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Prowse SR, Brazzelli M, Treweek S. What factors influence the uptake of bowel, breast and cervical cancer screening? An overview of international research. Eur J Public Health 2024; 34:818-825. [PMID: 38702983 PMCID: PMC11293835 DOI: 10.1093/eurpub/ckae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND For cancer screening programmes to be effective in early detection it is important that those invited can access screening services and understand the benefits of participation. A better understanding of the factors that matter to potential participants of cancer screening programmes can assist in developing strategies to increase current uptake. METHODS We conducted an overview of systematic reviews to answer the question: What factors influence the uptake of cancer screening services (breast, bowel and cervical) in high-income countries? A thematic approach supported by tabular summaries and qualitative heat maps was used to categorize factors, described as 'barriers' or 'facilitators'. RESULTS A total of 41 systematic reviews met the criteria for inclusion. The barrier with the greatest number of 'hot spots' across all three screening programmes was a fear of the unknown regarding a possible diagnosis of cancer or abnormal screening results, followed closely by a general lack of knowledge surrounding cancer screening programmes. The greatest collective facilitator to uptake was recommendation by a healthcare provider to attend screening. CONCLUSION Across all factors 'trust' and 'building trusted relationships' can be seen as integral to the success of cancer screening programmes and must be reflective of collaborative efforts to mitigate barriers and enhance facilitators to uptake. There is future scope to consider interventions that (i) increase demand for screening services, (ii) reduce barriers to uptake of services and/or (iii) are relevant to the healthcare system and those providing services.
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Affiliation(s)
- Sarah R Prowse
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
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2
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Iqbal N, Berstad P, Solbjør M, Diaz E, Czapka E, Hofvind S, Bhargava S. Access to colorectal cancer screening for Pakistani immigrants in Norway - a qualitative study. BMC Health Serv Res 2024; 24:799. [PMID: 38992652 PMCID: PMC11238370 DOI: 10.1186/s12913-024-11275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND The Norwegian colorectal cancer (CRC) screening program started in May 2022. Inequalities in CRC screening participation are a challenge, and we expect that certain groups, such as immigrants, are at risk of non-participation. Prior to the start of the national screening program, a pilot study showed lower participation rates in CRC screening among immigrants from Pakistan. These immigrants are a populous group with a long history in Norway and yet have a relatively low participation rate also in other cancer screening programs. The purpose of this study was to identify and explore perspectives and factors influencing CRC screening participation among immigrants from Pakistan in Norway. MATERIALS AND METHODS In this study we used a qualitative study design and conducted 12 individual interviews with Pakistani immigrants aged between 50 and 65 years. The participants varied in terms of gender, age, education, work, residence time in Norway and familiarity with the Norwegian language and culture. We performed thematic analysis with health literacy as a theoretical framework to understand Pakistani immigrants' perspectives on CRC screening. RESULTS We identified four main themes: Health-related knowledge, the health care system, screening, and social factors. Within these themes we identified several factors that affect Pakistani immigrants' accessibility to CRC screening. These factors included knowledge of the causes and development of cancer, sources of health-related information, the general practitioner's role, understanding of screening and the intention behind it, language skills and religious beliefs. CONCLUSION There are many factors influencing Pakistani immigrants' decision of participation in CRC screening. The roles of the general practitioner and adult children are particularly important. Key elements to improve accessibility to CRC screening and enable informed participation for Pakistani immigrants are measures that improve personal and organizational health literacy.
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Affiliation(s)
- Nadia Iqbal
- Cancer Registry of Norway, Norwegian Institute of Public Health, P.O. Box 5313, Majorstuen, Oslo, 0304, Norway.
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Paula Berstad
- Cancer Registry of Norway, Norwegian Institute of Public Health, P.O. Box 5313, Majorstuen, Oslo, 0304, Norway
| | - Marit Solbjør
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU - Norwegian University of Science and Technology, P.O. Box 8905, Trondheim, N-7491, Norway
| | - Esperanza Diaz
- Department of Global Public Health, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Elżbieta Czapka
- Department of Social Sciences, University of Gdańsk, Bażyńskiego 8, Gdańsk, 80-309, Poland
| | - Solveig Hofvind
- Cancer Registry of Norway, Norwegian Institute of Public Health, P.O. Box 5313, Majorstuen, Oslo, 0304, Norway
- Department of Health and Care Sciences, The Arctic University of Norway, P.O. Box 5313, Tromsø, 0304, Norway
| | - Sameer Bhargava
- Cancer Registry of Norway, Norwegian Institute of Public Health, P.O. Box 5313, Majorstuen, Oslo, 0304, Norway
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
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Tavakoli B, Feizi A, Zamani-Alavijeh F, Shahnazi H. Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies. BMC Womens Health 2024; 24:268. [PMID: 38678224 PMCID: PMC11055241 DOI: 10.1186/s12905-024-03096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/16/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND The variation in breast cancer incidence rates across different regions may reflect disparities in breast cancer screening (BCS) practices. Understanding the factors associated with these screening behaviors is crucial for identifying modifiable elements amenable to intervention. This systematic review aims to identify common factors influencing BCS behaviors among women globally. METHODS Relevant papers were sourced from PubMed, Scopus, Embase, and Google Scholar. The included studies were published in English in peer-reviewed journals from January 2000 to March 2023 and investigated factors associated with BCS behaviors. RESULTS From an initial pool of 625 articles, 34 studies (comprising 29 observational and 5 qualitative studies) with 36,043 participants were included. Factors influencing BCS behaviors were categorized into nine groups: socio-demographic factors, health status history, knowledge, perceptions, cultural factors, cues to action, motivation, self-efficacy, and social support. The quality appraisal scores of the studies ranged from average to high. CONCLUSIONS This systematic review highlights factors pivotal for policy-making at various levels of breast cancer prevention and assists health promotion professionals in designing more effective interventions to enhance BCS practices among women.
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Affiliation(s)
- Banafsheh Tavakoli
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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4
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Dumky H, Fridell K, Leifland K, Metsälä E. Breast cancer screening and immigrant women-A scoping review of attendance, knowledge, barriers and facilitators. Nurs Open 2023; 10:5843-5856. [PMID: 37259178 PMCID: PMC10416041 DOI: 10.1002/nop2.1865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 03/03/2023] [Accepted: 05/07/2023] [Indexed: 06/02/2023] Open
Abstract
AIM The aim of this study was to summarize the latest research reports about immigrant women and attendance in breast cancer screening. DESIGN Scoping review. METHODS Literature searches were made in CINAHL, PubMed, Web of Science, Google Scholar, Oatd and Oalster. Twenty-three articles were included in the study. Data were analysed with inductive content analysis. RESULTS Out of data four main categories were formed: attendance rates, incidence, barriers and facilitators, and knowledge and perception. The results show that attendance rates, barriers and facilitators for attendance, knowledge and experience of breast cancer and breast cancer screening differ between several factors such as the woman's migrant background, country of origin, religion, length of stay in the new home country and sociodemographic factors.
