Provider beliefs associated with cervical cancer screening interval recommendations: A pilot study in Federally Qualified Health Centers

摘要

Background Among providers who serve low-income and uninsured women, resistance to extending the cervical cancer screening interval following normal Pap and co-test results has been documented. Our objective was to examine provider characteristics and beliefs associated with guideline-consistent screening interval recommendations. Method We collected cross-sectional survey data between 2009 and 2010 from 82 primary care providers in six Federally Qualified Health Centers in Illinois, USA. The relationships between characteristics, beliefs, and screening interval recommendations (1year vs. 3years) were tested with Pearson chi-square, negative binomial and ordered logistic regression. Results Compared to providers who recommended annual intervals after a normal co-test, providers who recommended a guideline-consistent (i.e., 3years) screening interval were significantly more likely to report the goodness, ease, and benefit of their recommendation and perceived encouragement for a 3-year interval from professional organizations and journals (p<.05). Providers who recommended a 3-year interval were also less likely to report that longer intervals increase patient risk for cervical cancer (p<.05). Interval recommendations were not associated with provider specialty, gender, or years in practice. Conclusion Messages that promote the benefits of longer screening intervals after a normal co-test, the natural history of human papillomavirus and cervical cancer, and low risk of developing cancer with a longer interval may be useful to promote evidence-based screening in this population of Federally Qualified Health Center providers. Dissemination of targeted messages through professional journals and specialty organizations should be considered. Highlights ? Annual cervical cancer screening is common, but not recommended by guidelines. ? Pilot study assessed provider factors associated with screening recommendations. ? Screening recommendations are associated with positive beliefs about screening tests. ? Perceived risk of the patient developing cancer between screenings is significant. ? Professional journals and organizations can disseminate screening interval messages.