Intention to return for Papanicolaou smears in adolescent girls and young women

Objective. Sexually active adolescent girls have high rates of abnormal cer vical cytology. However, little is known about factors that influence inten tion to return for Papanicolaou screening or follow-up. The aim of this stu dy was to determine whether a theory-based model that assessed knowledge, a ttitudes, and behaviors predicted intention to return. Methods. The study design consisted of a self-administered, cross-sectional survey that assessed knowledge, beliefs, perceived control over follow-up, perceived risk, cues for Papanicolaou smears, impulsivity, risk behaviors, and past compliance with Papanicolaou smear follow-up. Participants were r ecruited from a hospital-based adolescent clinic that provides primary and subspecialty care, and the study sample consisted of all sexually active gi rls and young women who were aged 12 to 24 years and had had previous Papan icolaou smears. The main outcome measure was intention to return for Papani colaou smear screening or follow-up. Results. The enrollment rate was 92% (N = 490), mean age was 18.2 years, 50 % were black, and 22% were Hispanic. Eighty-two percent of participants int ended to return. Variables that were independently associated with intentio n to return included positive beliefs about follow-up (odds ratio [OR]: 1.0 7; 95% confidence interval [CI]: 1.02-1.11), perception that important othe rs believe that the participant should obtain a Papanicolaou smear (OR: 1.9 3; 95% CI: 1.38-2.74), perceived control over returning (OR: 1.24; 95% CI: 1.06-1.46), and having received cues to obtain a Papanicolaou smear (OR: 1. 31; 95% CI: 1.08-1.60). Conclusions. Analysis of this novel theoretical framework demonstrated that knowledge and previous behaviors were not associated with intention to ret urn for Papanicolaou smear screening and follow-up in this population of yo ung women. However, modifiable attitudinal components, including personal b eliefs, perception of others' beliefs, and cues to obtaining Papanicolaou s mears, were associated with intention to return.