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Cho SJ, Tian Y. Celebrity Identification and Reasoned Action: An Integrative Model of the Relationship Between Media Use and Breast Cancer Screening Intention. HEALTH COMMUNICATION 2024; 39:2186-2195. [PMID: 37733416 DOI: 10.1080/10410236.2023.2258308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This study investigates the relationship between media use and breast cancer screening intentions by integrating the celebrity identification model and the theory of reasoned action. It tests an integrative model with survey data from 315 U.S. adult women. The study found that media use for breast cancer information was positively associated with parasocial interaction (PSI) and identification with celebrities who have or have had breast cancer; PSI was positively associated with attitudes, descriptive and injunctive norms in breast cancer screening, while identification with celebrities was positively associated with descriptive norms; attitudes, injunctive norms and descriptive norms were positively associated with breast cancer screening intentions. The study supports the mediating effect of PSI, identification, attitudes, and descriptive and injunctive norms on the association between media use and breast cancer prevention intentions.
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Affiliation(s)
- Suahn Jang Cho
- Department of Communication & Media, University of Missouri-St. Louis
| | - Yan Tian
- Department of Communication & Media, University of Missouri-St. Louis
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2
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Pinheiro LC, Soroka O, Razon DT, Antoine F, Rothman J, Kanis MJ, Khan U, Tamimi RM, Nanus D, Phillips E. Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents. J Behav Med 2022; 45:954-961. [PMID: 36083412 DOI: 10.1007/s10865-022-00358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Abstract
Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - Orysya Soroka
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA
| | - Dominic T Razon
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Francesse Antoine
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Julia Rothman
- College of Human Ecology, Cornell University - Martha Van Rensselaer Hall, Ithaca, NY, USA
| | - Margaux J Kanis
- Division of Gynecological Oncology, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Uqba Khan
- Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Rulla M Tamimi
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - David Nanus
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Weill Cornell Medicine, NY, New York, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA. .,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.
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3
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Okayama M, Nagaoka T, Sugisaki K. Cancer Screening Rate and Related Factors in the Japanese Child-Rearing Generation. Healthcare (Basel) 2022; 10:healthcare10030508. [PMID: 35326986 PMCID: PMC8950849 DOI: 10.3390/healthcare10030508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
In Japan, although the incidence of cancer is increasing, the cancer screening rate is low compared to that in other countries. This study aimed to evaluate the factors associated with cancer screening behavior in Japanese men and women of child-rearing age. The survey was conducted among 2410 child-rearing adults from a countrywide database in August 2018. Among the respondents, there were 1381 (57.3%) who had been screened for cancer and 1029 (42.7%) who had not been screened. When stratified by sex, 503 (40.9%) men and 878 (74.3%) women had been screened for cancer, and education, income, and family history were associated with cancer screening. Among the men, where they lived, age, and family history were associated with cancer screening. In women, annual income was associated with stomach, colon, breast, and uterine cancer screening. In addition, uterine cancer screening was related to the women’s educational level. Our results suggest a need to improve the cancer screening rate among the child-rearing generation, especially for those with limited education and low income.
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Affiliation(s)
- Mutsumi Okayama
- Department of Health and Welfare, Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan; (M.O.); (T.N.)
- Department of Psychology, Faculty of Education and Humanities, Jumonji University, 2-1-28 Sugasawa, Niiza 352-8510, Japan
| | - Tomo Nagaoka
- Department of Health and Welfare, Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan; (M.O.); (T.N.)
- Department of Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai 270-1695, Japan
| | - Koshu Sugisaki
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan
- Correspondence:
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Allen CG, Todem D, Williams KP. Adherence to Mammography and Pap Screening Guidelines Among Medically Underserved Women: the Role of Family Structures and Network-Level Behaviors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1155-1162. [PMID: 33107009 PMCID: PMC8076331 DOI: 10.1007/s13187-020-01879-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Poor adherence to screening recommendations is an important contributing factor to disparities in breast and cervical cancer outcomes among women in the USA. Screening behaviors are multifactorial, but there has been limited focus on how family network beliefs and behaviors influence individual's likelihood to complete screening. This research aims to fill this gap by evaluating the role of family network composition and screening behaviors on women's likelihood to adhere to mammogram and pap screening recommendations. We used an ego network approach to analyze data from 137 families and their networks. Primary outcomes were whether an individual had received a mammogram in the past year and whether she had received a pap screening in the past 3 years. Network-level predictors included network composition (size of network, average age of network members, satisfaction with family communication) and network screening behaviors. We conducted multivariable logistic regressions to assess the influence of network-level variables on both mammogram and pap smears, adjusting for potential individual-level confounders. Each network had an average age of 47.9 years, and an average size of 3.05 women, with the majority of members being sisters (57.7%). We found differences in network screening behaviors by race, with Arab networks being less likely to have completed self-breast exams (OR = 0.21, 95%CI = 0.05-0.76, p = 0.02), ever a gotten pap screen (OR = 0.11, 95%CI = 0.01-0.85, p = 0.04), and gotten pap screening in the last 3 years (OR = 0.31, 95%CI = 0.10-0.99, p = 0.04) compared with African American networks. Network screening behaviors also strongly influenced the likelihood of an individual completing a similar screening behavior. This analysis sheds light on family network characteristics that influence screening behaviors among medically underserved women. These findings support the development and dissemination of screening interventions among female's family networks.