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Affiliation(s)
- Hanna Dumky
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - Kent Fridell
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | | | - Eija Metsälä
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
- Metropolia University of Applied SciencesMetropoliaFinland
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5
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Le Bonniec A, Sun S, Andrin A, Dima AL, Letrilliart L. Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1115-1142. [PMID: 35705780 DOI: 10.1007/s11121-022-01388-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
Screening is an essential prevention practice for a number of health conditions. However, screening coverage remains generally low. Studies that investigate determinants of screening participation are becoming more common, but oftentimes investigate screening for health conditions in an individualized rather than integrated fashion. In routine clinical practice, however, healthcare professionals are often confronted with situations in which several screening procedures are recommended for the same patient. The consideration of their common determinants may support a more integrated screening approach. The objectives of this umbrella review were therefore to examine: 1) the determinants (barriers and facilitators) that have been identified in relation to recommended health screening procedures; and 2) the modifiable determinants (in primary care) common across health conditions or specific to individual procedures. Results were presented through a narrative synthesis. PubMed, PsycInfo and Cochrane were searched up to January 2022. Systematic reviews reporting determinants of participation in health screening procedures with grade A or B recommendation according to the US Preventive Services Task Force were included. A total of 85 systematic reviews were included, most which contained both qualitative and quantitative studies on determinants that describe individual factors (961 occurrences), social factors (113 occurrences, healthcare professional factors (149 occurrences), health system factors (105 occurrences) and screening procedure factors (99 occurrences). The most studied screening procedures concerned cervical cancer/human papillomavirus (n = 33), breast cancer (n = 28), colorectal cancer (n = 25) and the human immunodeficiency virus (n = 12). Other conditions have been under-studied (e.g. cardiovascular problems, lung cancer, syphilis). The individual domain, including determinants such as knowledge, beliefs and emotions, was the most covered across health conditions. Healthcare professional's recommendations and the quality of patient-provider communication were identified to have a strong influence on screening participation in most conditions. The other three domains included determinants which were more specific to a condition or a population. Various determinants modifiable in primary care were found in the individual domain and in the health system, healthcare professional and screening procedure domains. Quality was assessed as low for most systematic reviews included. The identification of various modifiable determinants common across conditions highlights the potential of an integrated screening participation approach. Interventions may address common determinants in a broader person-centred framework within which tailoring to specific procedures or populations can be considered. This approach needs to be explored in intervention studies. The systematic review registration is PROSPERO CRD42019126709.
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Affiliation(s)
- Alice Le Bonniec
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France.
| | - Sophie Sun
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Collège Universitaire de Médecine Générale, Université Claude Bernard Lyon 1, Lyon, France
| | - Amandine Andrin
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université Lumière Lyon 2, Lyon, France
| | - Alexandra L Dima
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurent Letrilliart
- Research On Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Collège Universitaire de Médecine Générale, Université Claude Bernard Lyon 1, Lyon, France
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Poppleton A, Howells K, Adeyemi I, Chew‐Graham C, Dikomitis L, Sanders C. The perceptions of general practice among Central and Eastern Europeans in the United Kingdom: A systematic scoping review. Health Expect 2022; 25:2107-2123. [DOI: 10.1111/hex.13433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Aaron Poppleton
- Centre for Primary Care and Health Services Research University of Manchester Manchester UK
- School of Medicine Keele University Keele UK
- NIHR Greater Manchester Patient Safety Translational Research Centre (GM‐PSTRC) Manchester UK
| | - Kelly Howells
- Centre for Primary Care and Health Services Research University of Manchester Manchester UK
| | - Isabel Adeyemi
- Centre for Primary Care and Health Services Research University of Manchester Manchester UK
| | | | - Lisa Dikomitis
- Kent and Medway Medical School University of Kent and Canterbury Christ Church University Canterbury UK
| | - Caroline Sanders
- Centre for Primary Care and Health Services Research University of Manchester Manchester UK
- NIHR Greater Manchester Patient Safety Translational Research Centre (GM‐PSTRC) Manchester UK
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7
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Racine L, Andsoy I, Maposa S, Vatanparast H, Fowler-Kerry S. Examination of Breast Cancer Screening Knowledge, Attitudes, and Beliefs among Syrian Refugee Women in a Western Canadian Province. Can J Nurs Res 2021; 54:177-189. [PMID: 34038264 PMCID: PMC9109584 DOI: 10.1177/08445621211013200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Women living in the Arab world present low breast cancer screening rates,
delayed diagnosis, and higher mortality rates. Purpose To further explore the Muslim Syrian refugee women’s breast self-examination
(BSE), utilization of clinical breast examination (CBE) and mammography. Methods A cross-sectional descriptive exploratory study design was used. The sample
consisted of 75 refugee women. Data were collected using Champion’s Health
Belief Model Scale, the Cancer Stigma Scale, and the Arab Culture-Specific
Barriers to Breast Cancer Questionnaire. Descriptive, Pearson correlation
and logistic regression analyses were used to analyze the data. Results A minority of women had BSE (32%), CBE (12%) and mammograms (6.7%) anytime
during their lifetime. Women’s breast cancer screening (BCS) knowledge
ranked at a medium level (M = 10.57, SD = 0.40). Low knowledge score, BSE
information, policy opposition, responsibility, barriers to BSE, and
seriousness were found to be statistically significant in women’s BSE
practice. BSE benefits and religious beliefs significantly predict CBE Age,
education, knowledge, responsibility, susceptibility, social barriers, and
religious beliefs were statistically significant in women’s mammography use
(p < .01). Conclusions Participants’ breast cancer screening practices were low. Health beliefs,
Arab culture and stigma about cancer affected women’s BCS practices.
Faith-based interventions may improve knowledge and practices.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Isil Andsoy
- Department of Nursing, Karabuk University, Karabuk, Turkey
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8
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Emami L, Ghahramanian A, Rahmani A, Mirza Aghazadeh A, Onyeka TC, Nabighadim A. Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices. Nurs Open 2021; 8:890-899. [PMID: 33570277 PMCID: PMC7877223 DOI: 10.1002/nop2.696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/28/2020] [Accepted: 10/29/2020] [Indexed: 12/26/2022] Open
Abstract
AIM This study sought to investigate the beliefs, fear and awareness about breast cancer and mammography screening practices of women in Iran. METHODS This descriptive-correlational study was conducted at Tabriz, East Azerbaijan Province, northwest of Iran from February-July 2017. One hundred and fifty-two women aged 40 years and older, who were referred to 12 health centres for health services were selected via clustering sampling. Associations between variables and mammography screening practices were examined using bivariate and multivariate logistic regression analyses. Participants who had a mammogram within the last 24 months were compared with those who had none. Sociodemographic questionnaire, Champion's Breast Cancer Fear Scale, Champion's Health Belief Model Scale for Mammography Screening, Breast Cancer Awareness Scale and Powe Fatalism Inventory were the tools used for data gathering. RESULTS Just 38.2% of women reported having a mammogram within the last 24 months. Self-efficacy (OR = 5.36, B = 1.68, p < .001), susceptibility (OR = 2.83, B = 1.04, p < .001), motivation (OR = 2.11, B = 0.75, p = .024) and lower perceived barriers (OR = 0.25, B = -1.37, p < .001) were associated with being screened. Neither fatalistic belief nor awareness towards breast cancer was significant.
