Abstract
Cervical cancer is caused by the Human Papillomavirus, the most common sexually transmitted infection worldwide. Screening every 3 years for cervical cancer as recommended by The American Cancer Society, and The American College of Obstetricians and Gynecologists is paramount in diagnosing and reducing the burden of cervical cancer. In addition, the national health objective, Healthy People 2020 is for at least 93% of all U.S. women to have cervical cancer screening completed within the past 3 years. Cervical cancer screening rates in Hispanic women are substantially below this goal. The purpose of this study was to examine the relationships between cervical cancer screening and predisposing factors (acculturation, education, intimate partner violence [IPV], marital status, and number of children) and enabling factors (health insurance, income, and usual source of care) among Hispanic women under the Andersen Model of Healthcare Utilization (Andersen, 1968). This study decreased gaps in the current literature by 1) sampling Hispanic women from different nationalities, 2) testing IPV as a potential predictor of cervical cancer screening, 3) testing number of children as a potential predictor of cervical cancer screening, 4) testing predictors of cervical cancer screening in a sub-sample of refugee Hispanic women, and comparing results to non-refugees. Cross-sectional data was obtained from a randomized controlled trial SEPA III: The Effectiveness Trial in Miami-Dade County, FL. The sample consisted of two hundred ninety-five Hispanic women ages 21 to 50 years old, of which ninety-two (31%) were refugees. The data analysis included descriptive statistics, independent t-tests, chi-square tests, Fisher’s Exact Tests, and logistic regressions. Predisposing factors (acculturation, employment, education, intimate partner violence, marital status, and number of children) and enabling factors (household income, health insurance, and usual source of care) were analyzed in logistic regression models to test whether they were related to cervical cancer screening. Predictors of cervical cancer screening were then compared in two subgroups, refugees vs non-refugees. The women in this study had high cervical cancer screening (95%) rates compared to the national average. The refugee group had an even higher rate compared to the non-refugee group (98% vs. 93%). Employment was the only statistically significant predictor of screening for the total sample, refugee subsample, and non-refugee subsample. The results of this study may provide considerations for nursing practice, policy, and further research to improve cervical cancer screening rates in Hispanic women. Further studies should assess potential social determinants of cervical cancer screening as well Hispanic cultural factors.