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Affiliation(s)
- Caitlin G Allen
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - David Todem
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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5
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Barta JA, Shusted CS, Ruane B, Pimpinelli M, McIntire RK, Zeigler-Johnson C, Myers RE, Evans NR, Kane GC, Juon HS. Racial Differences in Lung Cancer Screening Beliefs and Screening Adherence. Clin Lung Cancer 2021; 22:570-578. [PMID: 34257020 DOI: 10.1016/j.cllc.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND One challenge in high-quality lung cancer screening (LCS) is maintaining adherence with annual and short-interval follow-up screens among high-risk individuals who have undergone baseline low-dose CT (LDCT). This study aimed to characterize attitudes and beliefs toward lung cancer and LCS and to identify factors associated with LCS adherence. METHODS We administered a questionnaire to 269 LCS participants to assess attitudes and beliefs toward lung cancer and LCS. Clinical data including sociodemographics and screening adherence were obtained from the LCS Program Registry. RESULTS African-American individuals had significantly greater lung cancer worries compared with Whites (6.10 vs. 4.66, P < .001). In making the decision to undergo LCS, African-American participants described screening convenience and cost as very important factors significantly more frequently than Whites (60% vs. 26.8%, P< .001 and 58.4% vs. 37.8%, P = .001; respectively). African-American individuals with greater than high school education had significantly higher odds of LCS adherence (aOR 2.55; 95% CI, 1.14-5.60) than Whites with less than high school education. Participants who described screening convenience and cost as "very important" had significantly lower odds of completing screening follow-up after adjusting for demographic and other factors (aOR 0.56; 95% CI, 0.33-0.97 and aOR 0.54; 95% CI, 0.33-0.91, respectively). CONCLUSION Racial differences in beliefs about lung cancer and LCS exist among African-American and White individuals enrolled in an LCS program. Cost, convenience, and low educational attainment may be barriers to LCS adherence, specifically among African-American individuals. IMPACT More research is needed on how barriers can be overcome to improve LCS adherence.
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Affiliation(s)
- Julie A Barta
- The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Division of Pulmonary and Critical Care Medicine, Philadelphia, PA
| | - Christine S Shusted
- The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Department of Medicine, Philadelphia, PA
| | - Brooke Ruane
- The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Division of Pulmonary and Critical Care Medicine, Philadelphia, PA
| | - Marcella Pimpinelli
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Russell K McIntire
- Thomas Jefferson University, Jefferson College of Population Health, Philadelphia, PA
| | - Charnita Zeigler-Johnson
- Thomas Jefferson University, Department of Medical Oncology, Division of Population Science, Philadelphia, PA
| | - Ronald E Myers
- Thomas Jefferson University, Department of Medical Oncology, Division of Population Science, Philadelphia, PA
| | - Nathaniel R Evans
- The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Division of Thoracic Surgery, Philadelphia, PA
| | - Gregory C Kane
- The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Department of Medicine, Philadelphia, PA
| | - Hee-Soon Juon
- Thomas Jefferson University, Department of Medical Oncology, Division of Population Science, Philadelphia, PA.
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Pruckner GJ, Schober T, Zocher K. The company you keep: health behavior among work peers. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:251-259. [PMID: 31664627 PMCID: PMC7072047 DOI: 10.1007/s10198-019-01124-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
There is widespread agreement that behavior crucially influences one's health. However, little is known about what actually determines health-related behavior. We explore the impact of the place where many people spend most of their time, at work, and analyze whether an individual's decision to participate in health screening is related to the observed behavior of peers at work. We use linked employer-employee data and exploit the transitions of workers to new jobs. We find that the health behavior of co-workers highly correlated. A comparison of individuals moving into new firms shows that participation in general health checks, mammography screening, and prostate-specific antigen tests increases with the share of work peers attending these screenings. To differentiate between peer effects and common influences at the workplace, we further separate the peer groups within firms and show that workers with similar characteristics tend to have a stronger effect on individual screening participation.
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Affiliation(s)
- Gerald J Pruckner
- Christian Doppler Laboratory for Aging, Health and the Labor Market, Johannes Kepler University Linz, Altenbergerstraße 69, Linz, Austria
- Department of Economics, Johannes Kepler University Linz, Altenbergerstraße 69, 4040, Linz, Austria
| | - Thomas Schober
- Christian Doppler Laboratory for Aging, Health and the Labor Market, Johannes Kepler University Linz, Altenbergerstraße 69, Linz, Austria.
- Department of Economics, Johannes Kepler University Linz, Altenbergerstraße 69, 4040, Linz, Austria.
| | - Katrin Zocher
- Christian Doppler Laboratory for Aging, Health and the Labor Market, Johannes Kepler University Linz, Altenbergerstraße 69, Linz, Austria
- Department of Economics, Johannes Kepler University Linz, Altenbergerstraße 69, 4040, Linz, Austria
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7
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Bremer D, Lüdecke D, von dem Knesebeck O. Social Relationships, Age and the Use of Preventive Health Services: Findings from the German Ageing Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214272. [PMID: 31689892 PMCID: PMC6862648 DOI: 10.3390/ijerph16214272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 01/01/2023]
Abstract
This paper investigates the associations between social relationships, age and the use of preventive health services among German adults. Data stem from the German Ageing Survey (10,324 respondents). The use of preventive health services was assessed by asking for regular use of flu vaccination and cancer screening in the past years. Predictors of interest were structural (having a partner, size of the social network) and functional aspects of social relationships (perceived informational support) and age. Logistic regression models were used to measure the associations between preventive health services use and these predictors. Self-perceived health, gender and education were considered as covariates. Having a partner (OR = 1.20, 95% CI: 1.07-1.34) and perceived informational support (OR = 1.38, 95% CI: 1.13-1.69) were associated with a higher probability of getting flu vaccination regularly over the past years. Informational support (OR = 1.42, 95% CI: 1.17-1.72) and having a partner (OR = 1.57, 95% CI: 1.41-1.75) were positively associated with regular cancer screening over the past years. Associations between the size of the social network and use of preventive health services were not statistically significant. Associations between the use of preventive health services and social relationships varied by age. Structural and functional aspects of social relationships may support preventive health behavior. To increase preventive health behavior and the use of preventive health services, it is necessary to integrate information on social relationships into routine care and to strengthen sources of social support.