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Affiliation(s)
- Lida Emami
- Medical Surgical Department, Nursing and Midwifery FacultyIslamic Azad UniversityBonab BranchBonabIran
| | - Akram Ghahramanian
- Medical and Surgical Department, Nursing and Midwifery Faculty, Hematology and Oncology Research CenterTabriz University of Medical SciencesTabrizIran
| | - Azad Rahmani
- Medical Surgical Department, Nursing and Midwifery FacultyTabriz University of Medical SciencesTabrizIran
| | - Ahmad Mirza Aghazadeh
- Department of Basic sciencesParamedical FacultyTabriz University of Medical SciencesTabrizIran
| | - Tonia C. Onyeka
- Department of Anaesthesia/Pain & Palliative Care UnitMultidisciplinary Oncology CentreCollege of MedicineUniversity of NigeriaItuku‐Ozalla CampusEnuguNigeria
| | - Amirreza Nabighadim
- Department of UrologyUro‐Oncology Research CenterTehran University of Medical SciencesTehranIran
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9
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Sacca L, Markham C, Fares J. Using Intervention Mapping to Develop Health Education and Health Policy Components to Increase Breast Cancer Screening and Chemotherapy Adherence Among Syrian and Iraqi Refugee Women in Beirut, Lebanon. Front Public Health 2020; 8:101. [PMID: 32351923 PMCID: PMC7174686 DOI: 10.3389/fpubh.2020.00101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 03/12/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Despite the continuous increase in the incidence of metastatic breast cancer among Syrian and Iraqi refugee women residing in camp settings in Lebanon, mammography and chemotherapy adherence rates remain low due to multiple social, economic, and environmental interfering factors. This in turn led to an alarming increase in breast cancer morbidity and mortality rates among the disadvantaged population. Methods: Intervention mapping, a systematic approach which guides researchers and public health experts in the development of comprehensive evidence-based interventions (EBIs) was used to plan a health education and health policy intervention to increase breast cancer screening and chemotherapy adherence among Iraqi and Syrian refugee women aged 30 and older who are residing in refugee camps within the Beirut district of Lebanon. Results: The generation of the logic model during the needs assessment phase was guided by an extensive review of the literature and reports published in peer-reviewed journals or by international/local organizations in the country to determine breast cancer incidence and mortality rates among refugee women of Syrian and Iraqi nationalities. The underlying behavioral and environmental determinants of the disease were identified from qualitative and quantitative studies carried out among the target population and also aided in assessing the sub-behaviors related to the determinants of breast cancer screening and chemotherapy completion as well as factors affecting policy execution to formulate performance objectives. We then developed matrices of change objectives and their respective methods and practical applications for behavior change at the intrapersonal, interpersonal, organizational, and societal levels. Both educational components (brochures, flyers) and technological methods (videos disseminated via Whats app and Facebook) will be adopted to apply the different methods selected (modeling, self-reevaluation, consciousness raising, persuasion, and tailoring). We also described the development of the educational and technological tools, in addition to providing future implementers with methods for pre-testing and pilot-testing of individual and environmental prototype components. Conclusion: The use of intervention mapping in the planning and implementation of holistic health promotion interventions based on information collected from published literature, case reports, and theory can integrate the multiple disciplines of public health to attain the desired behavioral change.
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Affiliation(s)
- Lea Sacca
- The University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion and Behavioral Sciences, Houston, TX, United States
| | - Christine Markham
- The University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion and Behavioral Sciences, Houston, TX, United States
| | - Johny Fares
- The University of Texas MD Anderson Cancer Center, Department of Infectious Disease, Infection Control, and Employee Health, Houston, TX, United States
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10
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Brzoska P, Aksakal T, Yilmaz-Aslan Y. Utilization of cervical cancer screening among migrants and non-migrants in Germany: results from a large-scale population survey. BMC Public Health 2020; 20:5. [PMID: 31906964 PMCID: PMC6945536 DOI: 10.1186/s12889-019-8006-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Studies from European and non-European countries have shown that migrants utilize cervical cancer screening less often than non-migrants. Findings from Germany are inconsistent. This can be explained by several limitations of existing investigations, comprising residual confounding and data which is restricted to only some regions of the country. Using data from a large-scale and nationwide population survey and applying the Andersen Model of Health Services Use as the theoretical framework, the aim of the present study was to examine the role that different predisposing, enabling and need factors have for the participation of migrant and non-migrant women in cervical cancer screening in Germany. METHODS We used data from the 'German Health Update 2014/2015' survey on n = 12,064 women ≥20 years of age. The outcome of interest was the participation in cancer screening (at least once in lifetime vs. no participation). The outcome was compared between the three population groups of non-migrants, migrants from EU countries and migrants from non-EU countries. We employed multivariable logistic regression to examine the role of predisposing, enabling and need factors. RESULTS Non-EU and EU migrant women reported a lower utilization of cervical cancer screening (50.1 and 52.7%, respectively) than non-migrant women (57.2%). The differences also remained evident after adjustment for predisposing, enabling and need factors. The respective adjusted odds ratios (OR) for non-EU and EU migrants were OR = 0.67 (95%-CI = 0.55-0.81) and OR = 0.80 (95%-CI = 0.66-0.97), respectively. Differences between migrants and non-migrants were particularly pronounced for younger age groups. Self-rated health was associated with participation in screening only in non-migrants, with a poorer health being indicative of a low participation in cancer screening. CONCLUSIONS The disparities identified are in line with findings from studies conducted in other countries and are indicative of different obstacles this population group encounters in the health system. Implementing patient-oriented health care through diversity-sensitive health services is necessary to support informed decision-making.
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Affiliation(s)
- Patrick Brzoska
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Tuğba Aksakal
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
- Bielefeld University, School of Public Health, Department of Epidemiology & International Public Health, 33501 Bielefeld, Germany
| | - Yüce Yilmaz-Aslan
- Bielefeld University, School of Public Health, Department of Epidemiology & International Public Health, 33501 Bielefeld, Germany
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11
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Grimley CE, Kato PM, Grunfeld EA. Health and health belief factors associated with screening and help-seeking behaviours for breast cancer: A systematic review and meta-analysis of the European evidence. Br J Health Psychol 2019; 25:107-128. [PMID: 31876992 DOI: 10.1111/bjhp.12397] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 10/28/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this systematic review was to identify health or health belief factors associated with mammography attendance or with self-initiated medical help-seeking for breast cancer symptoms among women in Europe. METHODS Five databases were searched for articles published between 2005 and 2018. Meta-analyses were conducted for 13 factors related to screening attendance and two factors associated with help-seeking behaviour. Where there were too few studies to include in the meta-analysis, a narrative synthesis was undertaken. RESULTS Sixty-five studies were included. Never having had cervical screening (d = -.72, p < .001) and higher perceived barriers to mammography (d = -.40, p < .001) were associated with lower levels of screening attendance. Possessing health insurance (d = .49, p < .001), greater perceived benefits (d = .31, p < .001) and motivation (d = .36, p = .003) towards screening, and higher perceived seriousness (d = .24, p = .019) and susceptibility (d = .20, p = .024) towards breast cancer were associated with a higher level of screening attendance. Presenting with a non-lump symptom was associated with a longer time to presentation (d = .32, p < .001). The narrative synthesis revealed that previous benign breast disease was associated with a higher level of screening attendance but with a longer time to presentation. CONCLUSIONS The review identified key similarities in factors associated with screening and help-seeking behaviours which offer scope for combined interventions aimed at women that target both behaviours. Furthermore, the review highlighted that fewer studies have focused on help-seeking behaviour, despite two thirds of breast cancer cases being self-detected. Future research should further examine predictors of help-seeking behaviour including a focus on modifiable factors, such as BMI, and physical activity.
