Purpose: Women who receive an abnormal Pap result may experience negative psychological factors. The purpose of this study is to assess the baseline occurrence of negative psychological factors and evaluate the relationships between psychological factors and demographic characteristics among Appalachian women who received abnormal Pap results. Methods: We conducted a secondary analysis of data collected from Appalachia Kentucky women (N = 521) ages ≥18 enrolled in an intervention. Data included sociodemographics, Beck depression and anxiety inventories, fatalism, and personal control measures. Multiple variable logistic regression was used to investigate the association between demographics and psychological factors. Findings: Participants were predominantly White (96.2%), with mean age 28.93 ± 11.03 years, and the majority (77%) had yearly income below $20,000. Depression was reported by 34.6% (n = 173); 10% (n = 50) experienced moderate or severe anxiety; 20.6% (n = 107) had fatalistic beliefs; and 55.1% (n = 289) believed they lacked personal control over cancer. Women with lower income had higher occurrence of depression (P =.003). Women with moderate to severe anxiety were significantly older than those with low to moderate depression (34.44 vs 28.34, P <.001). Controlling for other variables, as age increased, the odds of fatalistic beliefs increased, OR (95%) = 1.042 (1.022, 1.062). When education level increased, the odds of fatalistic beliefs decreased, OR (95%) = 0.873 (0.800, 0.952). Conclusions: Given the high occurrence of depression, anxiety, and fatalistic beliefs among this population, health care providers should assess for underlying mental health diagnoses and psychological distress during each patient encounter and provide recommendations to address them.

Original languageEnglish
Pages (from-to)382-390
Number of pages9
JournalJournal of Rural Health
Issue number2
StatePublished - Mar 1 2022

Bibliographical note

Publisher Copyright:
© 2021 National Rural Health Association.


  • Appalachian
  • Pap screening
  • abnormal Pap results
  • cervical cancer
  • psychological factors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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