Predictors of adherence to follow-up recommendations after an abnormal Pap smear among underserved inner-city women.
Suzanne M Miller, Erin K Tagai, Kuang-Yi Wen and 5 others
PMID 28190541WHAT IT FOUND
Higher confidence about returning for follow-up was associated with timely colposcopy; unemployment was associated with delay or non-attendance; women who tended to distract from health threats were more likely to attend 6-month follow-up.
Fatalism, distress and perceived risk were not.
Key findings
01Higher self-efficacy was associated with timely versus delayed initial colposcopy (OR = 1.504, 95% CI 0.021-2.216, p = 0.039).
02Unemployed women were less likely than employed women to have timely adherence (OR = 0.133) or delayed adherence (OR = 0.181).
03Low monitoring style was associated with greater adherence to 6-month follow-up (OR = 0.785, 95% CI 0.659-0.935, p = 0.007).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was modest (210 women), and only 19 women (9.0%) never attended initial colposcopy. This left few non-adherent cases to analyse. Participants were mostly non-Hispanic Black (82.2%) and recruited from one inner-city clinic. The results may not apply to other cultural or geographic groups. Follow-up recommendations were missing for 18 women, and 8 women had no follow-up recommendation documented. This reduced the number available for the 6-month analysis. The distress measure may not have been sensitive. The mean score suggested most participants rarely experienced intrusive thoughts. Self-efficacy was measured with 2 items and perceived risk with 1 item, both author-constructed. The study found associations at baseline. It did not show that improving self-efficacy, employment status, or monitoring style would increase adherence.
The easy way to misread this
Do not read these predictors as causes or as proof that counselling will improve adherence. The study measured baseline associations in 210 inner-city women and did not test whether changing self-efficacy, employment status, or monitoring style changes attendance.