The overarching goals of this project are to improve psychological, behavioral, and physical health outcomes, by developing information protocols for women at risk for cervical cancer, that are tailored to the specific coping style needs of the patient. The proposed study has three main aims: 1) to examine the coping style predictors of adjustment and adaptation to cervical dysplasia; 2) to investigate the relative efficacy of informational interventions in promoting adjustment and adaptation; and, 3) to assess whether, and how, differences in coping style moderate these intervention effects. Toward these ends, women with abnormal Pap smears (N=360) and referred for colposcopy to Pennsylvania Hospital will first be divided into """"""""monitors"""""""" (information-seekers) and """"""""blunters"""""""" (information-avoiders) on the basis of their scores on the Miller Behavioral Style Scale. In two interrelated 3- group designs, one-third of each coping style group will be randomly assigned to the following interventions: 1) combined sensory and procedural information about colposcopy vs. procedural information about colposcopy vs. minimal preparatory information; 2) specific behavioral recommendations (about screening regimens and preventive actions) focused on the negative consequences of non-adherence vs. specific behavioral recommendations focused on the positive consequences of adherence vs. minimal behavioral recommendations. Subjects will be assessed immediately before, during, and after colposcopy, at notification of health status, and at six-month and one-year follow-up intervals. Outcome measures will assess 1) Response to informational interventions; 2) Adjustment; 3) Concerns; 4) Coping strategies; 5) Knowledge; 6) Adherence; and, 7) Medical Status. In addition, the effects of the patient's demographic, medical history and risk factor profile will be assessed. The short-term goals of this project are to examine hypotheses about the etiology of dysfunction in women at risk for cervical cancer and its treatment, within an integrated illness model framework. The long-term goals are to develop predictive models of dysfunction and to identify mechanisms of its management. Such understanding will help target individuals at high risk so that tailored preventive interventions can be devised.
| Miller, S M; Roussi, P; Altman, D et al. (1994) Effects of coping style on psychological reactions of low-income, minority women to colposcopy. J Reprod Med 39:711-8 |
| Kushner, M G; Riggs, D S; Foa, E B et al. (1993) Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims. Behav Res Ther 31:105-10 |
| Lerman, C; Hanjani, P; Caputo, C et al. (1992) Telephone counseling improves adherence to colposcopy among lower-income minority women. J Clin Oncol 10:330-3 |
| Lerman, C; Miller, S M; Scarborough, R et al. (1991) Adverse psychologic consequences of positive cytologic cervical screening. Am J Obstet Gynecol 165:658-62 |
