Although Southeast Asian women are at exceedingly high risk for cervical cancer, low rates of the Pap testing necessary for early detection and successful treatment continue among this group. Previous research suggests that discussions about Pap testing with important people in a woman's life, particularly her doctor, may increase the likelihood of screening; therefore increasing women's discussions about cancer screenings is an important step toward behavior change. The purpose of this study was to determine the effectiveness of a culturally sensitive, seven-minute video intervention in reducing barriers to discussions about Pap tests among Thai women. This unique video presented Thai actors, speaking in Thai, in a soap opera format. Participants completed a self-report questionnaire at baseline, immediately after the intervention and at 3-month follow-up. The comparison group received an educational pamphlet. Although the results indicated that both groups experienced reductions in barriers to communicating with others about Pap tests, the intervention group had significantly stronger outcomes than the comparison group for communicating about Pap tests in general as well as to doctors. These findings suggest that intermediate communication effects such as self-efficacy, collective efficacy and perhaps interpersonal communication may reduce barriers to discussion and positive decision making regarding Pap tests.

Background

Electronic media have demonstrated efficacy in increasing knowledge and promoting health-protective behavior among individuals at high risk for chronic disease. In "Stimulating Cancer Screening among Women of Color through Video" (A. K. Yancey and L. Walden, 1994, J Cancer Educ 9:46-52) the development of a cost-effective documentary format for culturally sensitive health education videos was described. These videos could not be independently evaluated within the cancer control program for which they were developed.

Methods

A quasi-experimental study design tested the hypothesis that exposure to these videos increases cervical cancer screening behavior among samples of women from two clinic populations of predominantly low-income African-Americans and Latinos in New York City and Los Angeles. A 1-week-on-1-week-off design was utilized, in which the videos were continuously displayed in designated waiting rooms during on (intervention) weeks, with each facility serving as its own control during off weeks.

Results

The proportion of women seen as patients during the intervention weeks who subsequently obtained Pap smears was significantly higher than that of those seen during the control weeks at each site (P < 0.05).

Conclusions

Culturally sensitive videos displayed in waiting rooms may be useful in health promotion efforts in communities of color. The similarity of results in both clinic sites suggests that Spanish-language tapes may be constructed to appeal to Latinos of different nationalities.