The Family Planning Council of Southeastern Pennsylvania, in collaboration with the Cancer Prevention Research Center of the University of Rhode Island, is proposing an innovative study designed to address the risk behaviors associated with a recent alarming increase in the incidence of cervical neoplasias among young women. The proposed study is designed to develop, implement and evaluate interventions that increase consistent condom use and decrease cigarette smoking among 1,800 low income female youth aged 14-17 years who obtain family planning services at four diverse federally-funded family planning clinics. Smoking and unprotected sexual intercourse have been found to be independently associated with increased risks of cervical cancer in this population The proposed intervention is based on the Transtheoretical or Stages of Change model combined with one of the most promising modalities for reaching youth, an interactive computer based expert system whose efficacy will be evaluated alone and in combination with an adaptation of the anticipatory counseling model. Data will be collected at four points during a nine-month intervention period and at six-month intervals for 18 months post.intervention to assess effects over time. In addition, the intervention is aimed at increasing utilization of comprehensive, gynecologic health care including routine Pap smear screening, follow.up colposcopic examination and treatment of cervical dysplasia, the precursor of cervical cancers, when indicated. The proposed study represents the combined expertise of family planning researchers and service providers with considerable experience working with economically disadvantaged females and behavioral scientists with extensive research expertise in high risk behavior change.
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