Background and Design of the Community Awareness Resources and Education (CARE) Project: Reducing Cervical Cancer in Appalachia

ObjectiveThe Community Awareness Resources and Education (CARE) project: Reducing Cervical Cancer in Appalachia is part of the NIH Centers for Population Health and Health Disparities initiative. It aims to increase screening rates for cervical cancer, to assist in tobacco cessation, and to determine the role of human papillomavirus (HPV) in contributing to the increased risk of cervical cancer. MethodsEligible subjects were recruited from 14 clinics in Appalachian Ohio. CAREs cross sectional survey (CS) (571 participants) characterized social, behavioral, and environmental factors of Pap smear screening and smoking. The intervention projects tested programs to increase Pap smear screening (280 participants) or aid in smoking cessation (300 participants). A case control study (1360 participants) assessed social, behavioral, and biologic predictors of abnormal Pap tests. ResultsThe CS participants tended to be younger, more educated, and were more likely to be employed than the general population of Appalachian women 18 and over. They were similar to the other samples in terms of race, marital status, income level and smoking status. ConclusionsCARE will provide valuable information about the multi-level barriers to obtaining regular Pap smears and quitting smoking, as well as help to identify important biological and social risk factors related to abnormal Pap smears.