Group versus individual culturally tailored and theory based education to promote cervical cancer screening among the underserved: A randomized controlled trial

Abstract

Cervical cancer, although not widely considered a fatal disease in this day and age, still has a major impact on women’s health around the world and in the U.S. Worldwide, invasive cervical cancer is the second most common cancer among women and is prominent in Mexico. Screening rates for cervical cancer are lower among Hispanic women. Although interventions have been tested to determine effectiveness in increasing the uptake of cervical cancer screening, there is no support of the effectiveness of group education, especially among Hispanic women. The overarching goal of the current research was to determine the mode of educational delivery – individual or group — that is most effective in encouraging cervical cancer screening so as to reduce the burden of cervical cancer in Texas Border Counties. We also assessed the effect of mode of intervention delivery on knowledge, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, subjective norms, and self-efficacy. A secondary data analysis of a randomized controlled study embedded within the De Case en Casa program was conducted in El Paso and Hudspeth County. 300 women between the ages of 21 and 65 who were uninsured, had never been diagnosed with cervical cancer or never had a hysterectomy, had not had a Pap test in the past 3 years, and had an income greater than 200% of the federal poverty level participated in the study. 150 women received the intervention in a group setting and 150 women received the intervention individually. 80.7% of participants were screened. No significant difference was found in uptake of cervical cancer screening by mode of educational delivery. The decrease in perceived barriers reached significance by mode of intervention delivery, with a larger decrease among those who received the education in a group setting. There was a significant increase in perceived benefits by uptake of cervical cancer screening with a larger increase among those who were not screened. No other construct reached significance. In conclusion, findings demonstrated that group education is effective in increasing cervical cancer screening among Hispanic women in a border county.