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Kanbergs AN, Sullivan MW, Maner M, Brinkley-Rubinstein L, Goodman A, Davis M, Feldman S. Cervical Cancer Screening and Follow-Up Practices in U.S. Prisons. Am J Prev Med 2023; 64:244-249. [PMID: 36653100 DOI: 10.1016/j.amepre.2022.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The objective of this study is to better understand cervical cancer screening and follow-up practices in U.S. prisons. METHODS A 29-question survey examining cervical cancer screening practices, education, and facility/patient characteristics was disseminated to state-prison medical directors. RESULTS A total of 70% (35/50) of state medical directors completed the survey between August 2021 and January 2022. All prison systems provided cervical cancer screening both at intake and specified intervals. A total of 36% provided colposcopy on site, and 9% performed excisional procedures on site. A total of 11 states identified 1‒5 cases of cervical cancer within the last year. Frequently cited challenges included a perceived lack of patient interest, delays in community referral, and lack of follow-up of abnormal results after release. CONCLUSIONS This study found relatively high rates of screening with a perceived lack of patient interest as the most reported barrier. Follow-up care was also often affected by reported lack of patient interest, delays in community referral for diagnostic procedures, and patient release before follow-up. There is room for further optimization of screening and surveillance among incarcerated women by understanding and addressing systems-based challenges. By understanding patient barriers to primary screening, expanding access to onsite testing and community referral for abnormal results, and streamlining post-release follow-up, disparities in care among incarcerated women can be reduced.
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Affiliation(s)
- Alexa N Kanbergs
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Mackenzie W Sullivan
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Morgan Maner
- Center for Health Equity Research, Department of Social Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lauren Brinkley-Rubinstein
- Center for Health Equity Research, Department of Social Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Annekathryn Goodman
- Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michelle Davis
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Salyer C, Lee J, Lorvick J, Comfort M, Cropsey K, Smith S, Emerson A, Ramaswamy M. Cervical Cancer Prevention Behaviors Among Criminal-Legal Involved Women from Three U.S. Cities. J Womens Health (Larchmt) 2021; 31:533-545. [PMID: 34652231 PMCID: PMC9063145 DOI: 10.1089/jwh.2021.0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: This study aims to understand how criminal-legal involved women from three U.S. cities navigate different health resource environments to obtain cervical cancer screening and follow-up care. Methods: We conducted a cross-sectional study of women with criminal-legal histories from Kansas City KS/MO; Oakland, CA; and Birmingham, AL. Participants completed a survey that explored influences on cervical cancer prevention. Responses from all women with/without up-to-date cervical cancer screening and women with abnormal Pap testing who did/did not obtain follow-up care were compared. Proportions and associations were tested with chi-square or analysis of variance tests. Multivariable regression was performed to identify variables independently associated with up-to-date cervical cancer screening and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: There were n = 510 participants, including n = 164 Birmingham, n = 108 Kansas City, and n = 238 Oakland women. Criminal-legal involved women in Birmingham (71.3%) and Kansas City (68.9%) were less likely to have up-to-date cervical cancer screening than women in Oakland (84.5%, p = 0.01). More women in Birmingham (14.6%) and Kansas City (16.7%) needed follow-up for abnormal Pap than women in Oakland (6.7%, p = 0.003), but there were no differences in follow-up rates. Predictors for up-to-date cervical cancer screening included access to a primary care provider (OR: 3.3, 95% CI: 1.4-7.7), health literacy (OR: 0.3, 95% CI: 0.2-0.7), and health behaviors, including avoiding tobacco (OR: 0.4, 95% CI: 0.1-0.9) and HPV vaccination (OR: 3.4, 95% CI: 1.0-10.9). Conclusions: Cervical cancer screening and follow-up varied by study site. The results suggest that patient level factors coupled with the complexity of accessing care in different health resource environments impact criminal-legal involved women's cervical cancer prevention behaviors.
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Affiliation(s)
- Chelsea Salyer
- Division of Gynecologic Oncology, University of Kansas, Kansas City, Kansas, USA
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas, USA
| | - Jennifer Lorvick
- Community Health and Implementation Research Program, RTI International, Berkeley, California, USA
| | - Megan Comfort
- Applied Justice Research Program, RTI International, Berkeley, California, USA
| | - Karen Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sharla Smith
- Department of Population Health, University of Kansas, Kansas City, Kansas, USA
| | - Amanda Emerson
- School of Nursing, University of Missouri Kansas City, Kansas City, Missouri, USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas, Kansas City, Kansas, USA
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Salyer C, Lipnicky A, Bagwell-Gray M, Lorvick J, Cropsey K, Ramaswamy M. Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126556. [PMID: 34207093 PMCID: PMC8296431 DOI: 10.3390/ijerph18126556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities-Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing (n = 15, 38%), or colposcopy and/or biopsy (n = 14, 35%). Women who did not follow-up (n = 15, 26%) cited that they forgot (n = 8, 53%), were uninsured (n = 3, 20%), or were reincarcerated (n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3-16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1-13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.