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Affiliation(s)
- Daniel Bremer
- Department of Medical Psychology & Center for Health Care Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Daniel Lüdecke
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study. LANCET PUBLIC HEALTH 2018; 3:e438-e446. [PMID: 30143472 PMCID: PMC6123501 DOI: 10.1016/s2468-2667(18)30141-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence of the possible health benefits of social connectedness is increasing. We aimed to examine poor social connectedness as a possible barrier to participation in preventive health services among older people (aged 53-69 years). METHODS We analysed data from a prospective cohort study of 5362 socially stratified births from the Medical Research Council National Survey of Health and Development enrolled in England, Scotland, and Wales in March 1946. At ages 68-69 years, participants reported participation in blood pressure and cholesterol measurement, eyesight and dental check-ups, influenza immunisation, and bowel and breast cancer screening. Our primary outcome measure summed participation across all these tests and services at ages 68-69 years. We tested associations between structural and functional social connectedness from ages 53 years to 69 years and total count of participation in these preventive services in Poisson models controlling for sex, education, occupational class, employment, chronic illnesses, and general practitioner consultations for health problems. FINDINGS 940 (44%) of 2132 participants attended all preventive services within the recommended timeframes. At ages 68-69 years, being unmarried or not cohabiting (incident rate ratio [IRR] 1·33, 95% CI 1·20-1·47) and small personal social networks (IRR 1·51, 1·32-1·71) were independently associated with non-participation in more services, with associations consistent across most services. High social relationship quality at ages 68-69 years (IRR 0·91, 95% CI 0·87-0·95) and increasing social relationship quality from ages 53 years to 69 years (IRR 0·93, 0·89-0·97) were associated with low risk of non-participation. INTERPRETATION Individuals with poor social connectedness appear to be at greater risk of not engaging in the full range of preventive services than individuals with good social connectedness. Improvement of access to social contacts and networks in older ages is already recommended for the maintenance of good mental health. This study suggests that social connectedness could also improve participation in a wide range of preventive health services, and hence could improve use of the health-care system and population health. FUNDING UK Medical Research Council.
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Affiliation(s)
- Mai Stafford
- The Health Foundation, London, UK; MRC Unit for Lifelong Health and Ageing, University College London, London, UK.
| | - Christian von Wagner
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sarah Perman
- Screening Quality Assurance Service, Public Health England, London, UK
| | - Jayne Taylor
- London Borough of Hackney & City of London Corporation, Hackney Service Centre, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jessica Sheringham
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care North Thames, Department of Applied Health Research, University College London, London, UK
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Kroenke CH. A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival. Transl Behav Med 2018; 8:629-642. [PMID: 30016520 PMCID: PMC6065533 DOI: 10.1093/tbm/ibx061] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Women with larger personal social networks have better breast cancer survival and a lower risk of mortality. However, little work has examined the mechanisms through which social networks influence breast cancer outcomes and cancer outcomes more generally, potentially limiting the development of feasible, clinically effective interventions. In fact, much of the emphasis in cancer research regarding the influence of social relationships on cancer outcomes has focused on the benefits of the provision of social support to patients, especially through peer support groups, and only more recently through patient navigation. Though critically important, there are other ways through which social relationships might influence outcomes, around which interventions might be developed. In addition to social support, these include social resources, social norms, social contagion, social roles, and social burdens and obligations. This narrative review addresses how social networks may influence cancer outcomes and discusses potential strategies for improving outcomes given these relationships. The paper (a) describes background and limitations of previous research, (b) outlines terms and provides a conceptual model that describes interrelationships between social networks and relevant variables and their hypothesized influence on cancer outcomes, (c) clarifies social and psychosocial mechanisms through which social networks affect downstream factors, (d) describes downstream behavioral, treatment, and physiological factors through which these subsequently influence recurrence and mortality, and (e) describes needed research and potential opportunities to enhance translation. Though most literature in this area pertains to breast cancer, this review has substantial relevance for cancer outcomes generally. Further clarification and research regarding potential mechanisms are needed to translate epidemiological findings on social networks into clinical and community strategies to improve cancer outcomes.
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Affiliation(s)
- Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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10
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Carter-Harris L, Davis LL, Rawl SM. Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research. Res Theory Nurs Pract 2018; 30:333-352. [PMID: 28304262 DOI: 10.1891/1541-6577.30.4.333] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. METHODS Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. RESULTS Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. CONCLUSION This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.
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11
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Gunn CM, Parker VA, Bak SM, Ko N, Nelson KP, Battaglia TA. Social Network Structures of Breast Cancer Patients and the Contributing Role of Patient Navigators. Oncologist 2017; 22:918-924. [PMID: 28559408 DOI: 10.1634/theoncologist.2016-0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 03/13/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Minority women in the U.S. continue to experience inferior breast cancer outcomes compared with white women, in part due to delays in care delivery. Emerging cancer care delivery models like patient navigation focus on social barriers, but evidence demonstrating how these models increase social capital is lacking. This pilot study describes the social networks of newly diagnosed breast cancer patients and explores the contributing role of patient navigators. MATERIALS AND METHODS Twenty-five women completed a one hour interview about their social networks related to cancer care support. Network metrics identified important structural attributes and influential individuals. Bivariate associations between network metrics, type of network, and whether the network included a navigator were measured. Secondary analyses explored associations between network structures and clinical outcomes. RESULTS We identified three types of networks: kin-based, role and/or affect-based, or heterogeneous. Network metrics did not vary significantly by network type. There was a low prevalence of navigators included in the support networks (25%). Network density scores were significantly higher in those networks without a navigator. Network metrics were not predictive of clinical outcomes in multivariate models. CONCLUSION Patient navigators were not frequently included in support networks, but provided distinctive types of support. If navigators can identify patients with poorly integrated (less dense) social networks, or who have unmet tangible support needs, the intensity of navigation services could be tailored. Services and systems that address gaps and variations in patient social networks should be explored for their potential to reduce cancer health disparities. IMPLICATIONS FOR PRACTICE This study used a new method to identify the breadth and strength of social support following a diagnosis of breast cancer, especially examining the role of patient navigators in providing support. While navigators were only included in one quarter of patient support networks, they did provide essential supports to some individuals. Health care providers and systems need to better understand the contributions of social supports both within and outside of health care to design and tailor interventions that seek to reduce health care disparities and improve cancer outcomes.
