Decision making for Pap testing among Pacific Islander women

Abstract

This study employed a Multi-Attribute Utility (MAU) model to examine the Pap test decisionmaking process among Pacific Islanders (PI) residing in Southern California. A total of 585 PI women were recruited through social networks from Samoan and Tongan churches, and Chamorro family clans. A questionnaire assessed Pap test knowledge, beliefs and past behaviour. The three MAU parameters of subjective value, subjective probability and momentary salience were measured for eight anticipated consequences of having a Pap test (e.g., feeling embarrassed, spending money). Logistic regression indicated that women who had a Pap test (Pap women) had higher total MAU utility scores compared to women who had not had a Pap test within the past three years (No Pap women) (adjusted Odds Ratio ¼ 1.10). In particular, Pap women had higher utilities for the positive consequences 'Detecting cervical cancer early, Peace of mind, and Protecting my family', compared to No Pap women. It is concluded that the connection between utility and behaviour offers a promising pathway toward a better understanding of the decision to undergo Pap testing.

Overcoming Barriers to Cervical Screening Among Pacific Women: A Narrative Review

“…Having a bad experience resulting in pain and discomfort sometimes resulted in some women not engaging in cervical screening. 17,20,24,28,29 It was identified that there is a lack of Pacific health care providers and language-specific providers, which requires further development to improve access. 20,30 However, it is recognized that Pacific women may prefer a non-Pacific health care provider due to concerns regarding confidentiality.…”

“…Language-specific and culturally appropriate health resources can facilitate cervical screening through increasing knowledge. 18–20,27,29,38 One study identified that native Hawaiian women who accessed health information via the Internet were more likely to participate in cervical screening, highlighting the various mediums for education. 35…”

“…Pacific women have identified fear of cancer, peace of mind, and concern regarding protecting their family because there is a cultural responsibility that has facilitated their attendance for cervical screening. 28,29 The support and encouragement of family were a predictor for cervical screening and may be reflective of culturally appropriate programs disseminating information and supporting other women. 18,28,41…”