{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T03:50:58Z","timestamp":1781322658158,"version":"3.54.1"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T00:00:00Z","timestamp":1397001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:p>Objectives: Low-income, inner-city women bear a disproportionate burden of cervical cancer in both incidence and mortality rates in the United States, largely because of low adherence to follow-up recommendations after an abnormal cervical cytology result in the primary care setting. The goals of the present study were to delineate the theory-based psychosocial barriers underlying these persistent low follow-up rates and their sociodemographic correlates. Methods: Guided by a well-validated psychosocial theory of health behaviors, this cross-sectional, correlational study assessed the barriers to follow-up adherence among underserved women (N = 210) who received an abnormal cervical cytology result. Participants were recruited through an inner-city hospital colposcopy clinic, and were assessed by telephone prior to the colposcopy appointment. Results: Participants were largely of African American race (82.2%), lower than high school completion education (58.7%), single, never married (67.3%), and without full-time employment (64.1%). Knowledge barriers were most often endorsed (68%, M = 3.22), followed by distress barriers (64%, M = 3.09), and coping barriers (36%, M = 2.36). Forty-six percent reported more than one barrier category. Less education and being unemployed were correlated with higher knowledge barriers ( P &lt; .0001 and P &lt; .01, respectively) and more coping barriers ( P &lt; .05 and P &lt; .05, respectively). Women who were younger than 30 years displayed greater distress barriers ( P &lt; .05). Conclusion: In the primary care setting, assessing and addressing knowledge and distress barriers after feedback of an abnormal cervical cytology result may improve adherence to follow-up recommendations. The use of structured counseling protocols and referral to navigational and other resources may facilitate this process and thereby reduce disparities in cervical cancer.<\/jats:p>","DOI":"10.1177\/2150131914529307","type":"journal-article","created":{"date-parts":[[2014,4,10]],"date-time":"2014-04-10T01:43:49Z","timestamp":1397094229000},"page":"234-241","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Psychosocial Barriers to Follow-up Adherence After an Abnormal Cervical Cytology Test Result Among Low-Income, Inner-City Women"],"prefix":"10.1177","volume":"5","author":[{"given":"Siu-kuen Azor","family":"Hui","sequence":"first","affiliation":[{"name":"Fox Chase Cancer Center\/Temple University Health System, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center\/Temple University Health System, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuang-Yi","family":"Wen","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center\/Temple University Health System, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Fang","sequence":"additional","affiliation":[{"name":"Everest Clinical Research Services, Little Falls, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Li","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center\/Temple University Health System, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Buzaglo","sequence":"additional","affiliation":[{"name":"Research and Training Institute of Cancer Support Community, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Temple University School of Medicine, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,4,9]]},"reference":[{"key":"bibr1-2150131914529307","unstructured":"American Cancer Society. 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