{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:21:05Z","timestamp":1792023665045,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Health literacy plays an essential role in how individuals process health information to make decisions about health behaviours including cancer screening. Research is scarce to address health literacy as a strategy to improve cancer screening participation among women living with human immunodeficiency virus (HIV), particularly Black women who, despite the heavy burden of cervical cancer, report consistently low screening rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the feasibility, acceptability and preliminary efficacy of a health literacy\u2010focused intervention called CHECC\u2010uP\u2014Community\u2010based, HEalth literacy focused intervention for Cervical Cancer control\u2014among women living with HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a community\u2010based, single\u2010blinded randomized pilot trial. A total of 123 eligible women were enrolled and randomized to one of two conditions, control (i.e., cervical cancer brochure) or intervention (cervical cancer brochure plus 30\u201360\u2009min health literacy\u2010focused education followed by monthly phone counselling and navigation assistance for 6 months). Study assessments were done at baseline, 3\u00a0and 6 months. The final analysis sample included 58 women who completed all data points and whose\u00a0Papanicolaou\u00a0(Pap) test status was confirmed by medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All intervention participants who completed the programme would recommend the CHECC\u2010uP to other women living with HIV. However, adherence in the experimental conditions was low (49.6% attrition rate including 20 women who dropped out before the intervention began) due, in large part, to phone disconnection. Those who had received the intervention had a significantly higher Pap test rate compared to women in the control group at 6 months (50% vs. 21.9%, <jats:italic>p<\/jats:italic>\u2009=\u2009.025). Participation in the intervention programme was associated with improved health literacy and other psychosocial outcomes at 3 months but the trend was attenuated at 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CHECC\u2010uP was highly acceptable and led to improved Pap testing rates among Black women living with HIV. Future research should consider addressing social determinants of health such as phone connectivity as part of designing a retention plan targeting low\u2010income Black women living with HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>The findings should be incorporated into a future intervention framework to fulfil the unmet needs of Black women living with HIV to facilitate their decision\u2010making about Pap test screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Nineteen community members including women living with HIV along with HIV advocates and care providers participated in four focus groups to develop cervical cancer screening decision\u2010relevant information and the health literacy intervention. Additionally, a community advisory board was involved to provide guidance in the general design and conduct of the study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13644","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T08:50:19Z","timestamp":1669711819000},"page":"172-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Community\u2010based health literacy focused intervention for cervical cancer control among Black women living with human immunodeficiency virus: A randomized pilot trial"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-594X","authenticated-orcid":false,"given":"Hae\u2010Ra","family":"Han","sequence":"first","affiliation":[{"name":"The Johns Hopkins University School of Nursing Baltimore Maryland USA"},{"name":"The Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Center for Community Programs Innovation, and Scholarship Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyra J. W.","family":"Mendez","sequence":"additional","affiliation":[{"name":"National Cancer Institute Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Perrin","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University School of Nursing Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joycelyn","family":"Cudjoe","sequence":"additional","affiliation":[{"name":"United States Government Accountability Office  District of Columbia Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Taylor","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorcas","family":"Baker","sequence":"additional","affiliation":[{"name":"Older Women Embracing Life (OWEL) Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Murphy\u2010Stone","sequence":"additional","affiliation":[{"name":"School of Nursing The George Washington University Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"Sharps","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University School of Nursing Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21696"},{"key":"e_1_2_11_3_1","unstructured":"National Cancer Institute. 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The health literacy of America's adults: results from the 2003 national assessment of adult literacy.2006. 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