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Interactive Model of Client Health Behavior and Cervical Cancer Screening of African-American Women


Kelly Ackerson, Bronson School of Nursing, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008-5345. E-mail:


ABSTRACT Objective: Explore inductively African American women's use of Pap smear screening services and consider how well the data did or did not affirm the usefulness of the interaction model of client health behavior (IMCHB).

Design and Sample: The IMCHB guided this qualitative study designed to explore women's social influence and previous health care experience and their influence on the women's cognitive appraisal associated with Pap smears and cervical cancer. Interviews were conducted with 24 women, resulting in 2 groups: routine-use (n=11) (Pap smears every 1–3 years) and non-routine-use (n=13).

Measures: Content analysis approach to data analysis was used, where interview data were considered in relation to elements of IMCHB.

Results: Analysis revealed that the IMCHB was useful for framing cervical cancer screening health behavior research. Both groups' data fit well onto the framework. The routine-use group fit the entire model, with iterative (repeat) behavior in cervical cancer screening. The non-routine-use group also fit the model, but their iterative behavior in cervical cancer screening was intermittent due to negative personal influences.

Conclusions: This model can provide a focus to the delivery of gynecological care based on a client's unique characteristics that can be addressed with individualized nursing interventions designed to promote positive health outcomes.

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