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Abstract：
Cervical cancer screening guidelines in the United States were revised in 2018 to include the option of primary human papillomavirus (HPV) testing. The transition to this screening method may face difficulties as Pap testing has been the primary screening modality in the United States. The objective of this study is to assess information, motivation, and behavioral skills associated with willingness to receive an HPV test instead of a Pap test among women. The sample included U.S. 812 women, ages 30 to 65 years. Participants completed an online survey in 2018. The Information, Motivation, and Behavioral Skills (IMB) model was used to measure predictors of willingness for HPV testing. The outcome variables were willingness to receive the HPV test instead of the Pap test, with and without time interval details. Logistic regression modeling was used with SAS 9.4. Over half of the sample (55%) were willing to receive the HPV test. For the information domain, HPV knowledge was significantly associated with willingness for HPV testing (OR = 1.08, 95%CI 1.04-1.13). Significant motivating factors included: positive attitudes, social norms, perceived benefits, worry about cervical cancer, and worry about abnormal HPV tests. For behavioral skills, women were significantly more willing to get the HPV test if a provider recommended it (OR = 2.43, 95%CI 1.53-3.87) and currently up-to-date on cervical cancer screening guidelines (OR = 1.52, 95%CI 1.52-2.26). Addressing barriers and facilitators to willingness to transition to primary HPV testing over Pap testing is needed as the United States has updated guidelines for cervical cancer screening.
摘要：
美国的宫颈癌筛查指南在2018年进行了修订，以包括原发性人乳头瘤病毒（HPV）检测的选项。由于巴氏试验一直是美国的主要筛查方式，因此向这种筛查方法的过渡可能面临困难。这项研究的目的是评估信息，动机，以及与女性接受HPV检测而不是巴氏检测的意愿相关的行为技能。样本包括美国812名女性，年龄30至65岁。参与者在2018年完成了一项在线调查。信息,动机,和行为技能（IMB）模型用于测量HPV检测意愿的预测因子。结果变量是愿意接受HPV测试而不是Pap测试，有和没有时间间隔细节。采用SAS9.4进行Logistic回归建模。超过一半的样本（55％）愿意接受HPV检测。对于信息域，HPV知识与HPV检测意愿显著相关(OR=1.08,95CI1.04-1.13)。重要的激励因素包括：积极的态度，社会规范,感知到的好处，担心宫颈癌，担心HPV检测异常。对于行为技能，如果提供者推荐HPV检测(OR=2.43,95CI1.53~3.87),并且目前符合最新的宫颈癌筛查指南(OR=1.52,95CI1.52~2.26),女性更愿意接受HPV检测.由于美国更新了宫颈癌筛查指南，因此需要解决障碍和促进者愿意过渡到Pap检测的主要HPV检测。
