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Health Education and Promotion


Chinaro Kennedy


In the United States, cervical cancer disproportionately affects members of ethnic minorities, including immigrant women from Ghana. Overall cervical cancer incidence and mortality rates have declined in the United States due to opportunistic screening with Pap tests; however, rates have not declined for Black women and immigrant women, who continue to experience higher than average mortality rates. Immigrant women, including Ghanaian women, use screening less than nonimmigrant women. Several factors including poor acculturation, low educational level, certain personal attitudes, and lack of health insurance are known to reduce participation in screening. Using the theory of planned behavior as a guide, the purpose of this quantitative study was to determine if acculturation, level of education, and individual attitude predict Pap test use by Ghanaian immigrant women in Ohio while controlling for age, income, and health insurance status. A total of 247 participants aged 18 to 65 years completed questionnaires that included demographic questions and a 10-item attitude scale. Descriptive statistics and logistic regression were used to examine associations between the dependent and independent variables. Statistically significant associations were found between Pap test use and educational level (p = .001) and acculturation (p = .014); individual attitudes did not predict Pap test use, although overall attitudes were favorable toward screening. The social change implications of the study include advancement of knowledge regarding how Ghanaian immigrant women use preventative health care in the United States, which public health educators, policy makers, stakeholders, and governmental agencies can use develop programs for health promotion and disease prevention that influence members of this population.