Predicting intentions to obtain a Pap smear among African American and Latina women: Testing the theory of planned behavior

Objective: To determine the empirical adequacy of the theory of planned behavior (TPB) to explain Pap smear use intentions in African American and Latina women. Method: A correlational design was used, and a convenience sample of 108 African American and 96 Latina adult women were recruited from urban community-based agencies located in a large mid-Atlantic metropolitan area. The Pap Smear Questionnaire (PSQ) was designed and used. The Demographic Assessment Survey collected demographic information (age and socioeconomic status for both groups; and level of acculturation for the Latinas). Results: Direct relationships between attitude and perceived behavioral control and intention to obtain an annual Pap smear were found for African American and Latina women. The subjective norm did not significantly predict intention. Attitude (beta = .58; p < .001) provided the best explanation of intention among African American women to obtain an annual Pap smear, followed by perceived behavioral control (beta = .30; p < .001). Among Latinas, the findings reflected those of the African American sample. However, attitude (beta = .40; p < .001) and perceived behavioral control (beta = .35, p < .001) were weighted similarly. The external variables of age and income had indirect effects on intention for,African American and Latina women, respectively. Conclusion: The study findings did not support the empirical adequacy of the TPB for either of the ethnic groups. Future studies should test a modified version of the TPB that includes measures of both social support and subjective norms. Direct measure items of subjective norm, group-specific measures of perceptions of control, and other measures of acculturation should be added to the PSQ and further tested.