Access to community-controlled indigenous primary health organizations may account for some of the higher Pap test uptake among Aboriginal and Torres Strait Islander women in North Queensland, Australia

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Oncol before. Jul 28, 2021; 11: 725145. doi: 10.3389 / fonc.2021.725145. Electronic collection 2021.

ABSTRACT

BACKGROUND: Aboriginal and Torres Strait Islander Community Controlled Health Organizations (ACCHO) provide culturally appropriate primary care to Aboriginal and Torres Strait Islander people in Australia. The North Queensland population has a higher proportion of Aboriginal and Torres Strait Islander, greater coverage of the ACCHO population, and greater uptake in cervical screening than the rest of Queensland. . The association between regional differences in the use of ACCHOs for cervical screening and variations in screening uptake among Aboriginal and Torres Strait Islander women is currently unknown.

METHODS: This is a population-based study of 1,107,233 women, aged 20 to 69 years who underwent cervical screening between 2013 and 2017. Of these women, 132,972 (12 %) were from North Queensland, of which 9% were identified as Indigenous and Torres Strait Islander Women (2% in the rest of Queensland) through linkage with hospital records. Regional screening differentials by Aboriginal and Torres Strait Islander status were quantified using participation rate ratios (PRRs) with 95% confidence intervals (CI) from models negative binomial regression. Logistic regression was used to identify factors associated with screening Aboriginal and Torres Strait Islander women in ACCHOs.

RESULTS: Aboriginal and Torres Strait Islander women of northern Queensland (vs) The rest of Queensland had higher odds of screening in ACCHOs after adjusting for age and area variables. After adjusting for non-ACCHO variables, the regional screening differential among Aboriginal and Torres Strait Islander women was significantly higher (PRR 1.28, 95% CI 1.20-1.37) than that among other australian women [PRR = 1.11 (1.02-1.18)], but was attenuated during an additional adjustment for the ACCHO variables, [PRR = 1.15, (1.03-1.28)] become similar to the corresponding point estimate for other Australian women [PRR = 1.09, (1.01-1.20)]. However, the significant interaction between status and the Aboriginal and Torres Strait Islander region (p health services for all women.

CONCLUSIONS: Improving access to primary health care for Aboriginal and Torres Strait Islander women, especially through ACCHOs, can reduce existing disparities in uptake of cervical screening. Further gains will require higher levels of local community engagement and understanding of the experiences of the Aboriginal and Torres Strait Islander women identified to inform effective interventions.

PMID: 34395296 | PMC: PMC8355598 | DOI: 10.3389 / fonc.2021.725145


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