Study Personnel

Principal Investigators: Jamie L. Studts, PhD, William Helm, MD, and Sandra Sephton, PhD

Study Coordinator: Christina R Studts

Graduate Students: N/A
 

Study Synopsis

Cervical cancer is the second most common cancer in women worldwide. It is preceded by a pre-cancerous phase, cervical intraepithelial neoplasia (CIN) or squamous intraepithelial lesions (SIL) which can be detected on Pap smears and effectively treated prior to the development of cancer. Despite the fact that treatment is nearly completely effective at eliminating risk of cervical cancer, improving adherence with medical recommendations for women who have received a positive Pap smear remains a significant health care issue.

This study of adherence following colposcopy relies heavily on constructs delineated in the Cognitive – Social Health Information Processing (C-SHIP) model of health-protective behavior. In particular, this study investigates the role of general distress, perceived cervical cancer risk, cervical cancer-specific distress, social support, optimism, perceived stress, and information coping style on adherence to medical recommendations following colposcopy. The present study is designed to describe rates of adherence to medical recommendations following colposcopy and to develop a broader understanding of the sociodemographic, psychological, and social factors related to adherence in women at risk for cervical cancer.

Participants for the study were recruited from the University of Louisville Colposcopy Clinic which serves low income women of all races with abnormal Pap smears, SIL/CIN, and cervical cancer. To be eligible for the study, women had to be undergoing colposcopy for the first time and not undergoing the procedure following a recent pregnancy or birth (within 12 months).

The design of the study is predominantly cross-sectional with the majority of data collection occurring during the participant’s visit to the University of Louisville Colposcopy Clinic. Following provision of informed consent, participants were asked to complete a questionnaire including measures of health status, prior behavior, psychological functioning, attitudes and beliefs about cervical cancer, as well as information about sociodemographic characteristics. Additionally, participants were asked to give permission to access their clinic medical record to obtain data regarding: (1) attendance at scheduled colposcopy clinic visits over the course of the following year; (2) results of colposcopy; and (3) additional data bearing on the results of the study. Participants also completed a follow-up questionnaire, which included nine items addressing participants’ experience with scheduling and attending colposcopy clinic appointments, as well as discomfort, pain, and anxiety experienced during and following colposcopy. The final question inquired about the participant’s level of satisfaction with the colposcopy experience.

To address the initial aim of the study, simple adherence rates based on clinic records will be calculated. To address the second aim of the study, the adherence classification will be used to conduct a series of Chi-square analyses as well as t-tests comparing adherent vs. nonadherent study participants on the various sociodemographic, behavioral/psychosocial, and cervical cancer-specific measures administered. Using adherence as the outcome variable, a hierarchical logistic regression analysis (HLRA) based on the C-SHIP model will be tested. The HLRA will examine the effect of sociodemographic factors as covariates on the initial step of the analysis and then assess the influence of C-SHIP model variables on the second step of the analysis.

The study has completed accrual following the enrollment of 111 participants.  Currently, analyses are being conducted and medical records are being reviewed for the appropriate follow-up information.
 

Publications

1. Studts, C. R., Sephton, S., Helm, C. W., & Studts, J. L. (2006). Perceived cervical cancer risk among women undergoing colposcopy. Poster presented at the 27th annual scientific sessions of the Society of Behavioral Medicine, San Francisco, CA.