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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Vietnamese American women have higher rates of invasive cervical cancer than any other racial/ethnic group (43 per 100,000 compared to 8 per 100,000 among non-Latina white women). Further, approximately 25% of Vietnamese women have never received a Pap smear (compared to 5% of non-Latina white women). The National Institutes of Health Consensus Development Panel on cervical cancer has recommended that funding priorities should include research focusing on racial/ethnic minority populations and women who have never had a Pap smear. We have previously developed a culturally and linguistically appropriate cervical cancer control outreach intervention for Vietnamese women, and documented its acceptability and feasibility in terms of program delivery. Our primary objective is to evaluate the effectiveness of our outreach intervention in increasing the uptake of Pap testing among never screened Vietnamese women. Secondary objectives are as follows: to examine the effectiveness of the intervention in improving knowledge about cervical cancer and Pap testing; to document the costs of the program; and to assess the cost-effectiveness of the intervention. A randomized controlled trial will be conducted. Trial participants will include 250 Vietnamese American women, aged 20-79 years, who have never been screened for cervical cancer. These women will be identified from a community-based survey of 1,000 Vietnamese households. Participants will be individually randomized to intervention or control status. Bilingual, bicultural Vietnamese women will deliver the cervical cancer control outreach intervention to women in the intervention arm. The intervention will include home visits, follow-up telephone calls, use of a video and pamphlet, and tailored counseling and logistic assistance. Outcome evaluation will be based on a follow-up survey as well as medical record verification of self-reported Pap testing. If effective and cost-effective, our cervical cancer control intervention could be incorporated into outreach programs conducted by health care facilities and community-based organizations serving Vietnamese Americans, as well an the national Breast and Cervical Cancer Early Detection Program.