OBJECTIVE: To address socio-demographic factors associated with adherence to follow-up recommendations in a high-risk population of women referred for follow-up care after an abnormal Pap test. METHODS: 486 women aged 46-64 served by BCCEDP in two southeastern states between 1999-2002 and referred for follow-up care after an abnormal Pap test were the sampling frame for this cross-sectional study; 204 women completed a phone-based interview in 2004. Cox proportional hazards modeling was used to determine the association of various risk factors with time to adherence. RESULTS: Among those completing the phone interview (interview rate=61.4%) the mean age was 53.3 years, 64.7% were African-American women, 81.9% had low-grade cervical lesions, and all were either uninsured or under insured. Over 95% received follow-up care for an abnormal Pap test within 365 days of referral. When the BCCEDP criteria of follow-up within 60 days were applied, 52.9% were adherent. Rates of self-reported and program documented adherence differed significantly by state. After adjusting for state of residence, women who reported having symptoms of a chronic disease were more likely to be adherent within 365 days (aHR=1.42; 95% CI=1.00, 2.04). Neither age, race, lesion severity, education, number of dependent adults or children, self-perceived physical health, nor smoking status was associated with time to adherence. CONCLUSIONS: Findings suggest that institutional factors may be more important than individual factors in predicting time to adherence for an abnormal Pap test.
OBJECTIVE: To address socio-demographic factors associated with adherence to follow-up recommendations in a high-risk population of women referred for follow-up care after an abnormal Pap test. METHODS: 486 women aged 46-64 served by BCCEDP in two southeastern states between 1999-2002 and referred for follow-up care after an abnormal Pap test were the sampling frame for this cross-sectional study; 204 women completed a phone-based interview in 2004. Cox proportional hazards modeling was used to determine the association of various risk factors with time to adherence. RESULTS: Among those completing the phone interview (interview rate=61.4%) the mean age was 53.3 years, 64.7% were African-American women, 81.9% had low-grade cervical lesions, and all were either uninsured or under insured. Over 95% received follow-up care for an abnormal Pap test within 365 days of referral. When the BCCEDP criteria of follow-up within 60 days were applied, 52.9% were adherent. Rates of self-reported and program documented adherence differed significantly by state. After adjusting for state of residence, women who reported having symptoms of a chronic disease were more likely to be adherent within 365 days (aHR=1.42; 95% CI=1.00, 2.04). Neither age, race, lesion severity, education, number of dependent adults or children, self-perceived physical health, nor smoking status was associated with time to adherence. CONCLUSIONS: Findings suggest that institutional factors may be more important than individual factors in predicting time to adherence for an abnormal Pap test.
Authors: L Stewart Massad; Kathleen M Weber; Tracey E Wilson; Johanna L Goderre; Nancy A Hessol; Donna Henry; Christine Colie; Howard D Strickler; Alexandra M Levine; D Heather Watts; Charlesnika T Evans Journal: J Low Genit Tract Dis Date: 2012-04 Impact factor: 1.925
Authors: Alison G Abraham; Gypsyamber D'Souza; Yuezhou Jing; Stephen J Gange; Timothy R Sterling; Michael J Silverberg; Michael S Saag; Sean B Rourke; Anita Rachlis; Sonia Napravnik; Richard D Moore; Marina B Klein; Mari M Kitahata; Gregory D Kirk; Robert S Hogg; Nancy A Hessol; James J Goedert; M John Gill; Kelly A Gebo; Joseph J Eron; Eric A Engels; Robert Dubrow; Heidi M Crane; John T Brooks; Ronald J Bosch; Howard D Strickler Journal: J Acquir Immune Defic Syndr Date: 2013-04-01 Impact factor: 3.731
Authors: Tracy A Battaglia; M Christina Santana; Sharon Bak; Manjusha Gokhale; Timothy L Lash; Arlene S Ash; Richard Kalish; Stephen Tringale; James O Taylor; Karen M Freund Journal: Cancer Date: 2010-02-15 Impact factor: 6.860