A Longitudinal Analysis of Patient-Level Factors Associated with Pap Test Uptake Among Chinese American Women.

The purpose of this study was to longitudinally examine patient-level factors associated with Pap test uptake among middle-aged Chinese American women. The study analyzed data from 498 Chinese American women (1326 person-time-waves) who participated in the Study of Women's Health Across the Nation (SWAN) Series. Generalized estimating equation (GEE) was used to longitudinally examine patient-level factors associated with Pap test uptake over the 7-year period. Of the 1326 person-time-waves, 61% had a Pap test and 39% did not. Higher amounts of time spent by female healthcare providers for female health needs (eb = 3.35, p < 0.01), having a female healthcare provider for female health needs (eb = 3.36, p < 0.01),, and a history of cancer (eb = 6.05, p < 0.01) or fibroids (eb = 1.66, p < 0.01) were positively associated with Pap test uptake among Chinese American women, whereas not having a primary care provider (eb = 0.27, p < 0.05) and not having time to go to the doctor (eb = 0.31, p < 0.05) were negatively associated with Pap test uptake. Health education and health promotion messaging that accentuates the benefits of access to primary care providers and allocation of time to attend to health needs may bolster Chinese American women's acceptability and uptake of routine Pap testing for cervical cancer prevention. If health education and health promotion efforts are not developed, suboptimal rates of Pap testing will widen the disparity gap and contribute to Chinese American women's increased risk of cervical cancer morbidity and mortality in the coming years.