Perspectives on pap test follow-up care among rural appalachian women

Nancy Schoenberg, Julie Baltisberger, Shoshana Bardach, Mark Dignan

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Approximately one- to three-quarters of women notified of abnormal Pap test results do not receive appropriate follow-up care, dramatically elevating their risk for invasive cervical cancer. We explored barriers to and facilitators of follow-up care for women in two counties in Appalachian Kentucky, where invasive cervical cancer incidence and mortality are significantly higher than the national average. In-depth interviews were conducted among 27 Appalachian women and seven local health department personnel. Those who had been told of an atypical Pap test result tended to have one of three reactions: (1) not alarmed and generally did not obtain follow-up care; (2) alarmed and obtained follow-up care; or (3) alarmed, but did not obtain care. Each of these typologies appeared to be shaped by a differing set of three categories of influences: personal factors; procedure/provider/system factors; and ecological/community factors. Recommendations to increase appropriate follow-up care included pursuing research on explanations for these typologies and developing tailored interventions specific to women in each of the response types.

Original languageEnglish
Pages (from-to)580-597
Number of pages18
JournalWomen and Health
Issue number6
StatePublished - Sep 2010


  • Abnormal findings
  • Cancer of the cervix
  • Cancer screenings
  • Health services
  • Public health

ASJC Scopus subject areas

  • General Medicine


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