Facilitators and Barriers to Cervical Cancer Screening Among African American Women

Title from PDF of title page viewed November 9, 2020Dissertation advisor: Jannette Berkley-PattonVitaIncludes bibliographical references (pages 96-108)Thesis (Ph.D.)--Department of Psychology. University of Missouri--Kansas City, 2020African American (AA) women are at greater risk for cervical cancer incidence and mortality compared to white women, primarily due to lack of screening and follow up. Up to 90% of cervical cancers are caused by persistent Human Papillomavirus (HPV) infections and the National Institute for Health (NIH) and Preventative Oncology International (POI) recently developed HPV self-test kits to increase rates of screening among underserved women. This study used the Theory of Planned Behavior (TPB) to examine attitudes, barriers, facilitators, and intentions related to receipt of cervical cancer screening among church-affiliated women and explored perceptions of HPV self-testing to increase access to cervical cancer screening. Thirty-five AA women aged 25 to 53 participated in focus group discussions and completed a brief survey. Seventy-four percent of participants reported receipt of cervical cancer screening in the past three years. Participants demonstrated positive attitudes towards cervical cancer screening and identified healthcare providers and the church as key supportive referents to screening. Participants noted several key barriers to screening, such as financial concerns, trauma histories, and prioritizing their children’s healthcare needs over screening. With regards to HPV self-testing, participants had concerns about their ability to correctly collect the sample as well as result accuracy. Several strategies to mitigate these concerns were discussed. Nearly all participants expressed willingness to use HPV self-testing if they did not have access to traditional medical care. Participants also noted that the church would be an appropriate medium for disseminating HPV self-test kits. Other considerations for future faith-based interventions, such as use of humor and facilitating community connectedness, was also discussed.Introduction -- Methodology -- Results -- Discussion -- Appendix A. Figure 1: Theory of Planned Behavior -- Appendix B. Recruitment Fliers -- Appendix C. Pre-Consent Screening Script -- Appendix D. Informed Consent -- Appendix E. Participant Contact Form -- Appendix F. Focus Group Discussion Guide -- Appendix G. Brief Survey -- Appendix H. Code Ma