FACTORS ASSOCIATED WITH PAP SMEAR TAKING IN GENERAL-PRACTICE - FOCUSING PUBLIC-HEALTH INITIATIVES

This study ascertained the relationships of patient, practitioner and consultation factors with: 1. taking a Pap smear or referral to a spec ialist in the consultation; and 2. an unsuccessful offer to take a Pap smear or making an appointment for a smear. In a cross-sectional stud y of 3478 women presenting to 230 randomly selected general practition ers in Brisbane and Toowoomba, information about most recent Pap smear , screening in the consultation, and independent variables were collec ted from patients and doctors. Relationships between three levels of o utcome variable (no action, Pap smear taken or referral, appointment o r refusal), and independent variables (practitioner variables, consult ation variables, patient variables) were modelled using polytomous log istic regression. Presenting for a routine checkup and breast cancer s creening were associated with ail types of action. Younger age, longer consultations and consultations with a female practitioner were assoc iated with Pap smear taking and referrals, and not appointments or ref usals. Being due for a Pap smear, having blood pressure measured, cons ulting a younger general practitioner and one who ascribed to current guidelines on screening were associated with an appointment or a refus al, when compared with no action. Results identify different profiles of those who get a Pap smear and those who do not, the former indicati ng a more proactive patient group, while the latter suggest more activ e general practitioners who attempted opportunistic screening of passi ve patients, or women who do not specifically seek Pap smears. We have identified factors that have-significance for developing public healt h programs focused on consumers and providers.