Dignan, Mark B., Robert Michielutte, H. Bradley Wells, Penny Sharp, Karen Blinson, L. Douglas Case, Ronny Bell, Joseph Konen, Stephen Davis, and Richard P. McQuellon. “Health education to increase screening for cervical cancer among Lumbee Indian women in North Carolina.” Health Education Research: Theory & Practice 13.4 (1998):545-56.
The age-adjusted cervical cancer mortality rate (1984-1988) in the U.S. was 7.6 per 100,000 among Native American women vs. 3.1 per 100,000 among the overall female population. This article suummarizes results of the North Carolina Native American Cervical Cancer Prevention Program, a culturally sensitive program funded by the National Cancer Institute, which hoped to reduce cervical cancer mortality by increasing the number of Lumbee women who obtain an annual Pap smear.
The program was developed along planning frameworks including PRECEDE/PROCEED and provided client education through two in-home visits, 2-3 weeks apart, to discuss cervical cancer, the Pap smear, follow-up care which might be needed, and ways to gain access to health care services. The health educator, a Lumbee female who was trained by the investigators, paid visits over a 30-month period. After the two home visits, clients received follow-up mailings. The project was structured according to the Solomon Four Group design. 979 women were enrolled in the project.
Results of the study showed that those who received the in-home education program were 50% more likely to have obtained a Pap smear in the previous year than those in the control group. Women who had an annual physical exam were 6 times more likely to report a Pap smear in the previous year than those who did not. Women aged 35-54 were less likely to have a Pap smear than those 24 or younger.