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In My Own Words: Misunderstanding of Pap Smears and Colposcopy Among Appalachian Women

Fortner, Kimberly B. MD1; Zite, Nikki B. MD, MPH1; Wallace, Lorraine S. PhD2

Journal of Lower Genital Tract Disease: October 2007 - Volume 11 - Issue 4 - pp 251-257
doi: 10.1097/LGT.0b013e318033999f
Original Articles

Objective. To evaluate knowledge of Pap smear screening and colposcopy among Appalachian women.

Materials and Methods. English-speaking women (18 years or older) referred for colposcopy after abnormal Pap testing at a teaching hospital in the southeastern United States were studied. Structured interviews were conducted to assess demographic characteristics, health literacy skills using the Rapid Estimate of Adult Literacy in Medicine, understanding of the Pap smear and colposcopy, state anxiety, and cervical intraepithelial neoplasia distress.

Results. The mean age of women was 29.6 ± 10.94, 93.2% white, 50.2% high school graduates or had an equivalency diploma, and 55.3% current cigarette use. Approximately one fifth (n = 22) of women had limited health literacy skills. Overall, womens' understanding of the Pap test, meaning of abnormal Pap test results, identification of risk factors contributing to abnormal Pap test results, and understanding of colposcopy was limited. Health literacy skills was the lone characteristic to significantly predict overall understanding of the Pap smear and colposcopy (unstandardized β coefficient [SE] = 0.68 [0.02], p < .05).

Conclusions. These findings demonstrate that Pap smear and colposcopy knowledge is associated with health literacy skills. Health care providers should be aware that many women lack sufficient knowledge of the Pap smear and colposcopy and tailor counseling during the clinical encounter accordingly.

Health literacy skills are associated with Pap smear and colposcopy knowledge among Appalachian women.

1Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, and 2Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN

Reprint requests to: Lorraine S. Wallace, PhD, Department of Family Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, U-67, Knoxville, TN 37920. E-mail: lwallace@mc.utmck.edu

©2007The American Society for Colposcopy and Cervical Pathology