Method: This study is a community based participatory research collaboration between 1 university and 4 community organizations. PI couples were recruited from Samoan, Tongan, and Chamorro churches and cultural social networks (i.e. clans). Participating women had to be between 21 and 65 years old and married or in a long-term relationship. A questionnaire assessed knowledge and beliefs regarding Pap tests, intention to get a Pap test, and utility parameter scores for 8 anticipated consequences of getting a Pap test.
Result: Logistic regression odds ratio suggested that a higher Multi-Attribute Utility score was associated with increased likelihood of having had a Pap test within the past three years. The three-year criterion was chosen for this study because American Cancer Society guidelines recommend that healthy women receive Pap tests once every three years. ANOVA tests compared three sets of utility parameters reported by women who had a Pap test in the past three years (Pap) with those who had not (No Pap) on: (1) subjective value, (2) subjective probability, and (3) momentary salience for each of eight perceived consequences of having a Pap test. Compared to the No Pap women, Pap women had significantly higher subjective value scores for the following consequences: "detecting cervical cancer early", "peace of mind", and "protecting my family." For the subjective probability parameter, Pap women had higher scores than No Pap women for the consequences of "protecting my family" and "time spent." For the momentary salience parameter, Pap women had higher scores than No Pap women for the following consequences: "detecting cervical cancer early", "peace of mind", "protecting my family", and "time spent." Pap and No Pap women did not differ on any of the parameters for the following consequences: "feeling discomfort", "feeling scared," and "feeling embarrassed."
Conclusion: Family values and logistical concerns appeared to be the strongest predictors of having a Pap test in PI population. Among the three model parameters, subjective values and momentary salience were more predictive than perceived likelihood. The connection between utility and behavior offers a promising pathway for intervention. An intervention designed to increase utility is underway.
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