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S. Jean Emans - One of the best experts on this subject based on the ideXlab platform.
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Intention to Return for Papanicolaou Smears in Adolescent Girls and Young Women
Pediatrics, 2001Co-Authors: Jessica A. Kahn, Bin Huang, Elizabeth Goodman, Gail B. Slap, S. Jean EmansAbstract:Objective. Sexually active adolescent girls have high rates of abnormal cervical cytology. However, little is known about factors that influence intention to return for Papanicolaou Screening or follow-up. The aim of this study was to determine whether a theory-based model that assessed knowledge, attitudes, 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 recruited from a hospital-based adolescent clinic that provides primary and subspecialty care, and the study sample consisted of all sexually active girls and young women who were aged 12 to 24 years and had had previous Papanicolaou smears. The main outcome measure was intention to return for Papanicolaou 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 intended to return. Variables that were independently associated with intention to return included positive beliefs about follow-up (odds ratio [OR]: 1.07; 95% confidence interval [CI]: 1.02–1.11), perception that important others believe that the participant should obtain a Papanicolaou smear (OR: 1.93; 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 return for Papanicolaou smear Screening and follow-up in this population of young women. However, modifiable attitudinal components, including personal beliefs, perception of others9 beliefs, and cues to obtaining Papanicolaou smears, were associated with intention to return.
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Validity of Adolescent and Young Adult Self-Report of Papanicolaou Smear Results
Obstetrics and gynecology, 2000Co-Authors: Jessica A. Kahn, Elizabeth Goodman, Rebekah A Kaplowitz, Gail B. Slap, S. Jean EmansAbstract:Abstract Objective: To assess the validity of adolescent and young adult report of Papanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting. Methods: We conducted a cross-sectional study of 477 female subjects aged 12 to 24 years who attended an adolescent clinic and had a previous Papanicolaou smear. Subjects completed a self-administered survey assessing self-report of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou Screening and follow-up, and risk behaviors. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported results were calculated using the cytology report as the standard. Variables significantly associated with incorrect reporting were entered into logistic regression models controlling for age and race to determine independent predictors for incorrect reporting. Results: Of the 477 participants, 128 (27%) had abnormal cytology reports and 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79, specificity 0.89, positive predictive value 0.72, negative predictive value 0.92, and kappa (κ) 0.66. The adjusted odds ratios (OR) and 95% confidence intervals (CI) of the variables comprising a logistic regression model predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, CI 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0). Conclusion: The validity of adolescent and young adult self-reported Papanicolaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception inconsistently.
Jessica A. Kahn - One of the best experts on this subject based on the ideXlab platform.
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Mothers' intention for their daughters and themselves to receive the human papillomavirus vaccine: a national study of nurses.
Pediatrics, 2009Co-Authors: Jessica A. Kahn, Susan L. Rosenthal, Lili Ding, Bin Huang, Gregory D. Zimet, A. Lindsay FrazierAbstract:OBJECTIVES. The aims of this study were to examine mothers' intention to vaccinate their daughters and themselves against human papillomavirus and to determine which demographic, behavioral, and attitudinal factors were associated with intention to vaccinate daughters. METHODS. We surveyed 10 521 US mothers, all nurses, between June 2006 and February 2007. Multivariable logistic regression models were used to determine which of the following factors were associated with a mother's intention to vaccinate a 9-to 12-year-old daughter: demographic factors, gynecologic history, belief that one's daughter should have regular Papanicolaou testing, beliefs about Papanicolaou testing outcomes (3-item scale), and beliefs about human papillomavirus vaccines (7-item scale measuring beliefs about human papillomavirus vaccine efficacy, impact of vaccination on sexual and Papanicolaou Screening behaviors, severity of and susceptibility to human papillomavirus, and anticipated clinician recommendations). RESULTS. Of the 8832 mothers who completed a survey (84% response rate), 7207 had a daughter. Among mothers with a daughter, 48% intended to vaccinate a daughter if she were 9 to 12 years of age, 68% if she were 13 to 15 years of age, and 86% if she were 16 to 18 years of age. Forty-eight percent intended to receive the vaccine themselves if recommended. In multivariable regression models, variables significantly associated with intention to vaccinate a 9- to 12-year-old daughter included belief that one's daughter should have regular Papanicolaou testing and beliefs about human papillomavirus vaccines. CONCLUSIONS. In this first national study of mothers' attitudes about human papillomavirus vaccines, mothers' intention to vaccinate a daughter
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Intention to Return for Papanicolaou Smears in Adolescent Girls and Young Women
Pediatrics, 2001Co-Authors: Jessica A. Kahn, Bin Huang, Elizabeth Goodman, Gail B. Slap, S. Jean EmansAbstract:Objective. Sexually active adolescent girls have high rates of abnormal cervical cytology. However, little is known about factors that influence intention to return for Papanicolaou Screening or follow-up. The aim of this study was to determine whether a theory-based model that assessed knowledge, attitudes, 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 recruited from a hospital-based adolescent clinic that provides primary and subspecialty care, and the study sample consisted of all sexually active girls and young women who were aged 12 to 24 years and had had previous Papanicolaou smears. The main outcome measure was intention to return for Papanicolaou 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 intended to return. Variables that were independently associated with intention to return included positive beliefs about follow-up (odds ratio [OR]: 1.07; 95% confidence interval [CI]: 1.02–1.11), perception that important others believe that the participant should obtain a Papanicolaou smear (OR: 1.93; 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 return for Papanicolaou smear Screening and follow-up in this population of young women. However, modifiable attitudinal components, including personal beliefs, perception of others9 beliefs, and cues to obtaining Papanicolaou smears, were associated with intention to return.
