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Development of a text message-based intervention for follow-up colposcopy among predominately underserved Black and Hispanic/Latinx women

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Abstract

Purpose

Underserved Black and Hispanic/Latinx women show low rates of follow-up care after an abnormal Pap test, despite the fact that cervical cancer is one of the few preventable cancers if detected early. However, extant literature falls short on efficacious interventions to increase follow-up for this population. A concurrent mixed methods study was completed to evaluate the acceptability of a text message-based intervention and identify perceived barriers and facilitators to follow-up after an abnormal Pap test among underserved predominantly Black and Hispanic/Latinx women.

Methods

Patients who completed follow-up for an abnormal Pap test were recruited to complete a cross-sectional survey, qualitative interview assessing barriers and facilitators to follow-up, and text message content evaluation (N = 28). Descriptive statistics were performed to describe background variables and to evaluate the acceptability of text messages. A directed content analysis was completed for the qualitative interviews.

Results

Participants expressed interest in a text message-based intervention to increase abnormal Pap test follow-up. In the qualitative interviews, low knowledge about cervical risk and negative affect toward colposcopy/test results were identified as barriers to follow-up. Facilitators of follow-up included feeling relieved after the colposcopy and adequate social support. Participants rated the text messages as understandable, personally relevant, and culturally appropriate.

Conclusion

The findings suggest that underserved Black and Hispanic/Latinx women experience cognitive and emotional barriers that undermine their ability to obtain follow-up care and a text message-based intervention may help women overcome these barriers. Future research should develop and evaluate text message-based interventions to enhance follow-up after an abnormal Pap test.

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Data availability

Data are available from the corresponding author upon reasonable request.

Code availability

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Funding

The study was funded by the National Cancer Institute (R01CA104979, P30CA006927, P30CA072720, P30CA056036, and T32CA009035) and the National Center for Advancing Translational Sciences (UL1TR003017) at the National Institutes of Health.

Author information

Authors and Affiliations

  1. Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Ave, Philadelphia, PA, 19111, USA

    Maria Sansoni, Erin K. Tagai, Emmanuel Lapitan, Jenny Xu, Andrew Belfiglio & Suzanne M. Miller

  2. Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA

    Kuang-Yi Wen

  3. Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Shawna V. Hudson

  4. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Shawna V. Hudson & Racquel E. Kohler

  5. Rutgers School of Public Health, New Brunswick, NJ, USA

    Racquel E. Kohler

  6. Department of Obstetrics, Gynecology and Reproductive Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA

    Enrique Hernandez

Authors
  1. Maria Sansoni
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  2. Erin K. Tagai
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  3. Emmanuel Lapitan
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  4. Kuang-Yi Wen
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  5. Jenny Xu
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  6. Andrew Belfiglio
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  7. Shawna V. Hudson
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  8. Racquel E. Kohler
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  9. Enrique Hernandez
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  10. Suzanne M. Miller
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Corresponding author

Correspondence to Suzanne M. Miller.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Boards at Fox Chase Cancer Center and Temple University.

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All participants completed the informed consent process including review of the documents with study staff and signing the informed consent and HIPAA forms.

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Patients signed informed consent regarding publishing deidentified data.

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Sansoni, M., Tagai, E.K., Lapitan, E. et al. Development of a text message-based intervention for follow-up colposcopy among predominately underserved Black and Hispanic/Latinx women. Cancer Causes Control 33, 861–873 (2022). https://doi.org/10.1007/s10552-022-01573-y

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  • DOI: https://doi.org/10.1007/s10552-022-01573-y

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