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Affiliation(s)
- Chelsea Salyer
- Division of Gynecologic Oncology, University of Kansas, Kansas City, KS 66160, USA;
| | - Ashlyn Lipnicky
- Department of Population Health, University of Kansas, Kansas City, KS 66160, USA;
| | | | - Jennifer Lorvick
- RTI International Community Health and Implementation Research Program, Berkeley, CA 94704, USA;
| | - Karen Cropsey
- Department of Psychiatry, University of Alabama, Birmingham, AL 35294, USA;
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas, Kansas City, KS 66160, USA;
- Correspondence:
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Jodry D, Blemur D, Nguyen ML, Kuhn T, Easley K, Wang H, Ramaswamy M, Birdsong G, Kohut A, Manobianco B, Flowers L. Criminal Justice Involvement and Abnormal Cervical Cancer Screening Results Among Women in an Urban Safety Net Hospital. J Low Genit Tract Dis 2021; 25:81-85. [PMID: 33631779 DOI: 10.1097/lgt.0000000000000589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to elucidate the risk factors underlying abnormal cytology-based cervical cancer screening (Pap testing) in justice-involved women (JIW) compared with non-JIW in an urban safety net hospital. METHODS Retrospective chart review of women with a history of correctional involvement who received care at Grady Health System between 2010 and 2018 and had a Pap test was performed (n = 191). An age-matched cohort of women with no correctional involvement and had a Pap test at Grady served as the control (n = 394). Variables of interest were age, HIV, smoking, race, mental health history, and history of incarceration. Outcomes of interests were rate of abnormal Pap tests and follow-up. χ2 and logistic regression models evaluated associations between the variables of interest and outcomes. RESULTS Rates of abnormal Pap tests were significantly higher in JIW (35.6%) than controls (18.5%, p < .0001). Compared with controls, JIW were significantly more likely to have high-grade cervical cytology (odds ratio [OR] = 3.89, p < .0005) and be lost to gynecologic follow-up (OR = 8.75, p < .0001) and a history of severe mental illness (29.5% vs 4.3%, p < .0001). Those with abnormal Pap tests were likely to be HIV-positive (OR = 20.7, p < .001) and have a history of incarceration (OR = 2.33, p < .001). Predictors of high-grade Pap test were smoking history (OR = 0.16, p = .014), HIV-positive (OR = 3.66, p = .025), and history of incarceration (OR = 3.96, p < .0005). CONCLUSIONS Justice-involved women represent a high-risk subpopulation with significantly increased rates of high-grade cytology and lost to follow-up. This underscores the need for attention to screening programs and follow-up interventions for JIW.
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Affiliation(s)
- Dominique Jodry
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | | | - Minh Ly Nguyen
- Department of Infectious Disease, Emory University School of Medicine, Atlanta, GA
| | - Theresa Kuhn
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Kirk Easley
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA
| | - Heqiong Wang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
| | - George Birdsong
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Adrian Kohut
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Brittany Manobianco
- Department of Gynecology and Obstetrics, University of South Florida Morsani College of Medicine, Tampa, FL
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Escobar N, Plugge E. Prevalence of human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer in imprisoned women worldwide: a systematic review and meta-analysis. J Epidemiol Community Health 2019; 74:95-102. [DOI: 10.1136/jech-2019-212557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 11/04/2022]
Abstract
Background and objectivesImprisoned women have higher rates of abnormalities at cervical screening and some studies suggest that cervical cancer is the most common cancer in this population. The aim of this work was to summarise the current evidence on the prevalence of human papilloma virus (HPV) infection, cervical cancer and precancerous lesions in women in prison worldwide and to compare these rates with the general population.MethodsWe systematically searched and reviewed published and unpublished data reporting the prevalence of any HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer in imprisoned women. We created forest plots with prevalence estimates from studies with comparable outcomes and of prevalence ratios using data from national screening programmes as a comparison group.FindingsA total of 53 533 imprisoned women from 10 countries and 35 studies were included in the review. The prevalence of HPV among prisoners ranged from 10.5% to 55.4% with significant heterogeneity. The prevalence of CIN diagnosed by cytology in prisoners ranged from 0% to 22%. Ratios comparing the prevalence of CIN in imprisoned women to that in the community ranged from 1.13 to 5.46. Cancer prevalence estimates were at least 100 times higher than in populations participating in national screening programmes.ConclusionImprisoned women are at higher risk of cervical cancer than the general population. There is a high prevalence of HPV infection and precancerous lesions in this population. Targeted programmes for control of risk factors and the development of more effective cervical screening programmes are recommended.PROSPERO registration numberCRD42014009690.