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Affiliation(s)
| | - Pamela M Kato
- P. M. Kato Consulting, Mountain View, California, USA
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Birkbeck College, University of London, UK
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12
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Bell S, Edelstein M, Zatoński M, Ramsay M, Mounier-Jack S. 'I don't think anybody explained to me how it works': qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England. BMJ Open 2019; 9:e028228. [PMID: 31289079 PMCID: PMC6615777 DOI: 10.1136/bmjopen-2018-028228] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services. DESIGN A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HCWs) involved in vaccination in areas with large Polish and Romanian communities. CMs discussed their vaccination attitudes and their experiences of accessing vaccinations in England. HCWs shared their experiences in vaccinating Polish and Romanian communities. SETTING Recruitment focused on three geographical areas in England with large Polish and Romanian populations (in London, Lincolnshire and Berkshire). PARTICIPANTS 20 Polish and 10 Romanian CMs, and 20 HCWs. Most CMs were mothers or pregnant women and were recruited from London or Lincolnshire. HCWs included practice nurses, health visitors and school nurses recruited from the targeted geographical areas. RESULTS Although most CMs reported vaccinating according to the UK schedule, obstacles to vaccination were highlighted. CMs experienced difficulties navigating and trusting the English primary healthcare system, and challenges in accessing credible vaccination information in Polish and Romanian. CM vaccination expectations, largely built on knowledge and experiences from Poland and Romania, were often unmet. This was driven by differences in vaccination scheduling and service provision in England, such as nurses delivering vaccines instead of doctors. CMs reported lower acceptance of the influenza vaccine, largely due to perceptions around the importance and efficacy of this vaccine. HCWs reported challenges translating and understanding vaccination histories, overcoming verbal communication barriers and ensuring vaccination schedule completeness among families travelling between England and Poland or Romania. CONCLUSIONS This study identified vaccination uptake and delivery issues and recommendations for improvement. HCWs should discuss health service expectations, highlight differences in vaccination scheduling and delivery between countries, and promote greater understanding of the English primary healthcare system in order to encourage vaccination in these communities.
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Affiliation(s)
- Sadie Bell
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael Edelstein
- Department of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UK
| | | | - Mary Ramsay
- Department of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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13
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Bener A, Barışık CC, Acar A, Özdenkaya Y. Assessment of the Gail Model in Estimating the Risk of Breast Cancer: Effect of Cancer Worry and Risk in Healthy Women. Asian Pac J Cancer Prev 2019; 20:1765-1771. [PMID: 31244298 PMCID: PMC7021593 DOI: 10.31557/apjcp.2019.20.6.1765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background: There has been substantial interest in developing methods to predict the risk of breast cancer.
The Gail model is one the first model have been widely used to identify women at higher risk of breast cancer. Aim: This
study aimed to determine the 5-year and the general life-time risk of breast cancer and also to determine breast cancer
predictors in women using the Gail model. Methods: We used the Gail model to estimate the risk of breast cancer
in female Turkish outpatients aged above 35 years in this cross-sectional study. Age, life-style habits, breast-feeding
duration, family history of breast cancer, and body mass index were compared between high and low-risk subjects.
We have performed the Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item
(GAD-7) tools on patients regarding depression and anxiety. We also assessed the association of these covariates with
the estimated risk of breast cancer in multivariate linear regression analysis. Results: We enrolled 1065 subjects with
a mean age of 52.9 ± 8.4 years. The mean of the five-year risk for breast cancer was 1.33%±0.6. Meanwhile, the mean of
lifetime risks for breast cancer was 10.15%±3.18, respectively. Nearly one-third of the participants had one child,
55.9% had breast-fed their children more than six months. Meanwhile, 18.5% of the subjects had a high depression
score, 15.2% had a high anxiety score. Higher age, age at first birth, and parity; lower age at menarche; presence of
menopause and family history of breast cancer were higher in the high-risk group. Higher age, and age at first birth;
lower age at menarche; family history of breast cancer, presence of menopause, and parity were independently associated
with higher breast cancer risk. Conclusion: We identified certain risk factors for breast cancer in our study population
and Gail model is a reliable and useful breast cancer risk prediction model for clinical decision-making. This study
contributes to the body of evidence in order to facilitate early detection and better plan for possible malignancies in
Turkish population.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey. ,Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.,Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
| | - Cem Cahit Barışık
- Department of Radiology and Pathology, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ahmet Acar
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey.
| | - Yaşar Özdenkaya
- Department of Surgery, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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14
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Lemogne C, Turinici M, Panjo H, Ngo C, Canoui‐Poitrine F, Chauvet‐Gelinier J, Limosin F, Consoli SM, Goldberg M, Zins M, Ringa V. Personality and breast cancer screening in women of the GAZEL cohort study. Cancer Med 2018; 7:515-524. [PMID: 29277970 PMCID: PMC5806114 DOI: 10.1002/cam4.1268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/25/2017] [Accepted: 10/19/2017] [Indexed: 12/24/2022] Open
Abstract
The potential benefit of breast cancer screening is mitigated by the risk of false positives and overdiagnosis, thus advocating for a more personalized approach, based on the individual benefit-harm balance. Since personality might influence the women's appraisal of this balance, this prospective observational cohort study examined whether it could influence mammography use. A total of 2691 postmenopausal women of the GAZEL Cohort Study completed the Bortner Type A Rating Scale and the Buss and Durkee Hostility Inventory in 1993. Associations between personality scores and subsequent mammography use, self-reported through up to five triennial follow-up questionnaires, were estimated with Odds Ratio (OR) and 95% confidence interval (CI) with logistic mixed model regressions, adjusting for age, occupational grade, marital status, family history of breast cancer, age at menarche, age at first delivery, gynecological follow-up, hormone therapy use, and depressive symptoms. Individual propensity scores were used to weight the analyses to control for potential selection biases. More than 90% of the participants completed at least two follow-up questionnaires. Type A personality, but not hostility, was associated with mammography use in both univariate (crude OR [95% CI]: 1.62 [1.24-2.11], P < 0.001) and multivariate analyses (OR [95% CI]: 1.46 [1.13-1.90], P < 0.01). Type A personality traits (i.e., sense of time urgency, high job involvement, competitiveness) independently predicted mammography use among postmenopausal women. While paying more attention to the adherence of women with low levels of these traits, clinicians may help those with higher levels to better consider the risks of false positives and overdiagnosis.
