Pap smear screening: Determinants of patient compliance

The objective of this study was to test three hypotheses: Women will demonstrate greater compliance with returning for an annual Pap smear if (1) they receive educational instruction about the Pap smear, (2) they believe they are at serious risk to develop cervical cancer, (3) or they are classified as Internal Health Locus of Control. One half of women being cared for in a public postpartum clinic saw an educational videotape explaining the Pap smear and the benefits of periodic Pap smears. All received questionnaires to categorize them according to the Health Belief and Health Locus of Control Models. These women were tracked to determine their compliance with recommended yearly Pap smear testing, and the groups were compared. Only 18% of those with normal Pap smears and 41% with abnormal results returned for repeat Pap smear testing. Viewing the educational videotape did not influence compliance, nor were the Health Belief or Locus of Control Model questionnaires predictive of compliance. In this study, a simple educational modality did not influence the rate of return for Pap smear testing, nor did two behavioral models appear to adequately identify individuals at risk for noncompliance. Health care professionals must not be dissuaded from the task of developing effective methods of patient education and instruments to identify patients at risk for noncompliance. Their attainment is an important part of the tasks necessary to meet our society's goals of health promotion and disease prevention.