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Recruitment Costs and Women's Perceptions of Cervical Cancer Screening Costs in a Trial of Low-Income, Under-Screened Women
Recruitment Costs and Women's Perceptions of Cervical Cancer Screening Costs in a Trial of...
Recruitment Costs and Women's Perceptions of Cervical Cancer Screening Costs in a Trial of Low-Income, Under-Screened Women

Detailed Information

자료유형  
 학위논문 서양
최종처리일시  
20260202104805
ISBN  
9798291558300
DDC  
614.4
저자명  
Isaacson, Sinead.
서명/저자  
Recruitment Costs and Womens Perceptions of Cervical Cancer Screening Costs in a Trial of Low-Income, Under-Screened Women
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
133 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-02, Section: A.
주기사항  
Advisor: Smith, Jennifer S.
학위논문주기  
Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약Both in the US and globally, cervical cancer incidence and mortality occurs disproportionately in underserved populations. Women at the highest risk of cervical cancer, however, are frequently missed by screening programs. Mailed at-home HPV testing creates opportunities to increase screening access. Best practices to reach under-screened populations and overcome traditional screening barriers are needed to maximize utility of self-collected HPV-based screening. The objective of this dissertation was to provide essential information for interventions targeting high-risk populations, using MBMT-3 trial data.In Aim 1, we tallied trial recruitment methods material and staffing costs and calculated the cost per person eligible, enrolled, and screened in the trial. Of 898 eligible women, the majority (65%, n=579) heard about the trial through Craigslist, which had the lowest cost per eligible woman ($25) and enrollee ($34). Postcards/posters/ flyers ($86 per enrollee) and bus ads ($124) were also successful. In contrast, costs per enrollee were highest for email broadcast ($1,307), 211 hotline ($1,275), and radio ads ($1,123). Craigslist tended to enroll those younger (median: 42 years, IQR: 33-51), more educated (63% ≥ some college), and a higher proportion identifying as White (49%). Postcards/posters/flyers and bus ads enrolled more reporting lower annual income (both median $10,400) and self-identifying as Black (postcards: 62%, bus: 76%).In Aim 2, we examined expected in-clinic screening costs as a potential screening barrier and compared expected to actual costs for control group participants. We explored differences between costs for Black and White participants to examine whether perceived financial barriers contribute to disparities. We found participants consistently overestimated screening costs; the median expected costs for participants completing screening was $215 compared to $5 for actual costs. While expected costs were higher for Black versus White participants (median $265 and $205, respectively), actual costs were similar.We find that Craigslist can be an effective and affordable outreach method for low-income, under-screened women, but using additional methods is important to ensure women of different socio-demographic backgrounds are reached. Outreach and educational interventions for existing affordable screening services may alleviate the impact of perceived costs as a barrier to cervical cancer screening, particularly for historically marginalized populations.
일반주제명  
Epidemiology
일반주제명  
Public health
일반주제명  
Oncology
일반주제명  
Womens studies
키워드  
Cancer screening
키워드  
Cervical cancer
키워드  
Financial barriers
키워드  
Health disparities
키워드  
Recruitment methods
키워드  
Screening
기타저자  
The University of North Carolina at Chapel Hill Epidemiology
기본자료저록  
Dissertations Abstracts International. 87-02A.
전자적 위치 및 접속  
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MARC

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■1001  ▼aIsaacson,  Sinead.
■24510▼aRecruitment  Costs  and  Women's  Perceptions  of  Cervical  Cancer  Screening  Costs  in  a  Trial  of  Low-Income,  Under-Screened  Women
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a133  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-02,  Section:  A.
■500    ▼aAdvisor:  Smith,  Jennifer  S.
■5021  ▼aThesis  (Ph.D.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aBoth  in  the  US  and  globally,  cervical  cancer  incidence  and  mortality  occurs  disproportionately  in  underserved  populations.  Women  at  the  highest  risk  of  cervical  cancer,  however,  are  frequently  missed  by  screening  programs.  Mailed  at-home  HPV  testing  creates  opportunities  to  increase  screening  access.  Best  practices  to  reach  under-screened  populations  and  overcome  traditional  screening  barriers  are  needed  to  maximize  utility  of  self-collected  HPV-based  screening.  The  objective  of  this  dissertation  was  to  provide  essential  information  for  interventions  targeting  high-risk  populations,  using  MBMT-3  trial  data.In  Aim  1,  we  tallied  trial  recruitment  methods  material  and  staffing  costs  and  calculated  the  cost  per  person  eligible,  enrolled,  and  screened  in  the  trial.  Of  898  eligible  women,  the  majority  (65%,  n=579)  heard  about  the  trial  through  Craigslist,  which  had  the  lowest  cost  per  eligible  woman  ($25)  and  enrollee  ($34).  Postcards/posters/  flyers  ($86  per  enrollee)  and  bus  ads  ($124)  were  also  successful.  In  contrast,  costs  per  enrollee  were  highest  for  email  broadcast  ($1,307),  211  hotline  ($1,275),  and  radio  ads  ($1,123).  Craigslist  tended  to  enroll  those  younger  (median:  42  years,  IQR:  33-51),  more  educated  (63%  ≥  some  college),  and  a  higher  proportion  identifying  as  White  (49%).  Postcards/posters/flyers  and  bus  ads  enrolled  more  reporting  lower  annual income  (both  median  $10,400)  and  self-identifying  as  Black  (postcards:  62%,  bus:  76%).In  Aim  2,  we  examined  expected  in-clinic  screening  costs  as  a  potential  screening  barrier  and  compared  expected  to  actual  costs  for  control  group  participants.  We  explored  differences  between  costs  for  Black  and  White  participants  to  examine  whether  perceived  financial  barriers  contribute  to  disparities.  We  found  participants  consistently  overestimated  screening  costs;  the  median  expected  costs  for  participants  completing  screening  was  $215  compared  to  $5  for  actual  costs.  While  expected  costs  were  higher  for  Black  versus  White  participants  (median  $265  and  $205,  respectively),  actual  costs  were  similar.We  find  that  Craigslist  can  be  an  effective  and  affordable  outreach  method  for  low-income,  under-screened  women,  but  using  additional  methods  is  important  to  ensure  women  of  different  socio-demographic  backgrounds  are  reached.  Outreach  and  educational  interventions  for  existing  affordable  screening  services  may  alleviate  the  impact  of  perceived  costs  as  a  barrier  to  cervical  cancer  screening,  particularly  for  historically  marginalized  populations.
■590    ▼aSchool  code:  0153.
■650  4▼aEpidemiology
■650  4▼aPublic  health
■650  4▼aOncology
■650  4▼aWomens  studies
■653    ▼aCancer  screening
■653    ▼aCervical  cancer
■653    ▼aFinancial  barriers
■653    ▼aHealth  disparities
■653    ▼aRecruitment  methods
■653    ▼aScreening
■690    ▼a0766
■690    ▼a0453
■690    ▼a0992
■690    ▼a0573
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g87-02A.
■790    ▼a0153
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358883▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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