The goal of pap smears is not to detect invasive cancer, but to detect precancerous-abnormalities that might develop into invasive cancer. Lack of adherence to follow-up treatment protocols for an abnormal pap smear limits the effectiveness of a screening program. Among women with abnormal pap smears, failure to return for follow-up care can increase morbidity, mortality, and the cost of health care. Estimates of failing to return for follow-up care among women with abnormal cytology range as high as 80%. Certain groups of women, namely African-Americans and the elderly, have poorer utilization rates of screening tests and higher mortality rates from cervical cancer. The use of community persons as lay health workers (""""""""lay health advisors"""""""" or """"""""community health advisors"""""""") has gained increased recognition in the United States over the last two decades. They have been used to address a broad range of community health issues in various settings. Since indigenous persons know their environments and are usually highly trusted in the community. the are better able to address health and other issues within their networks as opposed to outsiders. In many instances, they receive some type of specialized training to enhance their existing skills and knowledge. This fosters cooperative relationships with health professionals, enhances the potential to mobilize community resources, and offers new services and programs to the community We propose a randomized trial to compare standard phone reminders, made by clinic staff members, versus tailored phone reminders, made by community health advisors. The target population for this study will be African American women from an urban clinical setting, who have abnormal pap smears. The community health advisors will utilize the case manager approach in effort to improve compliance with follow-up recommendations and decrease the number of patients lost to follow-up. Follow-up data will be collected at six-month intervals for a period of eighteen months. This randomized trial represents a novel approach to improving cervical cancer-screening behavior among African American women who have abnormal pap smears. If the tailored intervention is effective. it could be an inexpensive way for other urban hospitals across the nation to improve compliance with cervical cancer screening for African American patients.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA088948-05
Application #
6850647
Study Section
Subcommittee G - Education (NCI)
Program Officer
Gorelic, Lester S
Project Start
2001-08-28
Project End
2006-06-30
Budget Start
2005-01-01
Budget End
2005-12-31
Support Year
5
Fiscal Year
2005
Total Cost
$130,410
Indirect Cost
Name
University of Alabama Birmingham
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294