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Affiliation(s)
- Cédric Lemogne
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Monica Turinici
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Henri Panjo
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
| | - Charlotte Ngo
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Gynecologic Surgery DepartmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Florence Canoui‐Poitrine
- Public Health departmentHenri‐Mondor HospitalAP‐HPCréteilFrance
- UPEC, DHU A‐TVB, IMRB, EA7376 CEpiA (Clinical Epidemiology And Ageing)Paris‐Est UniversityF‐94000CréteilFrance
| | - Jean‐Christophe Chauvet‐Gelinier
- Psychiatry unitNeurosciences department, Marion buildingCHU Le BocageDijonFrance
- Laboratory of psychopathology and medical psychology (IFR 100)Bourgogne UniversityDijonFrance
| | - Frédéric Limosin
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Silla M. Consoli
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Marcel Goldberg
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Marie Zins
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Virginie Ringa
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
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15
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Badakhsh M, Balouchi A, Taheri S, Bouya S, Ahmadidarehsima S, Aminifard M. Attitude and Practice Regarding Breast Cancer Early Detection among Iranian Women: A Systematic Review. Asian Pac J Cancer Prev 2018; 19:9-16. [PMID: 29373873 PMCID: PMC5844641 DOI: 10.22034/apjcp.2018.19.1.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2017] [Indexed: 02/01/2023] Open
Abstract
Objectives: To determining attitudes and practice regarding breast cancer early detection techniques (breast self-examination (BSE), clinical breast examination (CBE) and mammography) among Iranian woman. Methods: International (PubMed, ISI, and Google Scholar) and national (SID and Magiran) databases were reviewed up to September 2017 to identify articles related to the attitudes and practices of Iranian women concerning breast cancer screening behavior with reference to BSE , CBE and mammography. The screening steps, analysis of quality of the studies and extraction of the papers were performed by two reviewers. Results: Of the 532 studies included initially, 21 performed on 10,521 people were considered eligible. Subjects with a positive attitude toward BSE in various studies were 13.5% to 94.0% with an average of 47.6%. Positive attitudes to CBE and mammography were found in 21.0% and 26.4%, respectively. Participant performance of BSE ranged from 2.6% to 84.7%, with an average of 21.9%. The respective figures for CBE and mammography were 15.8% and 16.7%. Conclusion: Considering the poor performance and low rates for positive attitudes, it is suggested that educational programs should be conducted across the country.
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Affiliation(s)
- Mahin Badakhsh
- Midwifery Department, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.
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16
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Brzoska P. Disparities in health care outcomes between immigrants and the majority population in Germany: A trend analysis, 2006-2014. PLoS One 2018; 13:e0191732. [PMID: 29360874 PMCID: PMC5779703 DOI: 10.1371/journal.pone.0191732] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 01/10/2018] [Indexed: 12/05/2022] Open
Abstract
Background Immigrants often encounter barriers in the health system that may affect their health care outcomes. In order to better cater to the needs of immigrants, many health care institutions have increased their efforts in recent years to provide services which are more sensitive to the needs of an increasingly diverse population. Little is known about whether these efforts are successful. This study examines difference in outcomes of tertiary prevention between immigrants and the autochthonous population in Germany over the period of 2006–2014. Methods The analysis is based on a 10% random sample of routine data on completed tertiary preventive treatments in Germany during 2006–2014. Four different indicators of treatment effectiveness were compared between patients with a nationality from Germany, Portugal/Spain/Italy/Greece, Turkey and Former Yugoslavia using logistic regression adjusted for demographic/socioeconomic factors. Interaction terms for year were modeled to examine group differences over time. Results Depending on the outcome, Turkish and Former Yugoslavian nationals had an 23%-69% higher chance of a poor treatment effectiveness than Germans (OR = 1.23 [95%-CI = 1.15,1.32] and OR = 1.69 [95%-CI = 1.55,1.83], respectively). Fewer differences were observed between nationals from Portugal/Spain/Italy/Greece and Germans. Disparities did not significantly differ between the years in which services were utilized. Conclusion Measures implemented by health care institutions did not reduce existing health care disparities between immigrants and the majority population in Germany. One potential reason is that existing approaches are unsystematic and often not properly evaluated. More targeted strategies and a thorough evaluation is needed in order to improve health care for immigrants sustainably.
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Affiliation(s)
- Patrick Brzoska
- Chemnitz Technical University, Faculty of Behavioral and Social Sciences, Chemnitz, Germany
- * E-mail:
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17
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Rosano A, Dauvrin M, Buttigieg SC, Ronda E, Tafforeau J, Dias S. Migrant's access to preventive health services in five EU countries. BMC Health Serv Res 2017; 17:588. [PMID: 28830423 PMCID: PMC5568253 DOI: 10.1186/s12913-017-2549-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/15/2017] [Indexed: 01/29/2023] Open
Abstract
Background Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants’ access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants’ access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Methods Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Results Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. Conclusions The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants’ access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination.
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Affiliation(s)
- Aldo Rosano
- Roman Academy of Public Health, Rome, Italy.,Department of Social Inclusion, National Institute for Public Policies Analysis, INAPP, Rome, Italy
| | - Marie Dauvrin
- Institute of Health and Society, Université catholique de Louvain, Louvain, Belgium
| | - Sandra C Buttigieg
- Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida, Malta
| | | | - Jean Tafforeau
- Scientific Institute of Public Health, Brussels, Belgium
| | - Sonia Dias
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
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18
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Bener A, Çatan F, El Ayoubi HR, Acar A, Ibrahim WH. Assessing Breast Cancer Risk Estimates Based on the Gail Model and Its Predictors in Qatari Women. J Prim Care Community Health 2017; 8:180-187. [PMID: 28606030 PMCID: PMC5932695 DOI: 10.1177/2150131917696941] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The Gail model is the most widely used breast cancer risk assessment tool. An accurate assessment of individual’s breast cancer risk is very important for prevention of the disease and for the health care providers to make decision on taking chemoprevention for high-risk women in clinical practice in Qatar. Aim: To assess the breast cancer risk among Arab women population in Qatar using the Gail model and provide a global comparison of risk assessment. Subjects and Methods: In this cross-sectional study of 1488 women (aged 35 years and older), we used the Gail Risk Assessment Tool to assess the risk of developing breast cancer. Sociodemographic features such as age, lifestyle habits, body mass index, breast-feeding duration, consanguinity among parents, and family history of breast cancer were considered as possible risks. Results: The mean age of the study population was 47.8 ± 10.8 years. Qatari women and Arab women constituted 64.7% and 35.3% of the study population, respectively. The mean 5-year and lifetime breast cancer risks were 1.12 ± 0.52 and 10.57 ± 3.1, respectively. Consanguineous marriage among parents was seen in 30.6% of participants. We found a relationship between the 5-year and lifetime risks of breast cancer and variables such as age, age at menarche, gravidity, parity, body mass index, family history of cancer, menopause age, occupation, and level of education. The linear regression analysis identified the predictors for breast cancer in women such as age, age at menarche, age of first birth, family history and age of menopausal were considered the strong predictors and significant contributing risk factors for breast cancer after adjusting for ethnicity, parity and other variables. Conclusion: The current study is the first to evaluate the performance of the Gail model for Arab women population in the Gulf Cooperation Council. Gail model is an appropriate breast cancer risk assessment tool for female population in Qatar.
