摘要：Objectives. We conducted a trial to evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers. Methods. The study group included 234 women who had not received a Papanicolaou (Pap) test in the last 3 years. Experimental group participants received a lay health worker home visit. Our trial endpoint was Pap test receipt within 6 months of randomization. Pap testing completion was ascertained through women's self-reports and medical record reviews. We examined intervention effects among women who had ever received a Pap test (prior to randomization) and women who had never received a Pap test. Results. Three quarters of the women in the experimental group completed a home visit. Ever-screened experimental group women were significantly more likely to report Pap testing ( P < .02) and to have records verifying Pap testing ( P < .04) than were ever-screened control group women. There were no significant differences between the trial arms for women who had never been screened. Conclusions. Our findings indicate that lay health worker–based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women. Over 10% of Asian Americans are of Vietnamese descent, and the Vietnamese American population now exceeds 1 250 000. 1 The majority of Vietnamese Americans came to the United States as refugees or immigrants over the last 3 decades. 2 Cancer registry data show that in the United States, the incidence rate of cervical cancer among Vietnamese women is over twice that among non-Hispanic White women (16.8 vs 8.1 per 100 000). 3 Further, the President's Advisory Commission on Asian Americans recently identified cervical cancer among Vietnamese women as one of the most important health disparities experienced by Asian American populations. 4 According to American Cancer Society guidelines, women should be screened for cervical cancer every 1 to 3 years, depending on their risk factors for disease and previous screening history. 5 Additionally, national cervical cancer screening goals for the year 2010 specify that at least 97% of women should have received a Papanicolaou (Pap) test on at least 1 occasion, and 90% of women should have received a Pap test within the previous 3 years. 6 However, California survey data for 2003 indicated that only 70% of Vietnamese women aged 18 years and older had received Pap testing in the previous 3 years, compared with 84% of White, 87% of Black, and 85% of Hispanic women. 7 Lay health workers are community members who are not certified health care professionals, but have been trained to promote health or provide health care services within their community. The Cochrane Database for Systematic Reviews recently concluded that interventions based on lay health workers represent a promising approach to disease prevention, and recommended further research on the effectiveness of approaches using lay health workers for different health topics and demographic population subgroups. 8 We have previously described our development of a cervical cancer control intervention for Vietnamese American women that used lay health workers. 9 In this report, we provide findings from our randomized controlled trial to evaluate the effectiveness of the lay health worker–based intervention in improving levels of Pap test receipt among Vietnamese immigrants in Washington State.
