Search

Background: The impact of the Papanicolaou (Pap) smear on the prevention of cervical cancer is one of the greatest public health success stories. However, it is not clear if women understand the purpose of the Pap smear despite recent advancements and national attention over cervical cancer prevention. The purpose of this study was to examine Pap smear knowledge among three high-risk populations at different points in time. Methods: Women from three separate human papillomavirus (HPV) psychosocial studies completed surveys assessing Pap smear knowledge: (1) HPV-positive women (prevaccine population in 2005-2006, n=154, mean age 23.5), (2) college women (postvaccine population in 2008, n=276, mean age 18.9), and (3) minority college women (postvaccine population in 2011, n=711, mean age 23.3). Frequencies and logistic regression were employed to examine associations between demographic factors and accurate knowledge of Pap smear testing within each study. Results: Approximately one quarter of participants across all three samples did not know that the Pap smear is a test for cervical cancer. Participants also incorrectly believed that the Pap smear tests for HPV (82%-91%), vaginal infections (76%-92%), yeast infections (65%-86%), gonorrhea (55%-81%), herpes (53%-80%), HIV/AIDS (22%-59%), and pregnancy (17%-38%). Among all three studies, older age was the only factor significant with higher Pap knowledge. Higher HPV knowledge scores were significantly associated with higher Pap knowledge in studies 2 and 3 only. Conclusions: Knowledge about the purpose of the Pap smear remains low. Findings underscore the significant need for clear and consistent messages among high-risk women regarding the prevention of cervical cancer and other reproductive health conditions. [ABSTRACT FROM AUTHOR]

Objective: To report psychosocial differences between self-reported HPV-positive and HPV-negative Florida men. Method: Men (n=536) in an HPV natural-history study completed a cross-sectional survey (2007-2010). Results: Most participants were white, non-Hispanic, and unmarried with some college education. HPV knowledge was high overall. HPV-positive men reported more negative emotions and perceived threat (P<0.05). HPV-negative men were more likely to disclose test results. Most men (91%) reported strong intentions for the HPV vaccine if it became available for men. Conclusions: Men reported an array of responses to HPV tests with intentions to receive the HPV vaccine. Findings are important for HPV-related health messages for men. [ABSTRACT FROM AUTHOR]

Background It remains unclear whether the lack of clinical trial success and drug approval for cognitive impairment associated with schizophrenia (CIAS) is due to compounds being ineffective, or whether trial methodology itself has been a limiting factor in successfully demonstrating the efficacy of these agents. Schizophrenia is a heterogeneous disorder and whilst cognitive deficits are a core feature, the profile and degree of neuropsychological impairment can vary across patients. Though most individuals with schizophrenia exhibit some general cognitive impairment compared to antecedent expectations, such as premorbid intelligence, up to a quarter display cognitive performance in the 'normal' range. This may pose a problem for pro-cognitive drug trials in this population given that it potentially inflates baseline scores and reduces the scope to see improvement between treatment and placebo groups. In order to examine this potential issue, we investigated participant-level trajectories of cognitive performance among patients with schizophrenia enrolled in a multi-national, phase II clinical trial. Methods We conducted a post-hoc analysis of existing trial data from 463 patients with schizophrenia who participated in a randomized, double-blind, placebo-controlled trial. Patients met established diagnosis for schizophrenia (DSM-5), were clinically stable (non-acute) and had no more than moderate severity ratings on the Positive and Negative Syndrome Scale (PANSS). During the trial, participants completed two different neurocognitive test batteries, the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the MATRICS Consensus Cognitive Battery (MCCB), at 4 separate time points (screening, baseline, week 6 & week 12). Participant data were pooled across placebo and treatment groups to explore trajectories of cognitive performance, at the participant-level, across the course of the study. Results Linear mixed model analyses revealed that participants who performed within the 'normal range' at screening on cognitive tasks as measured by CANTAB, continued to perform well at baseline, week 6 and week 12, showing no significant change in their performance. By contrast, participants who performed below the normal range at screening, showed a significant improvement in their test performance across the remainder of the study. When compared in the context of MCCB, those participants who performed a standard deviation (SD) above the MCCB normative mean at screening, were also the participants who performed within the normal range on CANTAB. Approximately 25% of the overall sample were performing within a clinically normal cognitive range at screening. Conclusions Substantial variability was evident in cognitive performance among the current sample of patients with schizophrenia. We identified a subsample of patients whose performance fell within a clinically normal range. Cognitive improvement was observed only in those who exhibited a deficit at screening, bringing into question whether the inclusion of unimpaired patients in clinical trials increases the risk of ceiling effects and minimizes chance to see change. Further analyses will determine the interaction between different cognitive trajectories and the treatment arms included in this trial to explore whether there are individuals with a particular cognitive profile who are most likely to respond to treatment. This has potentially important methodological implications in the search to find a drug to treat CIAS. [ABSTRACT FROM AUTHOR]

Background: A low-income, African American neighborhood in Miami, Florida, experiences health disparities including an excess burden of cancer. Many residents are disenfranchised from the healthcare system, and may not participate in cancer prevention and screening services., Objective: We sought to describe the development of a partnership between a university and this community and lessons learned in using a community-based participatory research (CBPR) model., Methods: To better understand the community's health behaviors and status, a randomized door-to-door survey was conducted in collaboration with a community partner., Lessons Learned: This collaboration helped foster a mutual understanding of the benefits of CBPR. We also describe challenges of adhering to study protocols, quality control, and sharing fiscal responsibility with organizations that do not have an established infrastructure., Conclusions: Understanding the organizational dynamics of a community is necessary for developing a CBPR model that will be effective in that community. Once established, it can help to inform future collaborations.