Abstract B67: Role of social support in Pap test decision making among Pacific Islander women

Abstract

Background: Pacific Islanders (PIs) experience high cancer health disparities, including later stage of cervical cancer diagnosis due in large part to more than 10% lower Pap screening rates compared to non-Hispanic Whites. The aim of this community-based participatory research (CBPR) randomized control intervention is to increase rates of Pap testing among PI women residing in Southern California. Baseline data examined whether a Multi-Attribute Utility (MAU) model (a descriptive behavioral decision-making model) and women's perceived receipt of social support from their husband/partner significantly predicted Pap testing within the past three years. We also examined whether social support mediated the relationship between utility and Pap testing. Procedures: PI couples were recruited from Samoan, Tongan, and Chamorro churches and cultural social networks, and were randomly assigned to one of two educational interventions regarding cervical cancer screening. Participating women had to be between 21 and 65 years old and married or in a long-term relationship. A baseline questionnaire assessed women's MAU decision-making parameters (subjective value, subjective likelihood, and momentary salience) for eight anticipated consequences of getting a Pap test. Items also assessed female participants' perceived social support (appraisal, emotional, instrumental, and informational) from their husband/partner, and Pap testing behaviors. Results: Only half of the participants (49.9%) had received a Pap test within the past three years. A logistic regression model indicated that the total MAU score (which is the sum of the products of perceived subjective value, perceived subjective likelihood, and momentary salience across the eight parameters) was associated with higher rates of Pap testing (AOR= 1.10, p< 0.01). Four additional logistic regression models were run, one for each of the four different social support subscales. Appraisal support (AOR= 1.21, p= 0.000), emotional support (AOR= 1.25, p= 0.000), informational support (AOR= 1.13, p< 0.000), and instrumental support (AOR= 1.19, p= 0.000) were all associated with higher rates of Pap testing. Next, four mediational models were run, one for each of the four social support subscales, with instrumental support significantly mediating the relationship between MAU total scores and Pap testing. Specifically, the mediational model indicated MAU total scores had both a direct relationship with increased Pap testing, as well as an indirect relationship with increased Pap testing through its relationship with increased instrumental support. Conclusions: Results indicate that PI women's Pap testing follows a personal decision, with husband/partner's instrumental support enhancing the decision to receive a Pap test. Provision of such social support is the basis for the present intervention that educates men about the importance of expressing their concern for, and intention to assist with, regular Pap testing among PI women. Citation Format: Sora Park Tanjasiri, Jie Wu Weiss, Michele Mouttapa, Lola Sablan Santos, Jasmine Lacsamana DeGuzman, Vanessa Tuione May, Lourdes Quitugua, Dorothy Vaivao. Role of social support in Pap test decision making among Pacific Islander women. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B67. doi:10.1158/1538-7755.DISP13-B67