TITLE:
Challenges and Recommendations to Recruiting Women Who Do Not Adhere to Follow-Up Gynecological Care
AUTHORS:
LaShawn Wordlaw-Stinson, Sierra Jones, Shaneese Little, Laura Fish, Adriana Vidal, Cathrine Hoyo, Jennifer S. Smith, Patricia G. Moorman
KEYWORDS:
Non-Adherence; Patient Compliance; Cervical Cancer; Cervical Intraepithelial Neoplasia; Cancer Screening; Abnormal Pap Smear; Abnormal Pap Test; HPV; Patient Navigation
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.4 No.3,
March
20,
2014
ABSTRACT: Purpose: Non-adherence to recommended follow-up visits
after an abnormal cytological finding is associated with poorer outcomes and
higher health care costs. The purpose of this paper is to describe the challenges when examining reasons for
non-adherence to cervical cancer screening follow-up and to discuss the recommendations to overcome
those challenges. Methods: We conducted a telephone survey with two subgroups of women: 1) those which adhered to recommended follow-up care after an abnormal Pap test, and 2)
those which did not adhere. Results:
The follow-up accrual among non-adherent women lagged behind that of adherers.
We were able to contact and conduct a survey with 51% of the adherers and 26%
of the non-adherers. The challenges in studying non-adherent women were related to
several distinct factors: 1) the definition of non-adherence, 2) the
availability of alternate contact information, 3) the amount and type of
financial incentives, and 4) the availability of staffing. We describe strategies
employed to increase the accrual of non-adherent women. Discussion: This paper
describes four recommendations that may play a role in understanding and
reducing non-adherence to follow-up gynecological care.