battery of sociodemographic items was also included. Data reduction techniques were used to produce a measurement model with concealment lequivocation, falsification, and truthfulness as three orthogonal, internally reliable dimensions of deceptive communication in the practice of clinical medicine. Statistical controls indicated that social desirability of honest versus duplicitous responses were not correlated with willingness to admit using deception in patient-physician interactions. Summaries offrequency of use of different kinds of deceptive communication by different population subgroups were offered. Discussion focused on the theoretical utility of the measurement model and the practical implications for the practice of medicine. Finally, information management techniques available to health care providers were suggested to (a) increase conversational surveillance, (b) detect language selection/ use associated with different kinds of deceptive communication, and (c) provide interactional strategies to reduce patient deception.