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Emerson AM, Smith S, Lee J, Kelly PJ, Ramaswamy M. Effectiveness of a Kansas City, Jail-Based Intervention to Improve Cervical Health Literacy and Screening, One-Year Post-Intervention. Am J Health Promot 2019; 34:87-90. [PMID: 31315420 DOI: 10.1177/0890117119863714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess effectiveness, 1-year post-intervention, of a program delivered in jails with women to improve cervical health literacy (CHL) and up-to-date Papanicolaou (Pap) screening. DESIGN Pre-post design to evaluate Pap screening and CHL effects 1 year after our original randomized wait-list control study. SETTING Surveys conducted in Kansas City, 2015 to 2017 (baseline in 2014). PARTICIPANTS Adult women (n = 133). INTERVENTION One-week (10-contact-hour), small-group, CHL program. MEASURES Surveys to assess CHL components and up-to-date Pap screening. ANALYSIS χ2 and t tests, followed by best-subsets logistic regression using sociodemographic and CHL components to fit an optimal model for up-to-date screening 1-year post-intervention. RESULTS 73% (133/182) women retained at 1-year. From pre-intervention, 6 of 8 CHL components improved (.01 > P > .001). Up-to-date Pap screenings increased over pre-intervention (72%-82%, P < .05). Best-subset model to predict up-to-date screening included age; public benefits; medical insurance; 5 CHL components (knowledge, benefits, barriers, seriousness, susceptibility). CONCLUSION A brief intervention to promote cervical health literacy, delivered with women during a jail detention, can lead to sustained improvements in CHL and prevention practices.
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Affiliation(s)
- Amanda M Emerson
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sharla Smith
- Preventive Medicine and Public Health, University of Kansas, Wichita, KS, USA
| | - Jaehoon Lee
- Institute for Measurement, Methodology, Analysis, and Policy (IMMAP), Texas Tech University, College of Education, Lubbock, TX, USA
| | - Patricia J Kelly
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Megha Ramaswamy
- Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
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Brousseau EC, Ahn S, Matteson KA. Cervical Cancer Screening Access, Outcomes, and Prevalence of Dysplasia in Correctional Facilities: A Systematic Review. J Womens Health (Larchmt) 2019; 28:1661-1669. [PMID: 30939063 DOI: 10.1089/jwh.2018.7440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Incarcerated women often access health care primarily through contact with correctional systems. Cervical cancer screening within the correctional system can address the preventable outcome of cervical dysplasia and cancer in this high-risk population. Materials and Methods: A search of PubMed, EMBASE, CINAHL, and ClinicalTrials.gov was conducted for articles published between January, 1966 and December, 2018. All studies on a population of jailed or incarcerated females and at least one of the following outcomes: cervical cancer or dysplasia, pap smear screening, knowledge about screening, treatment of cervical dysplasia, and compliance with follow-up were analyzed. Results: Forty-two studies met inclusion criteria. All 21 studies with prevalence outcomes described a higher prevalence of cervical dysplasia and cancer in the women involved with corrections, compared to a variety of different sources that served as community control groups. The data on screening outcomes were inconsistent. Follow-up compliance for abnormal results was poor, with a study finding that only 21% of women were rescreened within 6 months of the recommended time period. Knowledge about cervical cancer and screening was evaluated in eight studies and was poor across all studies. Conclusion: Women involved in correctional systems have a higher prevalence of cervical dysplasia and cancer than women in the general population. Acceptance of screening varies, and no published interventions have been shown to improve screening within the prison system. Treatment and compliance with follow-up recommendations are extremely poor and should be a focus of future research.
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Affiliation(s)
- Erin Christine Brousseau
- Department of Obstetrics and Gynecology, Women and Infants Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Susie Ahn
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
| | - Kristen A Matteson
- Department of Obstetrics and Gynecology, Women and Infants Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Impact of a brief intervention on cervical health literacy: A waitlist control study with jailed women. Prev Med Rep 2017; 6:314-321. [PMID: 28435785 PMCID: PMC5393169 DOI: 10.1016/j.pmedr.2017.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/14/2017] [Accepted: 04/02/2017] [Indexed: 11/22/2022] Open
Abstract
Jailed women are four-five times more likely to have had cervical cancer compared to women without criminal justice histories. Previous research has shown that an important contributor to cervical cancer risk, and perhaps lack of follow-up, is incarcerated women's low health literacy about broader reproductive health issues. Little work has been done to address this disparity. Thus, the objective of this study was to test the effectiveness of an intervention to improve incarcerated women's cervical health literacy and ultimately address cervical cancer disparities. Using a waitlist control design, we compared changes in cervical health literacy (knowledge, beliefs, self-efficacy, and confidence for screening and follow-up) among 188 incarcerated women who completed a 10-hour intervention between 2014 and 2016 in three Kansas City jails. We used bivariate tests and multivariate analyses that controlled for baseline cervical health literacy level and key covariates. Women in the intervention group showed significant gains in seven out of eight cervical health literacy domains (all p < 0.01), whereas the control group only improved in one domain (p < 0.01). When controlling for covariates, the intervention group had less barriers, perceptions of seriousness, susceptibility to disease, and increased self-efficacy for cervical health screening and follow-up, compared to the control group (all p < 0.05). A brief intervention is an effective way to improve jailed women's cervical health literacy, but should be provided alongside systemic efforts that expand access to correctional preventive health services, including the human papillomavirus vaccine, community-based cancer screenings, and health insurance after women leave jails and transition back to communities.
