THE INFLUENCE OF FATALISM ON SELF-REPORTED USE OF PAPANICOLAOU SMEARS

Objective: Our objective was to examine the demographic and other pred ictors of fatalistic beliefs among Latinas (Hispanic women) and Anglo (non-Hispanic Caucasian) women and to assess the impact of these belie fs on the use of cervical cancer screening services. Methods: We used ethnographic interviews and a cross-sectional telephone survey in Oran ge County, California. Our sample included 94 Latinas and 27 Anglo wom en selected through organization-based network sampling for the ethnog raphic interviews and 803 Latinas and 422 Anglo women randomly selecte d for the telephone survey. Results: Latina immigrants (Latinas born o utside the United States) were more likely than U.S.-born Latinas or A nglo women to have fatalistic beliefs. Immigration, education levels, and insurance status predicted fatalistic beliefs. Fatalistic beliefs were independent predictors of Pap smear use by Latinas but not Anglo women. For example, after adjusting for potentially confounding variab les, Latinas who believed that fate was a risk factor for cervical can cer (odds ratio [OR] = .58), that they would rather not know if they h ad the disease (OR = .58), and that there is nothing one can do to pre vent it (OR = .45) were less likely than others to report that they ha ve had a Pap smear within the prior three years. Health insurance stat us, marital status, and immigration also predicted use of Pap smears. Insured Latinas were more likely than uninsured Latinas (OR = 2.89) to report having a Pap smear within the prior three years. In addition, married Latinas (OR = 2.32) and Angle women (OR = 3.09) were more like ly than unmarried women to report having appropriate cervical cancer s creening. Finally, Latina immigrants were less likely than other Latin as to report having a Pap smear (OR = .26). Conclusions: We conclude t hat fatalistic beliefs are among the factors that negatively influence Latinas' use of Pap smears and that it is important for health care p rofessionals to address those beliefs. Continued efforts are also nece ssary to decrease the economic and structural barriers to cervical can cer screening.