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Affiliation(s)
- Christine M Gunn
- Evans Department of Medicine, Women's Health Unit, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Victoria A Parker
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sharon M Bak
- Women's Health Unit Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Naomi Ko
- Department of Hematology and Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kerrie P Nelson
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tracy A Battaglia
- Department of Hematology and Oncology, Boston Medical Center, Boston, Massachusetts, USA
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Abstract
Similar to other Middle Eastern countries, breast cancer is the most common cancer among women in Qatar with increasing incidence and mortality rates. High mortality rates of breast cancer in the Middle Eastern countries are primarily due to delayed diagnosis of the disease. Thus screening and early detection of breast cancer are important in reducing cancer morbidity and mortality. With the aim of updating knowledge on existing interventions and developing effective intervention programs to promote breast cancer screening in Arabic populations in Qatar, this review addresses the question: What interventions are effective in increasing breast cancer knowledge and breast cancer screening rates in Arabic populations in Arabic countries and North America? Systematic literature review was performed to answer the proposed question. As the result of the search, six research studies were identified and appraised. From the findings, we infer several insights: (a) a language-appropriate and culturally sensitive educational program is the most important component of a successful intervention regardless of the study setting, (b) multi-level interventions that target both women, men, health care professionals, and/or larger health care system are more likely to be successful than single educational interventions or public awareness campaigns, and (c) more vigorous, personal and cognitive interventions that address psychosocial factors are likely to be more effective than less personal and informative interventions. This review has important implications for health care providers, intervention planners, and researchers.
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Affiliation(s)
- Tam Truong Donnelly
- University of Calgary-Qatar, Doha, Qatar
- Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB Canada
| | - Jasmine Hwang
- Faculty of Nursing, University of Calgary, 23 Edgeland Close NW, Calgary, AB Canada
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13
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Farhadifar F, Molina Y, Taymoori P, Akhavan S. Mediators of repeat mammography in two tailored interventions for Iranian women. BMC Public Health 2016; 16:149. [PMID: 26874508 PMCID: PMC4752754 DOI: 10.1186/s12889-016-2808-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 02/01/2016] [Indexed: 12/29/2022] Open
Abstract
Background Many theory-based interventions exist that incorporate theoretical constructs (e.g., self-efficacy, behavioral control) believed to increase the likelihood of mammography. Nonetheless, little work to date has examined if increased screening among women receiving such interventions occurs due to changes in these targeted constructs. The aim of this study is to address this gap in the literature in the context of two interventions for improving regular screening among Iranian women. Methods A sample of 176 women over 50 years old in Tehran, Iran were randomly allocated into one of these three conditions: 1) an intervention based on Health Belief Model (HBM); 2) an intervention based on an integration of the HBM and selected constructs from the TPB (TPB); and 3) a control group (CON). Questionnaires were administered before the intervention and after a 6-month follow-up. The Preacher and Hayes method of mediation was used in analytic models. Results Changes in susceptibility, self-efficacy, and perceived control appeared to mediate HBM-CON differences in screening. Barriers attenuated the mediating effect of self-efficacy. Changes in barriers and self-efficacy appeared to mediate TPB-CON differences in screening. Conclusion This study was successful in identifying which theory-based constructs appear to underlie the effectiveness of HBM- and TPB-based interventions. Specific constructs have been identified that should be targeted in clinical practice to increase mammography practices among Iranian women.
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Affiliation(s)
- Fariba Farhadifar
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yamile Molina
- Community Health Sciences, School Of Public Health, University of Illinois-Chicago, Chicago, USA
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Setareh Akhavan
- Tehran University of Medical Sciences, Imam Khomini Complex Hospital, Valiasr Hospital, Gynecology Oncology Ward, Tehran, Iran
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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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Petrova D, Garcia-Retamero R, Catena A. Lonely hearts don't get checked: On the role of social support in screening for cardiovascular risk. Prev Med 2015; 81:202-8. [PMID: 26361754 DOI: 10.1016/j.ypmed.2015.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Regular cardiovascular risk screening can prevent cardiovascular disease through timely implementation of lifestyle changes or medication. However, few studies have investigated what factors promote regular screening for risk factors like hypertension and high blood cholesterol. The aim of this study was to investigate the relationship between social support and adherence to cardiovascular risk screening. METHODS We analyzed data from the Spanish National Health Survey-a cross-sectional representative survey conducted by the Spanish Ministry of Health in 2012 (N=21,007). Participants reported whether they had their blood pressure and cholesterol levels measured by a health professional in the previous 12 months. Social support (i.e., the perception that emotional and practical support was available when needed) was measured with a validated scale. Multiple logistic regressions were conducted adjusted for demographic and health-related factors. RESULTS Compared to individuals who reported a lack of social support, individuals who perceived sufficient social support were on average twice more likely to report participation in blood pressure screening, OR=2.06, 95% CI [1.60, 2.66] and cholesterol screening, OR=2.85, 95% CI [1.99, 4.09]. These effects were uniform across different demographics and were replicated in a previous wave of the survey. Factors associated with worse screening adherence were low social class, being single or widowed, smoking, alcohol consumption, and no history of cardiovascular risk. DISCUSSION Perceptions of social support are positively related to cardiovascular risk screening adherence. Future research should investigate what type of social support most effectively increases screening participation among high risk populations.
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Affiliation(s)
- Dafina Petrova
- Mind, Brain, and Behavior Research Center, University of Granada, Spain.
