Addressing cervical cancer disparities among American Indian women: Implementing an educational module for healthcare providers

Allison EvelyN Peltier
Nursing, North Dakota State University
June, 2016


Many minority populations throughout the United States experience significant cancer-related disparities affecting their quality of life. American Indians represent one group of individuals who experience significant disparities in cancer screening, treatment, and health outcomes (Horowitz, 2012). Although effective screening exists, American Indian women are disproportionately affected by cervical cancer compared to other demographic groups. In relation to cervical cancer, American Indian women experience a higher prevalence, a more rapidly rising incidence, and higher mortality rates, which may be related to an interplay of unique risk factors, barriers in healthcare access, and cultural influences on health seeking behaviors (Schmidt-Grimminger et al., 2011). While primary care providers have an opportunity to reduce health disparities, significant gaps exist related to awareness of cervical cancer disparities among American Indian women (Rogers & Cantu, 2008). Many healthcare providers do not routinely discuss cervical cancer screening recommendations with American Indian patients and feel their inadequate understanding of cultural beliefs serves as a barrier to increasing discussions about cervical cancer (Jim et al., 2012). Enhancing healthcare providers' knowledge of cervical cancer disparities may help facilitate the provision of culturally competent care and improve the quality of care for American Indian women. Based on the need for enhanced awareness of cervical cancer disparities among American Indian women, a continuing education module was developed in collaboration with the American Association of Nurse Practitioners Continuing Education Center. The module incorporated information on American Indian culture, contributing factors to cervical cancer, and barriers to healthcare experienced by the population. The module was evaluated through pretest, posttest, and evaluation questions. Data were collected for approximately three months with a total of 203 participants. After completing the module, nearly half of the participants (48.5%; n = 99) reported they planned to modify their practice, and approximately 71.5% (n = 145) of the participants planned to discuss screening recommendations routinely or often. Six pretest and posttest content-related questions demonstrated learning occurred as a result of the module. Overall, the results indicate the continuing education module had a positive impact on the participants and enhanced their awareness of cervical cancer disparities among American Indian women.