Date of Graduation

Spring 5-20-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Dena Cuyjet



Background: While the incidence of cervical cancer in the US has significantly decreased due to the utilization of vaccination and screening tests, Asian, Native Hawaiian, and other Pacific Islander women consistently have the lowest rate of cervical cancer screening, making them at risk for undetected cervical cancer disease.

Problem: The low cervical cancer screening uptake can be attributed to a knowledge deficit about cervical cancer and its screening and the importance of early detection. Being an immigrant and with limited English proficiency can hinder women of Asian, Native Hawaiian, and other Pacific Islander from getting screened for cervical cancer.

Methods: A quality improvement project was implemented at a primary care clinic in Waipahu, Hawaii, using 5-step process interventions.

Interventions: A linguistically and culturally tailored educational material that discussed cervical cancer and its screening was integrated into 5-step process interventions. Bilingual videos and reading materials such as pamphlets & posters were heavily utilized. The multilingual staff and providers were assigned a specific task.

Results: A increase rate of 272.73 % in the number of women who completed Pap smear within two months of interventions, and the rate of participation for pap smear was 78.8%. The increase in knowledge and perception before & after pap smear was statistically significant at p = < 0.001, with one-sided and two-sided p.

Conclusions: Culturally tailored healthcare interventions using multimedia and multilingual providers' participation increases knowledge and participation of minority women in cervical cancer screening.

Keywords: culturally tailored interventions, cervical cancer, cervical cancer screening, minority ethnic group, culturally tailored education