Development and evaluation of a cervical cancer screening program for Chinese women

Despite of the proven efficacy of the Pap test, Asian populations still have low Pap screening compliance. The purpose of this dissertation was to investigate factors that influencing women's decision to obtain a Pap test, and to describe the development and evaluation of a cervical cancer educational program promoting the Pap screening behavior among women in Taiwan. ^ The first study examined factors associated with Pap screening compliance. Psychometric properties of measurement instruments were also assessed. The scale reliabilities were as the follows: Cronbach alpha 0.70 for knowledge scale, 0.88 for pros scale, 0.68 for cons scale, and 0.72 for perceived norms scale. Results from multiple logistic regression analysis, after adjusted for marital status, showed women who compliant to Pap screening guidelines had significantly higher knowledge, higher perceived benefits (pros), lower perceived barriers (cons), and higher perceived norms to receive a Pap test. ^ The second study described the development of a program called “Love yourself before you take care of your family”, designed to increase Pap screening behavior among women in Taiwan. The development of this program was guided by Intervention Mapping (IM), an innovative process of intervention design. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail campaigns, role model stories with women's testimonials, and phone intervention. ^ The third study examined the effectiveness of a randomized trial of the carefully-designed intervention (N = 424). Participants were female family members of inpatients admitted to one of the major teaching hospitals in Taiwan during August and September 1999. Women in the intervention group reported a higher rate of receiving a Pap test than women in the control group (50% versus 32%) after a three-month intervention (p = 0.002). Women in the intervention group showed increased knowledge (p = .016), perceived pros (p = 0.008), and susceptibility (p = .011) between baseline and follow-up. They also showed higher perceived pros of Pap tests than women in control group at follow-up (p = .031). This result suggested that program development based on theories and evidences could maximize the intervention impact for a specific target population. ^

AN INVESTIGATION OF THE EFFECT OF FORMALDEHYDE SPECIES ON ENVIRONMENTAL MEASUREMENT METHODS UNDER AMBIENT CONDITIONS

Species variations in formaldehyde solutions and gases were investigated by means of infrared spectral analysis. Double beam infrared spectrometry in conjunction with sodium chloride wafer technique and solvent compensation technique were employed. Formaldehyde species in various solutions were investigated. Formalin 37% was stable for many months. Refrigeration had no effects on its stability. Spectral changes were detected in 1000 ppm formaldehyde solutions. The absorbances of very diluted solutions up to 100 ppm were lower than the detection limit of the instruments. Solvent compensation improved resolution, but was associated with an observed lack of repeatability. Formaldehyde species in animal chambers containing animals and in mobile home air were analyzed with the infrared spectrophotometer equipped with a 10 cm gas cell. Spectra were not different from the spectrum of clean air. A portable single beam infrared spectrometer with a 20 meter pathlength was used for reinvestigation. Indoor formaldehyde could not be detected in the spectral; conversely, an absorption peak at 3.58 microns was found in the spectra of 3 and 15 ppm formaldehyde gas in animal chambers. This peak did not appear in the spectrum of the control chamber. Because of concerns over measurement bias among various analytical methods for formaldehyde, side-by-side comparisons were conducted in both laboratory and field measurements. The chromotropic acid method with water and 1% sodium bisulfite as collection media, the pararosaniline method, and a single beam infrared spectrometer were compared. Measurement bias was elucidated and the extent of the effects of temperature and humidity was also determined. The problems associated with related methods were discussed. ^