Center for Population Health & Health Disparities

PILOT 1

Using the Self-Regulation Model to Understand Cervical Cancer Screening in Appalachia

Investigator Kimberly Kelly, Ph.D

Rural Appalachian women have a higher mortality from cervical cancer than the U.S. population, and studies are needed to understand this disparity. The Self-Regulation Model (SRM) is a useful framework for conceptualizing lay understandings of disease and health behavior, but it has not been used in the context of cervical cancer and cervical cancer screening. Further, the 3 generation pedigree (3GP) to record family history information is another useful framework to understand disease, but it has not been used in a research capacity to understand familial patterns of screening. To address these needs, t he aims of the current study are guided by the SRM and compare those within cervical cancer screening guidelines vs. those not within guidelines in terms of self-system factors, cognitive and affective representations , health behaviors , and appraisal of the effectiveness of health behaviors. Fifty-two Appalachian women within cervical cancer screening guidelines and 52 Appalachian women not within guidelines will receive a brief questionnaire, provide a 3GP, and receive an audio-recorded structured interview that will address key variables from the SRM (e.g., self-system factors, cognitive and affective representations of cervical cancer and cervical cancer screening, current screening practices, and appraisal). Further, an intervention will be conducted with 10 Appalachian women, which is similar in nature to a genetic counseling session and consistent with prior work with the SRM, addressing specific issues noted in the brief assessment and in the 3GP, in an effort to:

reframe and restructure individual's Common Sense understandings of cervical cancer, and
increase the salience of familial patterns of disease and health behaviors.

This study will serve as preliminary data for studies to increase cancer screening in Appalachian women.