Fatalism and Cervical Cancer Screening Beliefs and Behaviors in a Medically Underserved Population in Southern California: A Pilot Study

Statement of the problem: Cervical cancer screening rates are still below Healthy People 2020 goals. Many factors affect cervical cancer screening behaviors. More research about the factors influencing cervical cancer screening behaviors is needed to inform family nursing practice (FNP). Methods: The Health Belief Model (HBM) (McEwen & Wills, 2014) guided the development of this pilot study. The primary aim of this study was to explore the effects of fatalism on cervical cancer screening behaviors (pap smear within the last five years), and the relationship between health beliefs and pap smear frequency in a medically underserved sample of women attending student-run free clinics in Southern California. A cross-sectional design was used to survey female participants (n=31). The survey was offered in English and Spanish and consisted of two instruments: The Fatalism Scale (Shen, Condit, Wright, 2009) consisting of three subscales: pre-determination, luck, and pessimism; and the Health Belief Model Scale for Cervical Cancer and Pap Smear (Guvenc, Akyuz, Acikel, 2011) consisting of four subscales: Barriers, fear, susceptibility, and motivation. Cross-tabulation (Chi-square) and correlation (Spearman’s rho) were used to analyze the data. Results: The subscales pre-determination and luck were found to have a statistically significant effect on cervical cancer screening behaviors (χ2 =6.795, p=.018; χ2=6.795, p =.018). The barriers subscale was found to have a statistically significantly, moderate strength inverse relationship with cervical cancer screening behaviors (rs=-.566, p=.001). The subscale susceptibility was found to have a weak-moderate inverse statistically significantly relationship with cervical cancer screening behaviors (rs=-.362, p=.045). Conclusions: Those participants that were found to have overall fatalistic beliefs, more barriers and greater susceptibility, reported not having had a pap smear in the last five years. This information will inform FNP and research. Additional research is required with larger samples.