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center, University of Granada, Spain; Max Planck Institute for Human Development, Germany
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Spain
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Jensen LF, Pedersen AF, Andersen B, Vedsted P. Social support and non-participation in breast cancer screening: a Danish cohort study. J Public Health (Oxf) 2015; 38:335-42. [DOI: 10.1093/pubmed/fdv051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Monnat SM. Race/ethnicity and the socioeconomic status gradient in women's cancer screening utilization: a case of diminishing returns? J Health Care Poor Underserved 2015; 25:332-56. [PMID: 24509030 DOI: 10.1353/hpu.2014.0050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Using three years (2006, 2008, 2010) of nationally representative data from the Behavioral Risk Factor Surveillance System, I assessed the socioeconomic status (SES) gradient for odds of receiving a mammogram in the past two years and a Pap test in the past three years among White, Black, Hispanic, and Asian women living in the U.S. Mammogram and Pap test utilization were less likely among low-SES women. However, women of color experience less benefit than Whites from increasing SES for both screenings; as income and education increased, White women experienced more pronounced increases in the likelihood of being screened than did women of color. In what might be referred to as paradoxical returns, Asian women actually experienced a decline in the likelihood of obtaining a recent Pap test at higher levels of education. My findings suggest that women of color differ from Whites in the extent to which increasing socioeconomic resources is associated with increasing cancer screening utilization.
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18
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Documet P, Bear TM, Flatt JD, Macia L, Trauth J, Ricci EM. The association of social support and education with breast and cervical cancer screening. HEALTH EDUCATION & BEHAVIOR 2015; 42:55-64. [PMID: 25394824 PMCID: PMC4526257 DOI: 10.1177/1090198114557124] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. PURPOSE This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education. METHOD Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection. RESULTS Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance. CONCLUSION Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment.
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Affiliation(s)
| | - Todd M Bear
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Laura Macia
- University of Pittsburgh, Pittsburgh, PA, USA
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Koehly LM, Ashida S, Schafer EJ, Ludden A. Caregiving networks-using a network approach to identify missed opportunities. J Gerontol B Psychol Sci Soc Sci 2015; 70:143-54. [PMID: 25224254 PMCID: PMC4296206 DOI: 10.1093/geronb/gbu111] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 08/04/2014] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This study demonstrates the added value to caregiving research by using a multi-informant social network approach within the context of Alzheimer's disease and related dementia. METHOD Sixty-six informants from 24 families enumerated caregiving network members in 2012. Comparisons were made between networks based on a single informant versus multiple informants in terms of network composition and caregiving roles, core-periphery structure, and identification of "missed opportunities" in recruitment. RESULTS On average, each informant beyond the index enumerated 6.2 new members, resulting in about 10 new members per family network when the multiple-informant approach is used. Compared with index informants' networks, multi-informant networks showed an 85% increase in identification of direct care providers (1.71 compared with 3.42) and a 48% increase in identification of those involved in care decision making (3.33 compared with 4.92). Informants from the same network generally showed agreement in reported participation in caregiving activities. However, the reports of non-participation in these roles were less consistent among the informants. Resulting structure indicated a core caregiving network (M = 6.12 members), with semi-peripheral and peripheral members (M = 5.19 and M = 14.83 members, respectively). DISCUSSION Results suggest that an iterative, targeted sampling approach with at least three informants allows for a more comprehensive assessment of caregiving processes. Applying this approach in future research will greatly enhance our knowledge and better inform future interventions to facilitate family adaptation.
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Affiliation(s)
- Laura M Koehly
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland.
| | - Sato Ashida
- Department of Community and Behavioral Health, College of Public Health, Aging Mind and Brain Initiative, The University of Iowa
| | - Ellen J Schafer
- Department of Community and Behavioral Health, College of Public Health, Aging Mind and Brain Initiative, The University of Iowa
| | - Amanda Ludden
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Levy K, Minnis AM, Lahiff M, Schmittdiel J, Dehlendorf C. Bringing patients' social context into the examination room: an investigation of the discussion of social influence during contraceptive counseling. Womens Health Issues 2015; 25:13-21. [PMID: 25491398 PMCID: PMC4275361 DOI: 10.1016/j.whi.2014.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 09/25/2014] [Accepted: 10/01/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although social networks are an increasingly recognized influence on contraceptive use, little is known about if and how social influences are discussed during women's contraceptive counseling visits. METHODS We performed a mixed-methods analysis of audio recordings of contraceptive counseling visits. We examined predictors of discussion of social influence arising in a contraceptive counseling visit and analyzed the content and process of social influence discussions. RESULTS Social influences were mentioned in 42% of the 342 visits included in the sample, with these discussions most commonly initiated by patients. Younger patients were more likely to have social influence mentioned than older patients. The content of social influence focused on side effects and adverse events, with the sources of influence being predominantly patients' friends and the media, with little input from partners. Providers were more likely to engage around the content of the social influence than the social influence itself. CONCLUSION The frequency with which social influence was mentioned in these visits supports the importance of women's social context on their contraceptive decision making. However, the fact that patients initiated the discussion in the majority of cases suggests that providers may not recognize the relevance of these influences or may not be comfortable engaging with them. Increasing providers' ability to elicit and engage patients about their social context with regard to contraception could enhance providers' ability to understand women's contraceptive preferences and provide appropriate counseling to address their specific concerns or questions.
