Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

Legacy Department

International Family and Community Studies

Committee Chair/Advisor

Holaday, Bonnie

Committee Member

Limber , Susan

Committee Member

McDonell , James

Committee Member

Robinson , Kathleen


Cervical cancer is one of the most common reproductive cancers among women in the United States. The incidence and mortality rates of cervical cancer among Hispanic women in the U.S. are almost two times higher than non-Hispanic Whites. Cervical cancer screening is associated with early cervical cancer detection and, thus, with reductions in cancer morbidity and mortality. In Hispanic populations, where cancer rates are disproportionately high, it is important to conduct research that accounts for the influence of culture in health-seeking behaviors. The purpose of this study was to use the Health Belief Model (HBM) as a theoretical framework to explore the culturally determined beliefs and attitudes influencing Hispanic women's decisions about cervical cancer and screening. A cross-sectional survey was conducted among self-identified Hispanic women, of various countries of origin, who were 18 to 65 years of age and who lived in seven cities in the Upstate of South Carolina. Generalized Linear Modeling was used to explore the effects of the hypothesized predictors. Results found evidence to support the hypothesized relationships between cervical cancer screening and health beliefs. Perceived threats (susceptibility and severity) and self-efficacy were the strongest predictors. The results also indicated that perceived benefits and barriers acted together to determine the women's likelihood of getting screened. The importance of familism demonstrated the need to incorporate relevant cultural concepts when examining screening behaviors in minority groups. Knowledge about cervical cancer and the Pap test, age, marital status, income, access to regular medical care, familism, and cues to cervical cancer screening were determining factors that influenced S.C. Upstate Hispanic women's perceptions of cervical cancer and the Pap test and their cervical cancer screening behaviors. The HBM can be used as a framework to design culturally appropriate cervical cancer screening interventions. Comprehensive approaches combining access to regular care and screening at a medical home and providing clear, accurate and culturally adapted information about cervical cancer, HPV, and screening will support the right of Hispanic women to access to cancer preventive care.

Included in

Sociology Commons



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