Improving cancer screening among women with mobility impairments: randomized controlled trial of a participatory workshop intervention.

PURPOSE: To assess the efficacy of an intervention to promote mammography and Papanicolaou (Pap) testing among women with mobility impairments overdue for screenings.

DESIGN

Randomized controlled trial.

SETTING

Urban and suburban Oregon.

PARTICIPANTS

Women aged 35 to 64 with mobility impairments who reported not receiving a Pap test in the past 3 years and/or mammogram (if age >40 years) in the last 2 years were eligible. A total of 211 women were randomized, and 156 completed the study (26% attrition). The majority were not employed and reported annual income <$10,000.

INTERVENTION: The Promoting Access to Health Services (PATHS) program is a 90-minute, small-group, participatory workshop with 6 months of structured telephone support, based on the health belief model and social cognitive theory.

MEASURES: Perceived susceptibility to breast and cervical cancer, perceived benefits of and self-efficacy for screening, intention to be screened, and self-reported receipt of mammography and Pap testing. ANALYSIS . Chi-square tests to examine the proportion of women obtaining screening; analysis of covariance to examine change in theoretical mediators.

RESULTS

The intervention group received more Pap tests than the control group at posttest (intervention 61%, control 27%, n  =  71, p < .01). No significant group effect was observed for mammography (intervention 49%, control 42%, n  =  125, p  =  .45).

CONCLUSION

Findings indicate that the PATHS intervention promotes Pap testing but not mammography among women with mobility impairments.