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      Associations of demographic variables and the Health Belief Model constructs with Pap smear screening among urban women in Botswana

      research-article
      International Journal of Women's Health
      Dove Medical Press
      cervical, screening, barriers, access, beliefs

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          Abstract

          Purpose

          Papanicolaou (Pap) smear services are available in most urban areas in Botswana. Yet most women in such areas do not screen regularly for cancer of the cervix. The purpose of this article is to present findings on the associations of demographic variables and Health Belief Model constructs with Pap smear screening among urban women in Botswana.

          Sample and methods

          The study included a convenience sample of 353 asymptomatic women aged 30 years and older who were living in Gaborone, Botswana. Data were collected using a demographic questionnaire and items of the Health Belief Model. Data analysis included descriptive statistics for demographic variables and bivariate and ordinal (logit) regression to determine the associations of demographic variables.

          Results

          Having health insurance and having a regular health care provider were significant predictors of whether or not women had a Pap smear. Women with health insurance were more likely to have had a Pap smear test than women without health insurance (91% vs 36%). Similarly, women who had a regular health care provider were more likely to have had a Pap smear test than women without a regular health care provider (94% vs 42%). Major barriers to screening included what was described as “laziness” for women who had ever had a Pap smear (57%) and limited information about Pap smear screening for women who had never had a Pap smear (44%).

          Conclusion

          There is a need for more information about the importance of the Pap smear test and for increased access to screening services in Botswana.

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          Most cited references24

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          Determination and quantification of content validity.

          M Lynn (1986)
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            Cervical cancer screening: who is not screened and why?

            The decline in death rates from cervical cancer in the United States has been widely attributed to the use of Papanicolaou (Pap) smears for early detection of cervical cancer. Pap smear screening rates, beliefs about appropriate screening intervals and factors affecting screening were examined using 1987 National Health Interview Survey data. Results indicate that through age 69, Blacks are screened at similar or higher rates than Whites. Hispanics, particularly those speaking only or mostly Spanish, are least likely to have received a Pap smear within the last three years. Of women who had never heard of or never had a Pap smear, nearly 80 percent reported contact with a medical practitioner in the past two years, while more than 90 percent reported a contact in the past five years. Overall, the most frequently reported reason for not having a recent Pap smear was procrastinating or not believing it was necessary. Thus, in developing screening programs, Hispanics, particularly Spanish speakers, must be targeted. In addition, educational programs should target unscreened women who forego the test due to underestimating its importance, procrastination, or because their medical care provider did not suggest the procedure. Women must be intensively educated that Pap smears should be scheduled routinely to detect asymptomatic cervical cancer.
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              Cervical cancer and Pap smear screening in Botswana: knowledge and perceptions.

              Cervical cancer is the most common cancer in Botswana. Little is known about women's use of Papanicolaou (Pap) cervical smear tests. The study is to explore knowledge and beliefs of 30 women about cervical cancer and Pap smear tests using the Health Belief Model. Women were recruited from all income levels using network sampling. Data were collected using a demographic questionnaire and semi-structured interview guide. Data analysis included descriptive statistics for demographic data and content analysis for interview data. Knowledge of cervical cancer and the Pap smear test was inadequate among women with low incomes. Pap smear utilization was also limited among low-income women. Of the 18 women who had at least one Pap smear test in their lifetime, eight (44%) had opportunistic testing as a result of having gynaecological symptoms. Twelve women (40%) had never had Pap smear tests. Major barriers to Pap smear screening included inadequate knowledge about Pap smear testing, providers' negative attitudes, and limited access to doctors. The study has implications for health education and health policy and for nurses' involvement in both.
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                Author and article information

                Journal
                Int J Womens Health
                Int J Womens Health
                International Journal of Women’s Health
                International Journal of Women's Health
                Dove Medical Press
                1179-1411
                2013
                24 October 2013
                : 5
                : 709-716
                Affiliations
                College of Nursing and Public Health, Adelphi University, Garden City, NY, USA
                Author notes
                Correspondence: Ditsapelo M McFarland, Adelphi University, One South Street, Garden City, NY 11530, USA, Tel +1 516 877 4560, Fax +1 516 877 4558, Email dmcfarland@ 123456adelphi.edu
                Article
                ijwh-5-709
                10.2147/IJWH.S50890
                3810782
                24179380
                ce9eccc2-3059-42a3-9304-161fe35cee05
                © 2013 McFarland. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Obstetrics & Gynecology
                cervical,screening,barriers,access,beliefs
                Obstetrics & Gynecology
                cervical, screening, barriers, access, beliefs

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