Pap Test Intervention

A Pap Test Intervention to Enhance Decision Making among PI Women: A Partnership with CSU Fullerton. Samoan National Nurses Association, Tongan Community Service Center, Orange County Asian and Pacific Islander Community Alliance, Claremont Graduate University.

This five year randomized CBPR study seeks to develop and evaluate a social support intervention targeting both men and women to increase Pap testing among three PI populations in Southern California: Chamorros, Tongans and Samoans.  Based upon well-established behavioral theories and methods, the overarching purpose of the study is to increase the utility of routine Pap tests (i.e., how worthwhile routine testing is perceived to be) and subsequently Pap testing behavior among PI women through social support from their male partners.  Using a longstanding CBPR collaborative that includes four community-based agencies and two universities, the specific aims are to:

1. Apply CBPR principles and processes for all community and university study partners;
2. Design and implement two culturally tailored educational interventions for PI women and men.  The interventions will be conducted separately, and will employ a video, flipchart, and brochure, along with small-group discussions facilitated by gender-matched community health educators;
3. Develop and validate men’s social support and women’s decision making instruments;
4. Recruit community-based organizational samples and randomly assign men and women in the organizations to the social support or usual care intervention;
5. Follow the cohort of PI women and men in this intervention study;
6. Examine the associations that test the conceptual model regarding social support, decision-making, and Pap testing intentions at pre-test and behaviors at one-year follow-up;
7. Follow the cohort of PI women and men in the social support vs. usual care interventions to assess the impact of the intervention.

This study will add to the existing science of cancer health disparities by illuminating the CBPR engagement aspects necessary to conduct rigorous intervention research in small-population communities.   It will adapt and apply well-established behavioral theories to understand the ways in which collectivist-oriented interventions influence individual women’s cancer screening behavioral changes.  The outcome will be a culturally-tailored intervention that holds the potential to become a model for other collectivistic populations.  Study strengths include:  i) a focus on a major cancer health disparity; ii) development and testing of methods that are applicable to other health disparities; iii) a theoretical focus on decision making (a priority area for NCI regarding translational research); iv) an intervention approach that investigates and develops new strategies to improve cultural tailoring and evaluation; and v) an ethnically diverse team of community and university investigators with an established track record in CBPR research.