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Objectives. We sought to promote cervical cancer screening among Vietnamese American women in Santa Clara County, Calif.
Methods. In 2001-2004, we recruited and randomized 1005 Vietnamese American women into 2 groups: lay health worker outreach plus media-based education (combined intervention) or media-based education only. Lay health workers met with the combined intervention group twice over 3 to 4 months to promote Papanicolaou (Pap) testing. We used questionnaires to measure changes in awareness, knowledge, and Pap testing.
Results. Testing increased among women in both the combined intervention (65.8% to 81.8%; P<.001) and media-only (70.1% to 75.5%; P<.001) groups, but significantly more in the combined intervention group (P=.001). Among women never previously screened, significantly more women in the combined intervention group (46.0%) than in the media-only group (27.1%) obtained tests (P<.001). Significantly more women in the combined intervention group obtained their first Pap test or obtained one after an interval of more than 1 year (became up-to-date; 45.7% to 67.3%, respectively; P<.001) than did those in the media-only group (50.9% to 55.7%, respectively; P=.035).
Conclusions. Combined intervention motivated more Vietnamese American women to obtain their first Pap tests and to become up-to-date than did media education alone. (Am J Public Health. 2007;97:1693-1700. doi:10.2105/AJPH. 2006.086470)
Cervical cancer can cause a woman to lose her fertility because of surgery or radiation treatment and can result in untimely death. Vietnamese American women have the highest incidence of cervical cancer of any racial or ethnic group in the United States, 5 times higher than that of non-Hispanic Whites (43.0 per 100000 vs 7.5 per 100000).1 In 1999, the Centers for Disease Control and Prevention initiated the Racial and Ethnic Approaches to Community Health (REACH 2010) program to reduce health disparities. In response, we formed a coalition of researchers and community members in Santa Clara County, Calif, called the Vietnamese REACH for Health Initiative, to address the cervical cancer disparity experienced by Vietnamese American women.
This disparity is entirely preventable. Persistent infection with a high-risk human papillomavirus (HPV) is generally accepted as the major cause of cervical cancer.2 However, both active and passive exposure to cigarette smoke is an additional risk factor.3 Although Vietnamese American women have a low prevalence of active smoking, passive smoke exposure is a genuine problem for...