Facilitating Follow-Up Adherence for Abnormal Pap Smears

Objective: Previous studies have suggested that psycho-educational interventions delivered by telephone improve adherence to initial colposcopy after an abnormal Pap smear. To further explore strategies for enhanced follow-up to medical care recommendations, we studied the impact of a theory-guided cognitive-affective barriers counseling intervention, delivered at 2-4 weeks before the colposcopy appointment, for inner city women. The comprehensive telephone barriers intervention was compared to an enhanced comparison group and a group that received tailored print materials. Methods: Participants (N = 211) were recruited through a colposcopy clinic and randomly assigned to: 1) telephone assessment of barriers to follow up adherence recommendations combined with tailored telephone barriers counseling; 2) telephone assessment combined with tailored barriers print brochure; or 3) telephone assessment with no barriers counseling. Participants were assessed at baseline, 1-week, 9 and 15 months post-colposcopy.

Sex

Female

Minimum age

18 Years

Inclusion Criteria:

* women 18 years old or older
* have recently received an abnormal Pap smear indicative of oncogenic HPV
* have been referred for initial colposcopic evaluation at the Women's Care Center at Temple University Hospital
* able to communicate with ease in English

Exclusion Criteria:

* unable to communicate readily in English
* do not have access to a telephone
* have a history of any malignancy
* display current evidence of positive invasive carcinoma of the cervix
* display presence of another life-threatening medical condition
* show evidence of dementia
* prior participation in research study
* HIV