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Affiliation(s)
- Abdulbari Bener
- 1 Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey.,2 University of Manchester, Manchester, UK.,3 Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
| | - Funda Çatan
- 1 Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey.,4 University of Nottingham, Nottingham, UK
| | - Hanadi R El Ayoubi
- 5 Al Amal Hospital, Hamad Medical Corporation, Qatar.,6 Hospital Saint Louis, Paris, France
| | - Ahmet Acar
- 1 Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey
| | - Wanis H Ibrahim
- 7 Hamad General Hospital, Weill-Cornell Medical College, Qatar
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19
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Increasing Breast Cancer Screening in Russian Immigrant Women: Identifying Barriers and Providing On-Site Mammography. J Dr Nurs Pract 2017; 10:71-78. [PMID: 32751045 DOI: 10.1891/2380-9418.10.1.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: There has been a significant decline in the use of mammography in the Russian immigrant population. Local Problem: Structural barriers to mammography include lack of or insufficient health insurance and distance to medical facilities. Organizational barriers include difficulty communicating with medical staff and navigating health care systems. The strongest mammography intervention is access. Methods: A Breast Health Tea event, small group discussions, and an on-site mammography event were held within this community to provide education about breast cancer and provide on-site screening mammography. Results: Twenty-seven women received the education and returned the questionnaires. Of these 27, 19 had mammograms. Of the 19, 16 had normal/benign results. Three required follow-up. Of the 3, 1 was positive for breast cancer, 1 was benign, and 1 went elsewhere. Conclusions: Providing access to on-site mammography has been shown to be an effective tool to reach communities that otherwise would not have access to these screenings. Advanced practice registered nurses can partner with public and private organizations and remove barriers to access for breast cancer screening in immigrant communities.
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20
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Keshinro A, Hatzaras I, Rifkind K, Dhage S, Joseph KA. The Impact of Primary Care Providers on Patient Screening Mammography and Initial Presentation in an Underserved Clinical Setting. Ann Surg Oncol 2016; 24:692-697. [PMID: 27766557 DOI: 10.1245/s10434-016-5618-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. METHODS We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis. Additional variables included race, age at diagnosis, family history of breast and ovarian cancer, and medical comorbidities. RESULTS Patients with a PCP received more mammograms (SMG) compared with patients without a PCP (61 vs. 37 %; p = 0.003). The majority (73 %) of patients without a PCP presented symptomatically with a palpable mass versus 42 % of patients with a PCP. A significant difference was noted with regard to final pathologic stage of breast cancer between the two groups (p = 0.019), and Caucasian and African American patients were more likely to have locally advanced breast cancer. CONCLUSIONS Underserved patients with a PCP are more likely to present asymptomatically and at an earlier stage of breast cancer compared with patients without a PCP. Community engagement programs that build relationships with patients may help bring vulnerable patients into the healthcare system for routine screening. Moreover, PCP education regarding the subtleties of breast cancer screening guidelines and referral to a breast specialist is also critical in improving outcomes of underserved patients.
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Affiliation(s)
- Ajaratu Keshinro
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Ioannis Hatzaras
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kenneth Rifkind
- Department of Surgery, NYU Langone Medical Center, NYU Lutheran Hospital, New York, NY, USA
| | - Shubhada Dhage
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA
| | - Kathie-Ann Joseph
- Department of Surgery, NYU Langone Medical Center, Bellevue Hospital Medical Center, New York, NY, USA.
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21
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Eichholzer M, Richard A, Rohrmann S, Schmid SM, Leo C, Huang DJ, Güth U. Breast cancer screening attendance in two Swiss regions dominated by opportunistic or organized screening. BMC Health Serv Res 2016; 16:519. [PMID: 27663642 PMCID: PMC5035496 DOI: 10.1186/s12913-016-1760-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/15/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In Switzerland, the French-speaking region has an organized breast cancer (BC) screening program; in the German-speaking region, only opportunistic screening until recently had been offered. We evaluated factors associated with attendance to breast cancer screening in these two regions. METHODS We analyzed the data of 50-69 year-old women (n = 2769) from the Swiss Health Survey 2012. Factors of interest included education level, place of residence, nationality, marital status, smoking history, alcohol consumption, physical activity, diet, self-perceived health, history of chronic diseases and mental distress, visits to medical doctors and cervical and colorectal cancer screening. Outcome measures were dichotomized into ≤2 years since most recent mammography versus >2 years or never. RESULTS In the German- and French-speaking regions, mammography attendance within the last two years was 34.9 % and 77.8 %, respectively. In the French region, moderate alcohol consumption (adjusted OR 2.01, 95 % CI 1.28-3.15) increased screening attendance. Compared to those with no visit to a physician during the recent year, women in both regions with such visits attended statistically significantly more often BC screening (1-5 times vs. no visit: German (adjusted OR 3.96, 95 % CI 2.58-6.09); French: OR 7.25, 95 % CI 4.04-13.01). Non-attendance to cervical screening had a negative effect in both the German (adjusted OR 0.44, 95 % CI 0.25-0.79) and the French region (adjusted OR 0.57, 95 % CI 0.35-0.91). The same was true for colorectal cancer screening (German (adjusted OR 0.66, 95 % CI 0.52-0.84); French: OR 0.52, 95 % CI 0.33-0.83). No other factor was associated with BC screening and none of the tests of interaction comparing the two regions revealed statistically significant results. CONCLUSION The effect of socio-demographic characteristics, lifestyle, health factors and screening behavior other than mammography on non-attendance to BC screening did not differ between the two regions with mainly opportunistic and organized screening, respectively, and did not explain the large differences in attendance between regions. Other potential explanations such as public promotion of attendance for BC screening, physicians' recommendations regarding mammography participation or women's beliefs should be further investigated.
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Affiliation(s)
- Monika Eichholzer
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland.
| | - Aline Richard
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland
| | - Seraina M Schmid
- Department of Gynecology & Obstetrics, Spital Grabs, Spitalstrasse 44, CH-9472, Grabs, Switzerland.,Breast Center St. Gallen, Rorschacher Strasse 150, CH-9006, St.Gallen, Switzerland
| | - Cornelia Leo
- Department of Gynecology and Obstetrics, Kantonsspital Baden AG, Interdisciplinary Breast Centre, CH-5404, Baden, Switzerland
| | - Dorothy J Huang
- Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Spitalstrasse 21, CH-4031, Basel, Switzerland
| | - Uwe Güth
- Breast Center Zurich, Seefeldstrasse 214, CH-8008, Zurich, Switzerland
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22
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Khazaee-Pool M, Majlessi F, Montazaeri A, Pashaei T, Gholami A, Ponnet K. Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS). BMC Womens Health 2016; 16:40. [PMID: 27444675 PMCID: PMC4957322 DOI: 10.1186/s12905-016-0318-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors. METHODS A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested. RESULTS Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds. CONCLUSION The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies.
