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

Abstract

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.