Evaluating a Stage Model in Predicting Monolingual Spanish-Speaking Latinas' Cervical Cancer Screening Practices: The Role of Psychosocial and Cultural Predictors
Available accessResearch articleFirst published online December, 2008
Evaluating a Stage Model in Predicting Monolingual Spanish-Speaking Latinas' Cervical Cancer Screening Practices: The Role of Psychosocial and Cultural Predictors
The goals of this study are to evaluate (a) the effectiveness of a stage model in predicting Latinas' self-report of obtaining a Pap test and (b) the unique role of psychosocial/cultural factors in predicting progress toward behavior change. One-on-one structured interviews with monolingual Spanish-speaking Latinas (n = 190) were conducted. Most participants (85%) intended to obtain a Pap smear within 1 year; therefore, staging women based on intention was not possible. Moreover, results from the polychotomous hierarchical logistic regression suggest that psychosocial and cultural factors were independent predictors of Pap test history. A stage model may not be appropriate for predicting Pap test screening among Latinas. Results suggest that unique cultural, psychosocial, and demographic factors may inhibit cervical cancer screening practices. Clinicians may need to tailor messages on these cultural and psychosocial factors to increase Pap testing among Latinas.
American Cancer Society. (2002). Cancer facts and figures 2002. Atlanta, GA: Author.
2.
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Upper Saddle River, NJ: Prentice Hall.
3.
Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations . Journal of Personality and Social Psychology, 51(6), 1173-1182.
4.
Brislin, R.W. (1970). Back translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1, 185-216.
5.
Clemow, L., Costanza, M.E., Haddad, W.P., Luckmann, R., White, M.J., Klaus, D., et al. (2000). Underutilizers of mammography screening today: Characteristics of women planning, undecided about, and not planning a mammogram. Annals of Behavioral Medicine, 22(1), 80-88.
6.
Cuellar, I., Arnold, B., & Gonzalez, G. (1995). Cognitive referents of acculturation: Assessment of cultural constructs in Mexican Americans. Journal of Community Psychology, 23(4), 339-356.
7.
Elder, J.P., Apodaca, J.X., Parra-Medina, D., & Zuniga, M.L. (1998). Strategies for health education. In S. Loue (Ed.), Handbook of immigrant health (pp. 183-202). New York: Plenum Press.
8.
Fishbein, M.A., & Ajzen, I. (1975). Beliefs, attitudes, intentions, and behavior. Reading, MA: Addison-Wesley.
9.
Fishman, B.M., Bobo, L., Kosub, K., & Womeodu, R.J. (1993). Cultural issues in serving minority populations: Emphasis on Mexican Americans and African Americans. American Journal of the Medical Sciences, 306(3), 160-166.
10.
Harlan, L.C., Bernstein, A.B., & Kessler, L.G. (1991). Cervical cancer screening: Who is not screened and why? American Journal of Public Health, 81, 885-890.
11.
Hayward, R.A., Shapiro, M.F., Freeman, H.E., & Corey, C.R. (1988). Inequities in health services among insured Americans. Do working-age adults have less access to medical care than the elderly? New England Journal of Medicine, 318(23), 1507-1512.
12.
Hazuda, H.P., Stern, M.P., & Haffner, S.M. (1994). Acculturation and assimilation among Mexican Americans: Scales and population based data. Social Science Quarterly , 69, 687-706.
13.
Hosmer, D.W., & Lemeshow, S. (2000). Applied logistic regression (2nd ed.). New York: John Wiley.
14.
Hubbell, F.A., Chavez, L.R., Mishra, S.I., & Valdez, R.B. (1996). Beliefs about sexual behavior and other predictors of Papanicolaou smear screening among Latinas and Anglo women. Archives of Internal Medicine, 156(20), 2353-2358.
15.
Jennings-Dozier, K. (1999). Predicting intentions to obtain a Pap smear among African American and Latina women: Testing the theory of planned behavior . Nursing Research, 48(4), 198-205.
16.