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Affiliation(s)
- Maryam Khazaee-Pool
- />Department of Health Education and Promotion, School of Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fereshteh Majlessi
- />Department of Health Education and Promotion, School of Health, Tehran University of Medical Sciences, P.O. Box 15875-6951, Tehran, Iran
| | - Ali Montazaeri
- />Mental Health Research Group, Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Tahereh Pashaei
- />Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Gholami
- />Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
- />Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Koen Ponnet
- />Department of Communication Studies and Sociology, University of Antwerp, Antwerp, Belgium
- />Higher Institute for Family Sciences, Odisee, Brussels, Belgium
- />Antwerp Maritime Academy, Antwerp, Belgium
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23
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Vahabi M, Lofters A, Kumar M, Glazier RH. Breast cancer screening disparities among immigrant women by world region of origin: a population-based study in Ontario, Canada. Cancer Med 2016; 5:1670-86. [PMID: 27105926 PMCID: PMC4944895 DOI: 10.1002/cam4.700] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/05/2016] [Accepted: 02/08/2016] [Indexed: 12/12/2022] Open
Abstract
Rates of mammography screening for breast cancer are disproportionately low in certain subgroups including low-income and immigrant women. The purpose of the study was to examine differences in rates of appropriate breast cancer screening (i.e., screening mammography every 2 years) among Ontario immigrant women by world region of origin and explore the association between appropriate breast cancer screening among these women groups and individual and structural factors. A cohort of 183,332 screening-eligible immigrant women living in Ontario between 2010 and 2012 was created from linked databases and classified into eight world regions of origin. Appropriate screening rates were calculated for each region by age group and selected sociodemographic, immigration, and healthcare-related characteristics. The association between appropriate screening across the eight regions of origin and selected sociodemographic, immigration, and health-related characteristics was explored using multivariate Poisson regression. Screening varied by region of origin, with South Asian women (48.5%) having the lowest and Caribbean and Latin American women (63.7%) the highest cancer screening rates. Factors significantly associated with lower screening across the world regions of origin included living in the lowest income neighborhoods, having a refugee status, being a new immigrant, not having a regular physical examination, not being enrolled in a primary care patient enrollment model, having a male physician, and having an internationally trained physician. Multiple interventions entailing cross-sector collaboration, promotion of patient enrollment models, community engagement, comprehensive and intensive outreach to women, and knowledge translation and transfer to physicians should be considered to address screening disparities among immigrant population. Consideration should be given to design and delivery of culturally appropriate and easily accessible cancer screening programs targeted at high- risk immigrant subgroups, such as women of South Asian origin, refugees, and new immigrants.
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Affiliation(s)
- Mandana Vahabi
- Faculty of Community ServicesDaphne Cockwell School of NursingRyerson UniversityTorontoOntarioCanada
- Graduate Program in Immigration and Settlement StudiesRyerson UniversityTorontoOntarioCanada
- Ryerson Centre for Global Health and Health EquityTorontoOntarioCanada
| | - Aisha Lofters
- Centre for Research on Inner City HealthLi Ka Shing Knowledge InstituteSt. Michael's HospitalTorontoOntarioCanada
- Department of Family and Community MedicineUniversity of TorontoTorontoOntarioCanada
- Department of Family and Community MedicineSt. Michael HospitalTorontoOntarioCanada
- Institute for Clinical Evaluative SciencesTorontoOntarioCanada
| | - Matthew Kumar
- Institute for Clinical Evaluative SciencesTorontoOntarioCanada
| | - Richard H. Glazier
- Centre for Research on Inner City HealthLi Ka Shing Knowledge InstituteSt. Michael's HospitalTorontoOntarioCanada
- Department of Family and Community MedicineUniversity of TorontoTorontoOntarioCanada
- Department of Family and Community MedicineSt. Michael HospitalTorontoOntarioCanada
- Institute for Clinical Evaluative SciencesTorontoOntarioCanada
- Dalla, Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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Brzoska P, Abdul-Rida C. Participation in cancer screening among female migrants and non-migrants in Germany: A cross-sectional study on the role of demographic and socioeconomic factors. Medicine (Baltimore) 2016; 95:e4242. [PMID: 27472697 PMCID: PMC5265834 DOI: 10.1097/md.0000000000004242] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
In many European countries, migrants utilize cancer screening less often than non-migrants. In Germany, in contrast, higher rates of utilization among migrants as compared with non-migrants have been reported. The role of demographic and socioeconomic factors potentially confounding the association between migration status and participation in screening, however, could not be studied. The present study aims to investigate the utilization of cancer screening among migrant and nonmigrant women residing in Germany, adjusting for potential confounders.We used self-reported information from women surveyed on whether they have ever participated in screening for cancer (n = 11,709). The data was collected as part of a cross-sectional representative telephone survey conducted by the Robert Koch-Institute in 2010. We distinguished between three groups of women: (1) respondents of non-German nationality, those who had immigrated to Germany after their birth or those who have two foreign-born parents ("migrants with two-sided migration background"), (2) respondents who only have one foreign-born parent ("migrant with one-sided migration background"), and (3) all others ("non-migrants").To account for confounders, logistic regression analysis was performed. Only individuals proficient in German were included in the survey, allowing to control for a bias arising from poor language proficiency.84.9% of nonmigrant women, 82.1% of women with a one-sided, and 70.5% of women with a two-sided migration background had utilized screening for cancer at least once in their lifetime before the survey. The adjusted odds ratios (OR) as compared with nonmigrant women were 0.99 (95% confidence interval [95% CI]: 0.77-1.27) and 0.55 (95% CI: 0.47-0.64), respectively.The study shows that migrant women with a two-sided migration background residing in Germany utilize screening for cancer less often than nonmigrant women-independently of demographic and socioeconomic factors. This is in line with findings from other countries. Likely, barriers that migrant women encounter limit them from taking informed choices. These barriers need to be identified and appropriate measures aiming to enhance informed decision making must be implemented.
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Affiliation(s)
- Patrick Brzoska
- Epidemiology Unit, Institute of Sociology, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
- Correspondence: Patrick Brzoska, Epidemiology Unit, Chemnitz University of Technology, Faculty of Behavioral and Social Sciences, Institute of Sociology, Chemnitz, Germany (e-mail: )
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Khodayarian M, Mazloomi-Mahmoodabad SS, Lamyian M, Morowatisharifabad MA, Tavangar H. Response costs of mammography adherence: Iranian women's perceptions. Health Promot Perspect 2016; 6:85-91. [PMID: 27386423 PMCID: PMC4932227 DOI: 10.15171/hpp.2016.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background: Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. Methods: A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). Results: One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." Conclusion: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women’s awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.