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Affiliation(s)
- Kira Levy
- UC Berkeley-UCSF Joint Medical Prgram Address: 570 University Hall #1190 University of California, Berkeley, 94720
| | - Alexandra M. Minnis
- Women's Global Health Imperative, RTI International School of Public Health, UC Berkeley Address: 351 California Street, Suite 500 San Francisco, CA 94104 Phone: (415) 848-1323
| | - Maureen Lahiff
- School of Public Health, UC Berkeley Address: 307 Haviland Hall University of California, Berkeley 94720 Phone: (510) 642-4028
| | - Julie Schmittdiel
- Kaiser Permanente Division of Research Address: 2000 Broadway Oakland, CA 94612 Phone: (510) 891-3872
| | - Christine Dehlendorf
- UCSF Department of Family and Community Medicine and Obstetrics, Gynecology and Reproductive Sciences Address: 1001 Potrero Ave, SFGH 20 San Francisco CA 94143 Phone: (415) 206-8712
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Lee MH, Choi KS, Lee YY, Suh M, Jun JK. Relationship between Social Network and Stage of Adoption of Gastric Cancer Screening among the Korean Population. Asian Pac J Cancer Prev 2014; 14:6095-101. [PMID: 24289632 DOI: 10.7314/apjcp.2013.14.10.6095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Few studies have examined the relationship between social support and stages of adoption of cancer screening. Here we investigated associations between both structural and functional aspects of social support and stages of adoption of gastric cancer screening in the general population of Korea. The study population was derived from the 2011 Korean National Cancer Screening Survey (KNCSS), an annual cross-sectional survey that uses nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 3,477 randomly selected respondents aged 40-74 years. Respondents were classified according to their stage of adoption of gastric cancer screening: precontemplation (13.2%), contemplation (18.0%), action/maintenance (56.1%), relapse risk (8.5%), and relapse stage (4.1%). Respondents with larger social networks were more likely to be in the contemplation/action/maintenance, or the relapse risk/relapse stages versus the precontemplation stage (OR=1.91, 95%CI: 1.52-2.91; p for tend=0.025). Emotional and instrumental supports were not associated with any stage of adoption of gastric cancer screening. However, respondents who reported receiving sufficient informational support were more likely to be in the relapse risk/relapse stages versus the precontemplation, or the contemplation/action/maintenance stage (p for trend=0.016). Interventions involving interactions between social network members could play an important role in increasing participation in gastric cancer screening.
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Affiliation(s)
- Myung Ha Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea E-mail :
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22
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Madadi M, Zhang S, Yeary KHK, Henderson LM. Analyzing factors associated with women's attitudes and behaviors toward screening mammography using design-based logistic regression. Breast Cancer Res Treat 2014; 144:193-204. [PMID: 24510010 DOI: 10.1007/s10549-014-2850-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 01/20/2014] [Indexed: 11/26/2022]
Abstract
We examined the factors associated with screening mammography adherence behaviors and influencing factors on women's attitudes toward mammography in non-adherent women. Design-based logistic regression models were developed to characterize the influencing factors, including socio-demographic, health related, behavioral characteristics, and knowledge of breast cancer/mammography, on women's compliance with and attitudes toward mammography using the 2003 Health Information National Trends Survey data. Findings indicate significant associations among adherence to mammography and marital status, income, health coverage, being advised by a doctor to have a mammogram, having had Pap smear before, perception of chance of getting breast cancer, and knowledge of mammography (frequency of doing mammogram) in both women younger than 65 and women aged 65 and older. However, number of visits to a healthcare provider per year and lifetime number of smoked cigarettes are only significant for women younger than 65. Factors significantly associated with attitudes toward mammography in non-adherent women are age, being advised by a doctor to have a mammogram, and seeking cancer information. To enhance adherence to mammography programs, physicians need to continue to advise their patients to obtain mammograms. In addition, increasing women's knowledge about the frequency and starting age for screening mammography may improve women's adherence. Financially related factors such as income and insurance are also shown to be significant factors. Hence, healthcare policies aimed at providing breast cancer screening services to underserved women will likely enhance mammography participation.
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Affiliation(s)
- Mahboubeh Madadi
- Department of Industrial Engineering, University of Arkansas, 4207 Bell Engineering, Fayetteville, AR, 72701, USA,
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Abstract
Although cervical cancer rates in the United States have declined sharply in recent decades, certain groups of women remain at elevated risk, including middle-aged and older women in central Appalachia. Cross-sectional baseline data from a community-based randomized controlled trial were examined to identify barriers to cervical cancer screening. Questionnaires assessing barriers were administered to 345 Appalachian women aged 40-64, years when Papanicolaou (Pap) testing declines and cervical cancer rates increase. Consistent with the PRECEDE/PROCEED framework, participants identified barriers included predisposing, enabling, and reinforcing factors. Descriptive and bivariate analyses are reported, identifying (a) the most frequently endorsed barriers to screening, and (b) significant associations of barriers with sociodemographic characteristics in the sample. Recommendations are provided to decrease these barriers and, ultimately, improve rates of Pap tests among this traditionally underserved and disproportionately affected group.
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Allen JD, Bluethmann SM, Sheets M, Opdyke KM, Gates-Ferris K, Hurlbert M, Harden E. Women's responses to changes in U.S. Preventive Task Force's mammography screening guidelines: results of focus groups with ethnically diverse women. BMC Public Health 2013; 13:1169. [PMID: 24330527 PMCID: PMC3913377 DOI: 10.1186/1471-2458-13-1169] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 12/03/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women's awareness of, attitudes toward, and intention to comply with these new guidelines. METHODS Women ages 40-50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. RESULTS Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. CONCLUSIONS Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women's screening behaviors and on breast cancer outcomes.