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Validity of Adolescent and Young Adult Self-Report of Papanicolaou Smear Results
Obstetrics and gynecology, 2000Co-Authors: Jessica A. Kahn, Elizabeth Goodman, Rebekah A Kaplowitz, Gail B. Slap, S. Jean EmansAbstract:Abstract Objective: To assess the validity of adolescent and young adult report of Papanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting. Methods: We conducted a cross-sectional study of 477 female subjects aged 12 to 24 years who attended an adolescent clinic and had a previous Papanicolaou smear. Subjects completed a self-administered survey assessing self-report of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou Screening and follow-up, and risk behaviors. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported results were calculated using the cytology report as the standard. Variables significantly associated with incorrect reporting were entered into logistic regression models controlling for age and race to determine independent predictors for incorrect reporting. Results: Of the 477 participants, 128 (27%) had abnormal cytology reports and 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79, specificity 0.89, positive predictive value 0.72, negative predictive value 0.92, and kappa (κ) 0.66. The adjusted odds ratios (OR) and 95% confidence intervals (CI) of the variables comprising a logistic regression model predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, CI 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0). Conclusion: The validity of adolescent and young adult self-reported Papanicolaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception inconsistently.
Eduardo L. Franco - One of the best experts on this subject based on the ideXlab platform.
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Human papillomavirus DNA versus Papanicolaou Screening tests for cervical cancer.
The New England journal of medicine, 2007Co-Authors: Marie-hélène Mayrand, Eliane Duarte-franco, Isabel Rodrigues, Stephen D. Walter, James A. Hanley, Alex Ferenczy, Samuel Ratnam, François Coutlée, Eduardo L. FrancoAbstract:Background To determine whether testing for DNA of oncogenic human papillomaviruses (HPV) is superior to the Papanicolaou (Pap) test for cervical-cancer Screening, we conducted a randomized trial comparing the two methods. Methods We compared HPV testing, using an assay approved by the Food and Drug Administration, with conventional Pap testing as a Screening method to identify high-grade cervical intraepithelial neoplasia in women ages 30 to 69 years in Montreal and St. John's, Canada. Women with abnormal Pap test results or a positive HPV test (at least 1 pg of high-risk HPV DNA per milliliter) underwent colposcopy and biopsy, as did a random sample of women with negative tests. Sensitivity and specificity estimates were corrected for verification bias. Results A total of 10,154 women were randomly assigned to testing. Both tests were performed on all women in a randomly assigned sequence at the same session. The sensitivity of HPV testing for cervical intraepithelial neoplasia of grade 2 or 3 was 94.6%...
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Assessing gains in diagnostic utility when human papillomavirus testing is used as an adjunct to Papanicolaou smear in the triage of women with cervical cytologic abnormalities.
American journal of obstetrics and gynecology, 1999Co-Authors: Eduardo L. Franco, Alex FerenczyAbstract:Abstract Objective: We aimed to provide simple methods for calculating expected sensitivity and specificity when an adjunctive test is added to a conventional test. Study Design: Use of adjunctive methods for the triage of women with cervical abnormalities produces an apparent gain in sensitivity over Papanicolaou cytologic testing alone. This increase in sensitivity can be misleading, even if deemed significant by results of a statistical test. Combined testing prevents a loss in specificity but sometimes offers no real gain in sensitivity. A nominal increase in sensitivity always occurs by chance whenever an adjunctive test is used in parallel with a conventional one, even if the new test is totally random with respect to the disease being evaluated. Results: Gains in sensitivity and losses in specificity have to be gauged against expected levels of these parameters when a random adjunctive test is coupled with Papanicolaou Screening and not gauged against the performance of cytologic testing alone. Conclusion: We provide simple formulas for calculating the expected sensitivity and specificity in conditions of combination testing to provide more realistic baselines for assessment of the Screening efficacy contributed by the adjunctive test. (Am J Obstet Gynecol 1999;181:382-6.)
