A community-based randomized trial of a faith-placed intervention to reduce cervical cancer burden in Appalachia

Prev Med. 2012 Jun;54(6):408-14. doi: 10.1016/j.ypmed.2012.03.019. Epub 2012 Apr 3.

Abstract

Objective: Faith Moves Mountains assessed the effectiveness of a faith-placed lay health advisor (LHA) intervention to increase Papanicolaou (Pap) test use among middle-aged and older women in a region disproportionately affected by cervical cancer and low screening rates (regionally, only 68% screened in prior 3 years).

Method: This community-based RCT was conducted in four Appalachian Kentucky counties (December 2005-June 2008). Women aged 40-64 and overdue for screening were recruited from churches and individually randomized to treatment (n=176) or wait-list control (n=169). The intervention provided LHA home visits and newsletters addressing barriers to screening. Self-reported Pap test receipt was the primary outcome.

Results: Intention-to-treat analyses revealed that treatment group participants (17.6% screened) had over twice the odds of wait-list controls (11.2% screened) of reporting Pap test receipt post-intervention, OR=2.56, 95% CI: 1.03-6.38, p=0.04. Independent of group, recently screened participants (last Pap >1 but <5 years ago) had significantly higher odds of obtaining screening during the study than rarely or never screened participants (last Pap ≥5 years ago), OR=2.50, 95% CI: 1.48-4.25, p=0.001.

Conclusions: The intervention was associated with increased cervical cancer screening. The faith-placed LHA addressing barriers comprises a novel approach to reducing cervical cancer disparities among Appalachian women.

Trial registration: ClinicalTrials.gov NCT01372241.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Appalachian Region
  • Community Health Workers / statistics & numerical data
  • Community-Based Participatory Research*
  • Cost of Illness*
  • Faith Healing / methods*
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Kentucky
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Pancreatitis-Associated Proteins
  • Papanicolaou Test*
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Infections / psychology
  • Patient Education as Topic
  • Patient Selection
  • Social Class
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / prevention & control
  • Uterine Cervical Neoplasms / psychology
  • Vaginal Smears / psychology
  • Vaginal Smears / statistics & numerical data*
  • Waiting Lists

Associated data

  • ClinicalTrials.gov/NCT01372241