Social Network Characteristics & Cervical Cancer Screening among Quechua Women in Andean Peru
BACKGROUND:
Peru
has high cervical cancer incidence and mortality rates compared to other Andean
countries. Therefore, partnerships between governmental and international
organizations have targeted rural areas of Peru to receive cervical cancer
screening via outreach campaigns. Previous studies have found a relationship
between a person's social networks and cancer screening behaviors. Screening
outreach campaigns conducted by the nonprofit organization CerviCusco created
an opportunity for a social network study to examine cervical cancer screening
history and social network characteristics in a rural indigenous community that
participated in these campaigns in 2012 and 2013. The aim of this study was to
explore social network characteristics in this community related to receipt of
cervical cancer screening following the campaigns.
METHODS:
An egocentric
social network questionnaire was used to collect cross-sectional network data
on community participants. Each survey participant (ego) was asked to name six
other women they knew (alters) and identify the nature of their relationship or
tie (family, friend, neighbor, other), residential closeness (within
5 km), length of time known, frequency of communication, topics of
conversation, and whether they lent money to the person, provided childcare or
helped with transportation. In addition, each participant was asked to report
the nature of the relationship between all alters identified (e.g., friend,
family, or neighbor). Bivariate and multivariate analyses were used to explore
the relationship between Pap test receipt at the CerviCusco outreach screening
campaigns and social network characteristics.
RESULTS:
Bivariate
results found significant differences in percentage of alter composition for
neighbors and family, and for mean number of years known, mean density, and
mean degree centrality between women who had received a Pap test (n = 19)
compared to those who had not (n = 50) (p's < 0.05). The final logistic
regression model was statistically significant (χ2 (2) = 20.911, p < .001).
The model included the variables for percentage of family alter composition and
mean density, and it explained 37.8 % (Nagelkerke R (2)) of the variance
in Pap test receipt, correctly classifying 78.3 % of cases. Those women
with higher percentages of family alter composition and higher mean density in
their ego networks were less likely to have received a Pap test at the
CerviCusco campaigns.
CONCLUSIONS:
According
to this exploratory study, female neighbors more than family members may have
provided an important source of social support for healthcare related decisions
related to receipt of a Pap test. Future studies should collect longitudinal
social network data on participants to measure the network effects of screening
interventions in rural indigenous communities in Latin American countries
experiencing the highest burden of cervical cancer.
- 1Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 135 Cannon Street, Ste. 303, MSC 835, Charleston, SC, 29425, USA. luquej@musc.edu.
- 2Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA, USA. sopoku@georgiasouthern.edu.
- 3Augusta University, GRU Cancer Center, Augusta, GA, USA. dferris@gru.edu.
- 4CerviCusco, Cusco, Peru. dferris@gru.edu.
- 5CerviCusco, Cusco, Peru. wendy_s14@hotmail.com.
- BMC Public Health. 2016 Feb 24;16(1):181. doi: 10.1186/s12889-016-2878-3.
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