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Early Detection of Cervical Cancer among Native American Women: A Qualitative Supplement to a Quantitative Study

Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hilllmesser{at}sph.unc.edu

Allan Steckler, DrPH

Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill

Mark Dignan, PhD

AMC Cancer Research Institute, Denver, Colorado

The North Carolina Native American Cervical Cancer Prevention Project was a 5-year (1989-1995) National Cancer Institute–funded, community-based, early detection of cervical cancer intervention implemented among two Native American tribes in North Carolina: the eastern band of the Cherokee Indians and the Lumbee. The initial quantitative analysis of the intervention showed modest effects and found that the intervention had different effects in the two communities. Due to the equivocal findings, a retrospective qualitative study was conducted. The qualitative study found that two types of factors influenced the intervention’s results. The first were project and intervention characteristics, and the second were community and cultural factors over which the project had no control. The community and cultural factors took two forms: enhancers, which contributed to greater intervention effect, and attenuators, which created barriers to success. Examples of each factor are presented, and implications for cervical cancer detection among Native American women are discussed.

Health Education & Behavior, Vol. 26, No. 4, 547-562 (1999)
DOI: 10.1177/109019819902600411


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