Development and implementation of an intervention to increase cervical cancer screening in inner-city women

Community interventions are increasingly recognized as an effective method for reaching individuals in need of health behavior change. We present our experience in developing and implementing an intervention to increase Pap test screening in an inner-city community with a high rate of cervical cancer mortality. Results of a baseline needs assessment survey showed that: almost one-half of the population was inadequately screened; 66 percent of inadequately screened women reported belonging to a church; and, a significant proportion of those who tended to rely on the physician for screening did not receive adequate testing. These results formed the basis of our community intervention strategy: lay peer educators, recruited predominantly from churches, were trained to motivate inadequately screened women to actively seek testing. The implementation of the intervention was flexible and responsive to insights gained in the field and process evaluation data. Recommendations for future community-based interventions are offered.