Kelaher, M., Gillespie, A.G., Allotey, P., Manderson, L., Potts, H., Sheldrake, M., et al. (1999). The Transtheoretical Model and cervical screening: Its application among culturally diverse communities in Queensland, Australia. Ethnicity & Health, 4(4), 259-276.
17.
Kruse, J., & Phillips, D.M. (1987). Factors influencing women's decision to undergo mammography. Obstetrics and Gynecology , 70(5), 744-748.
18.
Marin, G., & Triandis, H.C. (1985). Allocentrism as an important characteristic of the behavior of Latin Americans and Hispanics. In R. Diaz-Guerrero (Ed.), Cross-cultural and national studies in social psychology (pp. 85-104). Amsterdam: Elsevier.
19.
Marks, G., Solis, J., Richardson, J.L., Collins, L.M., Birba, L., & Hisserich, J.C. (1987). Health behavior of elderly Hispanic women: Does cultural assimilation make a difference? American Journal of Public Health, 77(10), 1315-1319.
20.
National Cancer Institute. (2002). Surveillance, epidemiology, and end results. Bethesda, MD: Author. Available from http://seer.Cancer.Gov
21.
Perez-Stable, E. (1987). Issues in Latino health care. Western Journal of Medicine, 146(2), 213-218.
22.
Peters, R.K., Bear, M.B., & Thomas, D. (1989). Barriers to screening for cancer of the cervix . Preventive Medicine, 18(1), 133-146.
23.
Prochaska, J.O., & DiClemente, C.C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395.
24.
Prochaska, J.O., Velicer, W.F., DiClemente, C.C., & Fava, J. (1988). Measuring processes of change: Applications to the cessation of smoking. Journal of Consulting and Clinical Psychology, 56(4), 520-528.
25.
Rakowski, W., Clark, M.A., Pearlman, D.N., Ehrich, B., Rimer, B.K., Goldstein, M.G., et al. (1997). Integrating pros and cons for mammography and Pap testing: Extending the construct of decisional balance to two behaviors . Preventive Medicine, 26(5,Pt.1), 664-673.
26.
Sabogal, F., Marín, G., Otero-Sabogal, R., Marín, B.V., & Perez-Stable, E.J. (1987). Hispanic familism and acculturation: What changes and what doesn't? Hispanic Journal of Behavioral Sciences, 9(4), 397-412.
27.
SAS Institute. (1999). SAS 8.0 [Computer software]. Cary, NC: SAS Institute.
28.
Skinner, C.S., Strecher, V.J., & Hospers, H. (1994). Physicians' recommendations for mammography: Do tailored messages make a difference? American Journal of Public Health, 84(1), 43-49.
29.
Stein, J.A., Fox, S.A., & Murata, P.J. (1991). The influence of ethnicity, socioeconomic status, and psychological barriers on use of mammography. Journal of Health and Social Behavior, 32(2), 101-113.
30.
Suarez, L., Lloyd, L., Weiss, N., Rainbolt, T., & Pulley, L. (1994). Effect of social networks on cancer-screening behavior of older Mexican-American women. Journal of the National Cancer Institute, 86(10), 775-779.
31.
Suarez, S.P., Perez-Garcia, A.M., & Bermudez-Moreno, J. (2000). The General Self-Efficacy Scale: Psychometric data from the Spanish adaptation. Psicothema , 12(Suppl. 12), 509-513.
32.
Vernon, S.W., Laville, E.A., & Jackson, G.L. (1990). Participation in breast screening programs: A review. Social Science & Medicine, 30(10), 1107-1118.
33.
Weinstein, N.D. (1988). The precaution adoption process. Health Psychology, 7(4), 355-386.
34.
Wells, K.B., Golding, J.M., Hough, R.L., Burnam, M.A., & Karno, M. (1989). Acculturation and the probability of use of health services by Mexican Americans. Health Services Research, 24(2), 237-257.
35.
Wilcher, R.A., Gilbert, L.K., Siano, C.S., & Arredondo, E.M. (1999). From focus groups to workshops: Developing a culturally appropriate cervical cancer prevention intervention for rural Latinas. International Quarterly of Community Health Education, 19(2), 83-102.
