Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Tolulope Osoba

Abstract

Cervical cancer is a public health threat that can be eliminated with the use of preventative measures. Individuals who live in Texas’s nonmetro areas are more likely than individuals who live in metro areas of Texas to be diagnosed with cervical cancer. In this study, the individual- and county-level factors in metro and nonmetro areas that facilitate or inhibit the receipt of cervical cancer preventative measures at multiple levels of influence were examined. The ecological model was used as the theoretical framework. Using secondary data from a national population health survey (n=1,303), the goal of this cross-sectional, quantitative study was to understand multilevel factors associated with cervical cancer preventative measures. The results of this study indicate that there is enough evidence to suggest an association between nonmetro status and cervical cancer preventative measures. Multinominal logistics regression analysis showed significant associations with individual-level factors but not with county-level factors for cervical cancer preventative measures. Specifically, the results indicate that individual-level factors (i.e., residing in a metro area, an individual’s sexual identity, and household income) were associated with initiating the human papillomavirus (HPV) vaccine. Results also indicate that an individual’s sexual identity, level of education, and health care coverage were associated with being current on pap testing. These findings will help practitioners understand the factors that need to be addressed to increase HPV vaccination and pap testing for individuals. Using the findings, practitioners will be able to develop individual-level interventions to increase cervical cancer preventative measures leading to positive social change.

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