Objectives Contributors to disparities and worse cervical cancer outcomes include limited education and loss to follow-up after an abnormal Pap smear. Effective interventions are necessary to engage diverse populations. The… Click to show full abstract
Objectives Contributors to disparities and worse cervical cancer outcomes include limited education and loss to follow-up after an abnormal Pap smear. Effective interventions are necessary to engage diverse populations. The authors piloted an intervention to assess acceptability, knowledge uptake, and follow-up. Materials and Methods This prospective pilot study recruited patients scheduled for colposcopy visits at a government-insured clinic and faculty clinics within an academic medical center to use the Patient Activated Learning System (PALS). The PALS intervention included 5 short educational videos about human papillomavirus and colposcopy. Participants completed a baseline knowledge questionnaire, viewed PALS videos followed by post-intervention knowledge and acceptability surveys. Perceptions of PALS, anxiety, and impact on follow-up were evaluated. Results Of 63 (70%) participants completing the intervention, 24 (38%) were from the government-insured clinic and 39 (62%) from faculty clinics. Median age was 36 (range 30–48), 38 (63%) were racial and ethnic minorities, and 21 (33%) were non-Hispanic White. The intervention improved knowledge scores for the entire cohort (60%–75%, p < .01), even when stratified by race/ethnicity (p < .01 for all), income (p < .01), education (p < .01), practice (p < .01), and insurance type (p < .001). Participants found PALS convenient to use (4.6/5), enjoyable (4.2/5), and acceptable (4.6/5); 75% said the videos alleviated colposcopy-related anxiety, and 84% indicated PALS made them more likely to follow up. The guideline concordant follow-up rate among study completers was 73%. Conclusion In this pilot study, PALS was effective and acceptable among a diverse cohort. These free, widely viewed videos can successfully engage diverse populations to improve colposcopy knowledge and follow-up.
               
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