Health education to increase screening for cervical cancer among Lumbee Indian Women in North Carolina

Although age-adjusted mortality rates from cancer among Native-Americans ar e generally lower than for the US population as a whole, cervical cancer mo rtality rates are higher, This report presents results from a National Canc er Institute-funded health education program conducted among the Lumbee tri be in North Carolina that was designed to increase the proportion of women, age 18 and older, who receive Pap smears to screen for cervical cancer, Th e Solomon Four Group research design was used for this project. Participant s were selected at random from the enrollment records of the Lumbee tribe a nd data collection was carried out during face-to-face interviews. The heal th education program was provided one-on-one in women's homes by a trained lay health educator and included verbal, print and videotape information, A total of 979 women were enrolled in the study, and 125 were lost to follow -up between the pre-test and post-test. Women who received the education pr ogram were found to be more likely to have knowledge of the Pap smear and t o report a Pap smear in the past year at the post-test than those in the co ntrol group, regardless of whether they received the pre-test interview, P < 0.05. Women most likely to respond to the education program were also lik ely to have reported that they receive an annual physical examination, Wome n with better knowledge of the Pap smear tended to have more education, hig her income and greater identification with Native-American culture than tho se with less knowledge. We conclude that the health education program was a ssociated with greater knowledge about cervical cancer prevention and highe r proportions of Lumbee women obtaining Pap smears in the past year.