The Effect of Education on Knowledge and Attitudes about Cervical Cancer Screening Among Women Living in Shelters and Residential Centers

Melissa Goldsmith
The American Cancer Society estimated that in the United States for the year 2000, 12,800 new cases of invasive cervical cancer would be diagnosed and 4,600 women would die from this disease. Little information is available regarding rates of cervical cancer among homeless women. However, low socioeconomic status is associated with higher death rates attributed to cervical cancer likely due to diminished access to regular cervical cancer screening. Additionally, homeless women may engage in behaviors such as cigarette smoking and having multiple sex partners that place them at risk for this disease. Few studies have addressed outcomes of health education for sheltered homeless women.

The purpose of this study was to determine if a cervical cancer prevention education program increased sheltered homeless women’s knowledge of cervical cancer risk factors and screening practices. Additionally, this study investigated the effect of the education program on women’s intent to seek cervical cancer screening and attitudes related to regular pelvic exams and Pap smears.

A non-experimental, pretest, posttest design was used. A one hour health education program titled “Preventing Female Cancer Below the Belt: The Pelvic Exam” was presented at six homeless/residential centers for women in a city in the Southwestern United States. The convenience sample consisted of 58 women who completed a pre and posttest that measured their knowledge about cervical cancer and associated risk factors, knowledge about pelvic exams and Pap tests, attitudes regarding pelvic exams, and actual and intended practices related to regular pelvic exams.

Women’s total knowledge scores were significantly higher on the posttest that was administered immediately following the health education program as compared to women’s total knowledge scores on the pretest. Scores on an item which measured the women’s attitude toward regular pelvic exams were significantly higher on the posttest as compared to the pretest. Forty-one percent of women reported that they recently had a pelvic exam or had one scheduled. Results of the posttest indicated more women (44.9%) reported that they planned on having a pelvic exam in the next month compared to the pretest (23.3%).
Results suggest that providing sheltered homeless women with a brief educational intervention increased their knowledge of cervical cancer and cervical cancer screening. Additionally, this educational program influenced women’s attitudes towards pelvic exams and cervical cancer screening as well as their intent to seek these services.

This research was supported by the Community Partnership Research Grant from the College of Nursing, The University of Arizona.