The study purpose is to describe and compare racial and rural differences in cervical cancer screening practices using data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) to conduct a cross-sectional study of screening and vaccination practices. The specific aims of the project are:

1. To describe and compare cervical screening practices and vaccination among physician practices residing in rural versus urban ZIP code tabulation areas (ZCTAs)
2. To describe and compare cervical screening practices and vaccination of age eligible African American versus European American women
3. To determine the joint effects of physician practice (urban versus rural), physician race, and patient race on cervical screening and vaccination practices

For this analysis, rural/urban classification will be assigned based upon the ZCTA in which the physician office or patient resides. Practices will also be characterized by the proportion of their patient population of different races, to ascertain whether practices serving largely minority populations lack adherence to screening and vaccination recommendations. Given the complex sampling design, analyses will incorporate the recommended weighting factors. The findings will inform policies to increase access to quality cancer-preventive services.

Publications

• Diffusion of Preventive Innovation: Racial and Rural Differences in Cervical Cancer Prevention and Control Practices
  Rural and Minority Health Research Center
  Date: 05/2013
  This report examines differences associated with residence and race/ethnicity in receipt of cervical cancer screening and HPV vaccination.