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Affiliation(s)
- Jennifer D Allen
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
- Harvard Medical School, Boston, USA
| | | | - Margaret Sheets
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
| | | | | | | | - Elizabeth Harden
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA
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Kaltsa A, Holloway A, Cox K. Factors that influence mammography screening behaviour: A qualitative study of Greek women's experiences. Eur J Oncol Nurs 2013; 17:292-301. [DOI: 10.1016/j.ejon.2012.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 07/19/2012] [Accepted: 08/03/2012] [Indexed: 11/29/2022]
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Christy SM, Rawl SM. Shared decision-making about colorectal cancer screening: a conceptual framework to guide research. PATIENT EDUCATION AND COUNSELING 2013; 91:310-7. [PMID: 23419327 PMCID: PMC3756595 DOI: 10.1016/j.pec.2013.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 12/27/2012] [Accepted: 01/11/2013] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To develop a conceptual framework to guide research on shared decision-making about colorectal cancer (CRC) screening among persons at average risk and their providers. METHODS Based upon a comprehensive review of empirical literature and relevant theories, a conceptual framework was developed that incorporated patient characteristics, cultural beliefs, provider/health care system variables, health belief/knowledge/stage of adoption variables, and shared decision-making between patients and providers that may predict behavior. Relationships among concepts in the framework, shared decision-making process and outcomes, and CRC screening behavior were proposed. Directions for future research were presented. RESULTS Many of the concepts in the proposed framework have been examined in prior research. However, these elements have not been combined previously to explain shared decision-making about CRC screening. CONCLUSION Research is needed to test the proposed relationships and hypotheses and to refine the framework. PRACTICE IMPLICATIONS Findings from future research guided by the proposed framework may inform clinical practice to facilitate shared decision-making about CRC screening.
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Affiliation(s)
- Shannon M Christy
- Purdue School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, USA.
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Vyas A, Madhavan S, LeMasters T, Atkins E, Gainor S, Kennedy S, Kelly K, Vona-Davis L, Remick S. Factors influencing adherence to mammography screening guidelines in Appalachian women participating in a mobile mammography program. J Community Health 2012; 37:632-46. [PMID: 22033614 DOI: 10.1007/s10900-011-9494-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The objectives of this study were to evaluate the characteristics (demographic, access to care, health-related behavioral, self and family medical history, psychosocial) of women age 40 years and above who participated in a mobile mammography screening program conducted throughout West Virginia (WV) to determine the factors influencing their self-reported adherence to mammography screening guidelines. Data were analyzed using the Andersen Behavioral Model of Healthcare Utilization framework to determine the factors associated with adherence to mammography screening guidelines in these women. Of the 686 women included in the analysis, 46.2% reported having had a mammogram in the past 2 years. Bivariate analyses showed predisposing factors such as older age and unemployed status, visit to a obstetrician/gynecologist (OB/GYN) in the past year (an enabling factor) and need-related factors such as having a family history of breast cancer (BC), having had breast problems in the past, having had breast biopsy in the past, having had a Pap test in past 2 years, and having had all the screenings for cholesterol, blood glucose, bone mineral density and high blood pressure in past 2 years to be significant predictors of self-reported adherence to mammography guidelines. In the final model, being above 50 years (OR=2.132), being morbidly obese (OR=2.358), having BC-related events and low knowledge about mammography were significant predictors of self-reported adherence. Breast cancer related events seem to be associated with mammography screening adherence in this rural Appalachian population. Increasing adherence to mammography screening may require targeted, community-based educational interventions that precede and complement visits by the mobile mammography unit.
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Affiliation(s)
- Ami Vyas
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, Robert C. Byrd Health Sciences Center (North), West Virginia University, Morgantown, WV 26506-9510, USA.
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Akinyemiju TF, Soliman AS, Yassine M, Banerjee M, Schwartz K, Merajver S. Healthcare access and mammography screening in Michigan: a multilevel cross-sectional study. Int J Equity Health 2012; 11:16. [PMID: 22436125 PMCID: PMC3414751 DOI: 10.1186/1475-9276-11-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 03/21/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Breast cancer screening rates have increased over time in the United States. However actual screening rates appear to be lower among black women compared with white women. PURPOSE To assess determinants of breast cancer screening among women in Michigan USA, focusing on individual and neighborhood socio-economic status and healthcare access. METHODS Data from 1163 women ages 50-74 years who participated in the 2008 Michigan Special Cancer Behavioral Risk Factor Survey were analyzed. County-level SES and healthcare access were obtained from the Area Resource File. Multilevel logistic regression models were fit using SAS Proc Glimmix to account for clustering of individual observations by county. Separate models were fit for each of the two outcomes of interest; mammography screening and clinical breast examination. For each outcome, two sequential models were fit; a model including individual level covariates and a model including county level covariates. RESULTS After adjusting for misclassification bias, overall cancer screening rates were lower than reported by survey respondents; black women had lower mammography screening rates but higher clinical breast examination rates than white women. However, after adjusting for other individual level variables, race was not a significant predictor of screening. Having health insurance or a usual healthcare provider were the most important predictors of cancer screening. DISCUSSION Access to healthcare is important to ensuring appropriate cancer screening among women in Michigan.
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Affiliation(s)
- Tomi F Akinyemiju
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Amr S Soliman
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - May Yassine
- Cancer Control and Prevention Program, Michigan Public Health Institute, Okemos, MI, USA
| | - Mousumi Banerjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences and Barbara Ann Karmanos Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sofia Merajver
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA
- University of Michigan Center for Global Health, Ann Arbor, MI 48109, USA
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Bird Y, Banegas MP, Moraros J, King S, Prapasiri S, Thompson B. The impact of family history of breast cancer on knowledge, attitudes, and early detection practices of Mexican women along the Mexico-US border. J Immigr Minor Health 2011; 13:867-75. [PMID: 21104130 DOI: 10.1007/s10903-010-9418-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Rates of breast cancer (BC) have increased in Mexico, with the highest incidence and mortality rates observed in the northern Mexican states. This study aimed to describe the BC knowledge, attitudes and screening practices among Mexican women with and without a family history of BC residing along the Mexico-US border, and identify factors associated with screening behaviors. One hundred and twenty eight Mexican women aged 40 and older completed an interviewer-administered questionnaire on sociodemographic characteristics, knowledge, family history, and screening practices. There were no significant differences between Mexican women with and without a family history. Over 60% of women in both groups had never had a mammogram/breast ultrasound, and more than 50% had never obtained a clinical breast exam. Age, marital status, insurance, and breast cancer knowledge significantly influenced BC screening behaviors among Mexican women. Further research is needed to examine other key factors associated with screening utilization, in effort of improving BC rates.
