Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities

Chelsea Salyer, Ashlyn Lipnicky, Meredith Bagwell-Gray, Jennifer Lorvick, Karen Cropsey and Megha Ramaswamy
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Chelsea Salyer: Division of Gynecologic Oncology, University of Kansas, Kansas City, KS 66160, USA
Ashlyn Lipnicky: Department of Population Health, University of Kansas, Kansas City, KS 66160, USA
Meredith Bagwell-Gray: School of Social Welfare, University of Kansas, Lawrence, KS 66045, USA
Jennifer Lorvick: RTI International Community Health and Implementation Research Program, Berkeley, CA 94704, USA
Karen Cropsey: Department of Psychiatry, University of Alabama, Birmingham, AL 35294, USA
Megha Ramaswamy: Department of Population Health, University of Kansas, Kansas City, KS 66160, USA

IJERPH, 2021, vol. 18, issue 12, 1-11

Abstract: Criminal-legal involved women experience significant barriers to preventive cervical care, and consequently there is a higher incidence of cervical cancer in this population. The purpose of this study is to identify variables that may facilitate abnormal Pap follow-up among criminal-legal involved women living in community settings. The study included n = 510 women with criminal-legal histories, from three U.S. cities—Birmingham, AL; Kansas City, KS/MO; Oakland, CA. Participants completed a 288-item survey, with questions related to demographics, social advantages, provider communication, and reasons for missing follow-up care. There were n = 58 women who reported abnormal Pap testing, and n = 40 (69%) received follow-up care. Most women received either repeat Pap/HPV testing ( n = 15, 38%), or colposcopy and/or biopsy ( n = 14, 35%). Women who did not follow-up ( n = 15, 26%) cited that they forgot ( n = 8, 53%), were uninsured ( n = 3, 20%), or were reincarcerated ( n = 3, 20%). In a multivariate analysis, both having a primary care provider (OR 4.6, 95% CI 1.3–16.0) and receiving specific provider communication about follow-up (OR 3.8, 95% CI 1.1–13.2) were independent predictors for abnormal Pap follow-up. Interventions that offer linkages to providers in the community or ensure abnormal Pap care plans are communicated effectively may mitigate the disparate incidence of cervical cancer among criminal-legal involved women.

Keywords: cervical cancer disparities; criminal-legal involved women; abnormal Pap follow-up (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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