A salon-based cervical cancer education project
Sealy, Diadrey-Anne Tiffy
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Cervical cancer is a major public health problem in the developing world, including Latin America and the Caribbean. Most countries in this region lack organized programs of screening for cervical cancer, despite the proven survival benefits associated with the Pap test. The purposes of this mixed-methods study are to explore the barriers that prevent women in Tobago from obtaining Pap smears and implement and evaluate an intervention designed to affect knowledge, attitude, and Pap smear receipt. Two focus groups (N= 6 and 7) were conducted using a semi-structured interview guide. The proceedings were audio-taped, transcribed verbatim, and coded to generate themes using the constant comparative approach. The main barriers identified by all participants were availability and accessibility of quality services, facilities that lack comfort and privacy, courtesy of providers, knowledge, gender of providers, cancer fatalism, and embarrassment. Phase Two of the four-month pilot study recruited and trained eight hairstylists from seven beauty salons, to deliver cervical cancer messages to women in Tobago. Stylists attended a 5-hr training session to develop skills for delivering messages designed to increase knowledge and Pap test receipt. The intervention consisted of hairstylists delivering the health chat to their clients, in addition to the placement of pamphlets in the salons. Participants (N= 133) completed a questionnaire at the start of the intervention and a telephone follow-up four months later. At baseline, 27% of eligible women had never had a Pap test, while only 37% had obtained one in the last year. Pap test receipt increased at the end of the intervention. Twenty-six women in the intervention reported that their hairstylists had spoken to them about cervical cancer and Pap smear receipt. Knowledge of the human papillomavirus as the cause of cervical cancer did not increase post-intervention. This pilot study suggests that there is a continuing need for intervention programs that will raise awareness and increase cervical cancer knowledge and behavior in communities. This study further suggests that hairstylists are willing to use their skills to educate and encourage their customers to engage in informed decision-making. Physicians should also be targeted to increase recommendations from providers for cervical cancer screening.