Social support and adherence behavior among women with abnormal Pap smears

Studies of hypertension, diabetes, and diet have indicated a relationship between social support and adherence to treatment regimens. Estimates of nonadherence following abnormal Pap test results range as high as 40%. In this study, the relationship between social support and adherence behavior was examined in a population of low-income, public-health-department patients with abnormal Pap smears.

Medical record reviews ascertained adherence behavior and interviews determined receipt of social support for 498 women.

Related to adherence were: receipt of any social support; receipt of each of three types of support (informational, emotional, and tangible support); amount of support received; satisfaction with support; and source of support. Reported need for support was not related to adherence behavior. Receipt of social support was more strongly related to adherence when the woman's emotional response to the notification of the abnormal Pap smear was greater, and when acculturation was higher (among Latinas). Knowledge of the results of the Pap test was found to be an intervening variable between receipt of informational support and adherence. Knowledge of the purpose of the Pap smear was found to be independently related to adherence. Among black women, emotional support was most strongly related to adherence, while among Latinas, tangible support was most strongly related to adherence. In a multivariate model, Pap-test knowledge and the interaction between emotional response and receipt of any social support were significantly related to adherence.

Findings suggest that supportive interventions, including provision of medical information, emotional support, child care, and transportation, could help to reduce nonadherence.