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Background: This study examines the relationship among psychosocial factors, behavioral risks for abnormal cervical cytology, and abnormal cervical cytology., Methods: A self-administered questionnaire was used to measure perceived stress, discrimination, lifetime stressful events, optimism, social support, and psychological state. Women with normal Pap smears attending a primary care clinic and women attending a colposcopy clinic because of an abnormal Pap smear were eligible. The scores between the two groups were compared., Results: A total of 265 women participated in the study. There were no significant relationships between psychosocial factors and cervical cytology status. In a regression model, age (B = -0.057, p = 0.001) was predictive of having abnormal cervical cytology. Smoking was correlated with an increased family Apgar score (p = 0.021), Perceived Stress Scale (PSS) score (p = 0.049), and Revised Life Stressor Checklist score (p < 0.001). A higher mean number of lifetime male partners was related to increased family Apgar score (p = 0.012), Revised Life Stressor Checklist score (p < 0.001), and major event discrimination (p < 0.001). Earlier age at coitarche was associated with increased family Apgar score (p < 0.001)., Conclusions: These results do not support that psychosocial factors play a role in the risk of developing abnormal cervical cytology. Behavioral risks for developing abnormal cervical cytology are associated with life stressors, family function, and perceived discrimination.

This review contrasts the planned and actual recruitment and retention efforts for a cervical cancer prevention study within a predominantly underserved population. Recruitment was a primary obstacle to trial progression and multiple strategies to improve recruitment were implemented to meet objectives. The actual recruitment strategies were expansion to five geographically distinct clinical sites, use of nurse practitioners focused primarily on patient issues, extremely flexible study hours and location, honorariums, support for transportation and child care, and creativity in maintaining contact with study participants. With these strategies, 90% of eligible patients consented to participate in the study.