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Affiliation(s)
- Mahsa Khodayarian
- Department of Health Education & Promotion, Shahid Sadoughi University of Medical Sciences (International Campus), Yazd, Iran
| | | | - Minoor Lamyian
- Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Ali Morowatisharifabad
- Department of Health Education & Promotion, Shahid Sadoughi University of Medical Sciences (International Campus), Yazd, Iran
| | - Hossein Tavangar
- Department of Nursing & Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Khazaee-pool M, Majlessi F, Foroushani AR, Montazeri A, Nedjat S, Shojaeizadeh D, Tol A, Salimzadeh H. Perception of breast cancer screening among Iranian women without experience of mammography: a qualitative study. Asian Pac J Cancer Prev 2016; 15:3965-71. [PMID: 24935582 DOI: 10.7314/apjcp.2014.15.9.3965] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Iran, there are high rates of breast cancer. It is among the five most common cancers, the first among cancers diagnosed, and is the leading cause of cancer deaths among Iranian women. OBJECTIVES The purpose of this qualitative study was to explore perception of breast cancer screening among Iranian women who have never had a mammograph. MATERIALS AND METHODS The current study was part of a qualitative research conducted by means of content analysis method and purposive sampling of 16 women over the age of 30 years who had not undergone mammography using individual semi-structured interviews. Interviews were recorded and transcribed verbatim. The data were under continuous consideration and comparative analysis in order to achieve data saturation. RESULTS After codification of data, three concept categories were achieved including: i) low awareness, ii) worries, and iii) lack of motivation. CONCLUSIONS Although there is a tendency among Iranian women to participate in breast cancer screening, there is a powerful cultural belief that breasts are sexual organs that should not be discussed publicly. Due to the incidence of breast cancer in Iranian women, it is critical that breast awareness education be performed by health care experts to explore the concepts of breast cancer and breast cancer screening.
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Affiliation(s)
- Maryam Khazaee-pool
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran E-mail :
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Sheppard VB, Hurtado-de-Mendoza A, Song M, Hirpa F, Nwabukwu I. The role of knowledge, language, and insurance in endorsement of cancer screening in women of African origin. Prev Med Rep 2016; 2:517-23. [PMID: 26844112 PMCID: PMC4721490 DOI: 10.1016/j.pmedr.2015.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND African women have lower use of cancer screening services compared to women born in the United States yet empirical data are limited about their cancer screening attitudes. OBJECTIVE To examine factors that are associated with higher endorsement of screening. METHOD We conducted a cross-sectional study of 200 women of African origin recruited via community-based outreach activities in Washington, DC. Endorsement of screening was assessed via self-report. The primary independent variables were cancer knowledge and English-language proficiency. Information was also collected about access, cancer-related beliefs, and prior breast screening behaviors. RESULTS Most participants (60%) were ≥ 40 years of age, 54% were married, and 77% were insured. Participants more likely to endorse breast cancer screening were insured (vs. uninsured) (odds ratio = 3.37; 95% confidence interval: 1.24, 9.17) and married (odds ratio = 3.23; 95% confidence interval: 1.14, 9.10) controlling for other factors. The likelihood of endorsing screening was higher among participants with English as a primary language (odds ratio = 3.83; 95% confidence interval: 1.24, 11.87) and those with greater breast cancer knowledge (odds ratio = 1.04; 95% confidence interval: 1.01, 1.08, per 1 point increase). CONCLUSIONS Average cancer knowledge in the sample was low as were non-conventional causes of cancer. Study results highlight the importance of improving cancer knowledge and reducing barriers related to language and insurance. Future studies are needed to consider nuances among diverse women of African origin.
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Affiliation(s)
- Vanessa B Sheppard
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Alejandra Hurtado-de-Mendoza
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Minna Song
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Fikru Hirpa
- Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Ify Nwabukwu
- African Women's Cancer Awareness Association, Silver Spring, MD, United States
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Lotrean LM, Ailoaiei R, Popa M, de Vries H. Knowledge regarding early detection of cancer among romanian women having relatives with cancer. Asian Pac J Cancer Prev 2015; 16:1091-5. [PMID: 25735337 DOI: 10.7314/apjcp.2015.16.3.1091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cancers can be detected in early stages through awareness of suspicious symptoms or by specific actions undertaken by individuals or participation in medical checks or screening programmes. The present research had three objectives: to assess the knowledge of Romanian women who have relatives with cancer with regard to cancer symptoms and detection methods; to identify socio-demographics factors influencing their level of knowledge; provide information regarding the attitudes of women from the study regarding medical help-seeking in case of any symptom which might be associated with cancer. This cross-sectional study was performed in an oncological hospital from Cluj-Napoca, Romania. It involved 160 women aged 18-70 years, who had relatives with cancer. An anonymous questionnaire was filled in by the participants. The results showed that around 10% of the study sample recognized all the 8 listed symptoms associated with cancer and all the 7 listed methods for cancer detection. The results of the linear regression analyses show that the level of knowledge regarding both symptoms and methods for detection was higher among younger women (B=-0.390, p<0.01, respectively B=-0.260; p<0.01), among those living in urban areas (B=0.872, p<0.01, respectively B=0.676; p<0.01) and those having higher educational level (B=0.883, p<0.001, respectively B=0.536; p<0.001). The majority of the participants agreed with the importance of looking for medical help within weeks up to one month in case that a symptom which might be associated with cancer was observed. The study underlines the necessity that much more information should be given to women who have relatives with cancer about what they can do to detect cancer in an early stage. This is especially needed for older women, women living in rural areas and women having a lower educational level.
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Affiliation(s)
- Lucia Maria Lotrean
- Department of Hygiene, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania E-mail :
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Factors influencing breast cancer screening in low-income African Americans in Tennessee. J Community Health 2015; 39:943-50. [PMID: 24554393 DOI: 10.1007/s10900-014-9834-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined demographic and lifestyle factors that influenced decisions and obstacles to being screened for breast cancer in low-income African Americans in three urban Tennessee cities. As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American women 40 years and older (n = 334) were selected from the Meharry CNP community survey database. There were several predictors of breast cancer screening such as marital status and having health insurance (P < .05). Additionally, there were associations between obstacles to screening and geographic region such as transportation and not having enough information about screenings (P < .05). Educational interventions aimed at improving breast cancer knowledge and screening rates should incorporate information about obstacles and predictors to screening.
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Andreeva VA, Unger JB. Determinants of Host Society Acculturation and Its Relationship with Health Behaviors and Outcomes: A New Research and Intervention Framework. J Immigr Minor Health 2014; 17:1420-6. [PMID: 25225079 DOI: 10.1007/s10903-014-0104-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Host society acculturation (or reverse acculturation) is a complex, multifactorial process reflecting the attitude- and behavior-level impact of immigrants on the host society. However, this phenomenon has rarely been the subject of systematic research in the area of public health. Using qualitative and quantitative findings from different health behavior domains, we strove to identify potential individual- and environment-level determinants of host society acculturation. Next, we developed a context-driven multilevel public health research and intervention framework for the study of the relationship between host society acculturation and health practices and outcomes. The framework posits a number of associations to be evaluated by future multidisciplinary research nationally and internationally.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA,
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Weber MF, Chiew M, Feletto E, Kahn C, Sitas F, Webster L. Cancer Screening among immigrants living in urban and regional Australia: results from the 45 and up study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8251-66. [PMID: 25153460 PMCID: PMC4143860 DOI: 10.3390/ijerph110808251] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/30/2014] [Accepted: 08/06/2014] [Indexed: 12/23/2022]
Abstract
Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006-2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening.
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Affiliation(s)
- Marianne F Weber
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - May Chiew
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Eleonora Feletto
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Freddy Sitas
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Lucy Webster
- School of Biomedical Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, NSW 2650, Australia.
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