ASPO Abstracts

Pap test completion among black women by nativity status, National Health Interview Survey 2013-2015

Authors: Leslie Cofie and Deeonna Farr

Category: Cancer Health Disparities
Conference Year: 2020

Abstract Body:
Background Provider recommendation has been associated with increased rates of cancer screening. However, little is known as to whether provider recommendation for Pap test varies by nativity and how that impact Pap test completion among black women. This study examined the association between nativity, Pap test recommendation and adherence in a US-based sample of black women. Method Responses from National Health Interview Survey (2010, 2013 and 2015) were restricted to black women aged 21-65 years for this study (N=4,935). Differences in sociodemographic, health access and acculturation factors between foreign and US-born women were examined using chi-square analysis and t-test statistics. Multivariate binary logistic regression analysis was used to examine the relationship between nativity, Pap test recommendation, and adherence, controlling for health access, acculturation and sociodemographic factors. Results There was a significant difference in screening recommendation (64.76% vs. 58.29%, p<.05). Women who received provider screening recommendation (AOR: 3.524, CI: 2.765- 4.492), had insurance (AOR: 2.463, CI: 1.827 3.321) and a usual source of care (AOR: 2.001, CI: 1.398 2.866) were significantly more likely to report Pap screening adherence. In stratified analysis, these factors remained significantly associated with screening adherence among US-born blacks. However, provider recommendation (AOR: 7.637, CI: 3.237- 18.016), having a usual source of care (AOR: 2.584, CI: 1.089-6.130) and longer years of US residence were associated with screening adherence among foreign-born black women. There were no significant differences in Pap test completion rates between foreign-born US- born women despite the variation in factors associated with adherence for both groups. Conclusion Influences on Pap test completion varied by nativity status. Even though foreign-born black women were less likely to report receiving a recommendation for a Pap test provider, they completed screening at the same rates of US-born black women. More work is needed to understand what factors facilitate Pap test screening among foreign-born women.

Keywords: Foreign-born blacks, Cervical cancer screening adherence, Provider recommendation