Barbara R. Gottlieb - One of the best experts on this subject based on the ideXlab platform.
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Sexual Orientation Disparities in Papanicolaou Test Use Among US Women: The Role of Sexual and Reproductive Health Services
American Journal of Public Health, 2014Co-Authors: Madina Agénor, Nancy Krieger, Sebastien Haneuse, S. Bryn Austin, Barbara R. GottliebAbstract:We investigated sexual orientation disparities in Papanicolaou Screening among US women aged 21 to 44 years (n = 9581) in the 2006 to 2010 National Survey of Family Growth. The odds ratios for lesbian versus heterosexual women and women with no versus only male sexual partners were 0.40 and 0.32, respectively, and were attenuated after adjustment for sexual and reproductive health (SRH) care indicators. Administering Papanicolaou tests through mechanisms other than SRH services would promote cervical cancer Screening among all women.
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SexualOrientation DisparitiesinPapanicolaou TestUseAmongUS SexualandReproductive HealthServices
2014Co-Authors: Madina Agénor, Nancy Krieger, Sebastien Haneuse, S. Bryn Austin, Barbara R. GottliebAbstract:We investigated sexual orientation disparities in Papanicolaou Screening among US women aged 21to44years(n=9581)inthe2006 to 2010 National Survey of Family Growth. The odds ratios for lesbian versus heterosexual women and women with no versus only male sexual partners were 0.40 and 0.32, respectively, and were attenuated after adjustment for sexual and reproductive health (SRH) care indicators. Administering Papanicolaou tests through mechanisms other than SRH services would promote cervical cancer Screening among all women. (Am J Public Health. 2014; 104:e68–e73. doi:10.2105/AJPH.2013. 301548)
Elizabeth Goodman - One of the best experts on this subject based on the ideXlab platform.
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Intention to Return for Papanicolaou Smears in Adolescent Girls and Young Women
Pediatrics, 2001Co-Authors: Jessica A. Kahn, Bin Huang, Elizabeth Goodman, Gail B. Slap, S. Jean EmansAbstract:Objective. Sexually active adolescent girls have high rates of abnormal cervical cytology. However, little is known about factors that influence intention to return for Papanicolaou Screening or follow-up. The aim of this study was to determine whether a theory-based model that assessed knowledge, attitudes, 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 recruited from a hospital-based adolescent clinic that provides primary and subspecialty care, and the study sample consisted of all sexually active girls and young women who were aged 12 to 24 years and had had previous Papanicolaou smears. The main outcome measure was intention to return for Papanicolaou 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 intended to return. Variables that were independently associated with intention to return included positive beliefs about follow-up (odds ratio [OR]: 1.07; 95% confidence interval [CI]: 1.02–1.11), perception that important others believe that the participant should obtain a Papanicolaou smear (OR: 1.93; 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 return for Papanicolaou smear Screening and follow-up in this population of young women. However, modifiable attitudinal components, including personal beliefs, perception of others9 beliefs, and cues to obtaining Papanicolaou smears, were associated with intention to return.
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Validity of Adolescent and Young Adult Self-Report of Papanicolaou Smear Results
Obstetrics and gynecology, 2000Co-Authors: Jessica A. Kahn, Elizabeth Goodman, Rebekah A Kaplowitz, Gail B. Slap, S. Jean EmansAbstract:Abstract Objective: To assess the validity of adolescent and young adult report of Papanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting. Methods: We conducted a cross-sectional study of 477 female subjects aged 12 to 24 years who attended an adolescent clinic and had a previous Papanicolaou smear. Subjects completed a self-administered survey assessing self-report of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou Screening and follow-up, and risk behaviors. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported results were calculated using the cytology report as the standard. Variables significantly associated with incorrect reporting were entered into logistic regression models controlling for age and race to determine independent predictors for incorrect reporting. Results: Of the 477 participants, 128 (27%) had abnormal cytology reports and 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79, specificity 0.89, positive predictive value 0.72, negative predictive value 0.92, and kappa (κ) 0.66. The adjusted odds ratios (OR) and 95% confidence intervals (CI) of the variables comprising a logistic regression model predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, CI 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0). Conclusion: The validity of adolescent and young adult self-reported Papanicolaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception inconsistently.
