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Sawitree Visanuyothin MD, MPH,

Factors Associated with Cervical Cancer Screening Adherence in Urban Area of Nakhon Ratchasima Province. Sawitree Visanuyothin MD, MPH, AIHD Institute for Health Development, Mahidol University, Thailand SMD Maharat Nakhon Ratchasima Hospital. Outline. Background and Rationale

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Sawitree Visanuyothin MD, MPH,

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  1. Factors Associated with Cervical Cancer Screening Adherence in Urban Area of NakhonRatchasima Province SawitreeVisanuyothin MD, MPH, AIHD Institute for Health Development, Mahidol University, Thailand SMD MaharatNakhonRatchasima Hospital

  2. Outline • Background and Rationale • Research Question and Objective • Conceptual Framework • Research Methodology • Preliminary Result • Discussion and Conclusion

  3. Background and Rationale • Early screening and early treatment are crucial to prevent and reduce the patient number of invasive stage.

  4. Background and Rationale • CUP Huetalae’s cervical cancer screening rate was reducing from 2007 to 2009.(10-40%) • Screening cervical cancer coverage of CUP Huetalae <Nakhon Ratchasima Provincial level but cervical cancer incidence rate (20-60/100,000) tended to be>national level. • Study in field of Thailand ; HPV vaccination was lesser efficiency than cervical cancer screening • The most of reviewed-studies: incomplete comprehensive factors • Urbanization widely spread but a few studies in urban area.

  5. Research questions Research Objectives • What factors associate with cervical cancer screening adherence? • To determine factors associated with cervical cancer screening adherence.

  6. Conceptual framework Independent variables Modifying factorAge, Marital status, Number of children, Education, Career, Income, Health insurance, BMI, Smoking history, Pill history, Family cervical cancer history Dependent variable • Perceived Susceptibility Perceived Severity • Perceived Benefit • Perceived Barrier • to Cervical Cancer • Cues to Action to have a Pap test Cervical Cancer Screening Status (Maintainer, Non-maintainer) Knowledge Self-Efficacy

  7. Research Methodology • Study design: a cross-sectional was conducted to collect data during July-September 2012. • Sample: Stratified random sampling; registered-women aged 30-60 years and lived in the catchment area. 702 (307) self-administered questionnaires were obtained from the respondents via trained research assistance. • Research instrument: A self-administered questionnaire Part I: socio-demographic and socio-economic questions Part II perceived threat,benefits and barriers and cues to actions (Cronbach’s Alpha = 0.948) Part III:knowledge questions (KR-20= 0.768) Part IV:self efficacy (Cronbach’s Alpha = 0.871) • Data management and analysis: Chi-square test and multiple logistic regression were used for data analysis.

  8. Location of Each PCU in CUP Huetalae in Muang District, NakornRatchasima Province, Thailand Thailand Joho PCU Muang District Nakorn Ratchasima Nakorn Ratchasima Family Practice Clinic PCU Red Cross 4 PCU Salawan Temple PCU Huetalae PCU Total Population 68,662 No. Women 30-60 years14187

  9. Stratified sampling with proportional to the size of the sites Sampling technique Target Population Women aged 30-60 yrs in urban area of NakhonRatchasimawhoregistered on CUP Huetalae (5 PCUs) Inclusion & Exclusion Criteria Salawan Temple 183 women Huetalae 154 women Family Practice Clinic 147 women Joho 156 women Red Cross 4 62 women Sample of 702 women aged 30-60 yrs

  10. Preliminary Results • 68.4 % of women 307 who returned the complete questionnaire were adherence on cervical cancer screening. • Cervical cancer screening maintainer was significantly associated with age group, married status, number of children, sexual activity, number of partner, pill taking, perceive barrier, and cervical cancer knowledge level. • Perceive barrier was the strongest predictors of cervical cancer screening adherence. (adjusted odds ratio=3.01: 95% CI:1.50-6.31)).

  11. Discussion and Conclusion • The percentage of women who were adherence on cervical cancer screening was much more higher than the annual report so the reporting system need to be improved among health care units, particularly in urban areas. • On the other hand, intention to screen does not assure that women will screen. Thus an increasing effective intervention should be focused on decrease barrier of cervical cancer screening and raise cervical cancer knowledge among woman in urban area of Thailand.

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