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Abstract
PURPOSE The purpose of this paper is to explore incarcerated women's awareness, beliefs, and experiences with human papillomavirus (HPV) infection and vaccination. DESIGN/METHODOLOGY/APPROACH Researchers conducted focus groups with 45 incarcerated women in an urban Midwestern US jail to assess how women talked about their Papanicolaou (Pap) test screening and abnormal Pap test follow-up experiences. Some focus group questions specifically assessed individual awareness, beliefs, and experiences with HPV infection and vaccination. Based on these data, the authors described participants' awareness of HPV, as well as used open coding to ultimately extract themes related to beliefs and experiences with HPV infection and vaccine. FINDINGS While all 45 participants reported experiencing an abnormal Pap test event within the last five years, only two-thirds of participants (n=30) reported having heard of the HPV infection. Several themes emerged from the analysis of the data: the women's beliefs about cause and severity of HPV; frustration with age requirements of the vaccine; varied experiences with vaccinations for themselves and their children; the impact of media exposure on knowledge; and desire for more HPV infection and vaccine information. ORIGINALITY/VALUE Incarcerated women's awareness and limited experiences with HPV infection and vaccination may be a barrier to adequate screening and cervical cancer prevention. This study has implications for the development of cervical health education for this high-risk group of women, who are four to five times as likely to have cervical cancer as non-incarcerated women.
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Affiliation(s)
- Tyson Pankey
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
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Ramaswamy M, Simmons R, Kelly PJ. The development of a brief jail-based cervical health promotion intervention. Health Promot Pract 2015; 16:432-42. [PMID: 25063589 PMCID: PMC4306642 DOI: 10.1177/1524839914541658] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women's cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities.
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Affiliation(s)
- Megha Ramaswamy
- University of Kansas School of Medicine, Kansas City, KS, USA
| | - Rebekah Simmons
- University of Kansas School of Medicine, Kansas City, KS, USA
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Nijhawan AE, Salloway R, Nunn AS, Poshkus M, Clarke JG. Preventive healthcare for underserved women: results of a prison survey. J Womens Health (Larchmt) 2012; 19:17-22. [PMID: 20088654 DOI: 10.1089/jwh.2009.1469] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We sought to determine the preventive healthcare needs of incarcerated women in the following areas: cervical cancer and breast cancer screening, sexually transmitted infection (STI) screening, hepatitis screening and vaccination, and smoking cessation. METHODS A cross-sectional interview survey of a random sample of 100 incarcerated women at the Rhode Island Department of Corrections (RIDOC) in Cranston, Rhode Island, was conducted. RESULTS Participants were 62% white, 11% African American, 13% Hispanic, and 14% of mixed race. Mean age was 35 years. Of those surveyed, 67% reported having had a Papanicolou (Pap) smear in the past year, the strongest predictor of which was having received a Pap smear while incarcerated. Of the inmates >40 years old, 58% reported having had a mammogram in the past 2 years. The majority (88%) reported testing for STIs in the past, and 39% desired testing during their current incarceration. As for hepatitis C, 70% had been tested previously and 37% of those reported testing positive. Hispanics were less likely than whites to have been tested for hepatitis C (OR 0.1). Over half (54%) of the women who reported testing positive for hepatitis C also reported having completed the hepatitis A and B vaccine series. Among smokers (80% of all survey participants), 61% were interested in quitting. Those who had been incarcerated multiple times were less likely to want to quit smoking (OR 0.1). CONCLUSIONS Incarceration presents a unique opportunity to provide preventive healthcare to high-risk, medically underserved women.
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Affiliation(s)
- Ank E Nijhawan
- Miriam Hospital, Albert Medical School of Brown University, Providence, Rhode Island 02906, USA.
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Ramaswamy M, Kelly PJ, Koblitz A, Kimminau KS, Engelman KK. Understanding the Role of Violence in Incarcerated Women's Cervical Cancer Screening and History. Women Health 2011; 51:423-41. [DOI: 10.1080/03630242.2011.590875] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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