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Affiliation(s)
- Yelena Bird
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
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Palos GR, Hare M. Patients, family caregivers, and patient navigators: a partnership approach. Cancer 2011; 117:3592-3602. [PMID: 21780094 DOI: 10.1002/cncr.26263] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Navigation services may be strengthened by establishing a partnership between the patient, family/caregiver, and the navigator. Involvement of a patient's familial or social network in the navigation process would allow patient navigators to spend more time and resources with the subset of patients who do not have support from family and friends. The Partnership Approach evolves from combining the strength of a patient's existing social support and network with the delivery of navigation services. METHODS To develop this novel approach, the Family and Caregiver Workgroup was convened at the American Cancer Society's National Leadership Summit. Individuals were asked to serve in this group due to their interest, research, or experience in family and caregiver issues. RESULTS By the end of the Summit, the workgroup had achieved 3 major outcomes: 1) enhancement of current patient navigation services by building a partnership between the patient, family or primary caregivers, and navigators; 2) identification of a set of core functions that a family/caregiver could perform in a partnership; and 3) consensus on a set of metrics to use with caregivers and patients. Five major domains were selected to measure patient and/or caregiver outcomes: quality of life, satisfaction with care, social support, distress, and caregiver burden. Metrics appropriate for each domain were recommended. CONCLUSIONS Integration of these domains and scales in current navigation services is needed to develop future research. Evidence from such research would help determine whether the Partnership Approach contributes to improved patient and caregiver outcomes.
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Affiliation(s)
- Guadalupe R Palos
- Cancer Survivorship Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
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Keating NL, O'Malley AJ, Murabito JM, Smith KP, Christakis NA. Minimal social network effects evident in cancer screening behavior. Cancer 2011; 117:3045-52. [PMID: 21264828 PMCID: PMC3119780 DOI: 10.1002/cncr.25849] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/15/2010] [Accepted: 11/16/2010] [Indexed: 01/02/2023]
Abstract
BACKGROUND Social networks may influence screening behaviors. We assessed whether screening for breast, prostate, or colorectal cancer is influenced by the actual screening behaviors of siblings, friends, spouses, and coworkers. METHODS We conducted an observational study using Framingham Heart Study data to assess screening for eligible individuals during the late 1990s. We used logistic regression to determine whether the probability of screening for breast, prostate, or colorectal cancer was influenced by the proportion of siblings, friends, and coworkers who had the same screening, as well as spouse's screening for colorectal cancer, adjusting for other factors that might influence screening rates. RESULTS Among 1660 women aged 41-70 years, 71.7% reported mammography in the previous year; among 1217 men aged 51-70 years, 43.3% reported prostate-specific antigen testing in the previous year; and among 1426 men and women aged 51-80 years, 46.9% reported stool blood testing and/or sigmoidoscopy in the previous year. An increasing proportion of sisters who had mammography in the previous year was associated with mammography screening in the ego (odds ratio [OR], 1.034; 95% confidence interval [CI], 1.000-1.065 for each 10% increase). A spouse with recent screening was associated with more colorectal cancer screening (OR, 1.65; 95% CI, 1.39-1.98 vs unmarried). Otherwise, screening behaviors of siblings, friends, and coworkers were not associated with screening in the ego. CONCLUSIONS Aside from a slight increase in breast cancer screening among women whose sisters were screened and colorectal cancer screening if spouses were screened, the screening behavior of siblings, friends, or coworkers did not influence cancer screening behaviors.
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Affiliation(s)
- Nancy L Keating
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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von Wagner C, Good A, Whitaker KL, Wardle J. Psychosocial determinants of socioeconomic inequalities in cancer screening participation: a conceptual framework. Epidemiol Rev 2011; 33:135-47. [PMID: 21586673 DOI: 10.1093/epirev/mxq018] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Cancer screening participation shows a strong, graded association with socioeconomic status (SES) not only in countries such as the United States, where insurance status can be a barrier for lower income groups, but also in the United Kingdom, where the National Health Service provides all health care to residents, including screening, for free. Traditionally, the literature on socioeconomic inequalities has focused on upstream factors, but more proximal (downstream) influences on screening participation also need to be examined, particularly those that address the graded nature of the association rather than focusing specifically on underserved groups. This review offers a framework that links some of the components and corollaries of SES (life stress, educational opportunities, illness experience) to known psychosocial determinants of screening uptake (beliefs about the value of early detection, fatalistic beliefs about cancer, self-efficacy). The aim is to explain why individuals from lower SES backgrounds perceive cancer screening tests as more threatening, more difficult to accomplish, and less beneficial. A better understanding of the mechanisms through which lower SES causes negative attitudes toward screening could facilitate the development of intervention strategies to reduce screening inequalities.
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Affiliation(s)
- C von Wagner
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
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Use of evidence-based strategies to promote mammography among medically underserved women. Am J Prev Med 2011; 40:561-5. [PMID: 21496756 DOI: 10.1016/j.amepre.2010.12.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/01/2010] [Accepted: 12/23/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND Several web-based resources recommend effective intervention strategies to promote use of mammography but there is limited information on whether the strategies are used, particularly by organizations that serve medically underserved women. PURPOSE In 2010, data collected by the Avon Breast Health Outreach Program (BHOP) were analyzed to examine the diffusion of evidence-based intervention strategies among funded organizations. METHODS Data on intervention strategies were obtained from a 2009 survey of Avon BHOP organizations funded during 2006-2009. Self-reported use of mammography was reported from annual intake forms administered to medically underserved women aged ≥40 years, excluding those with a history of breast cancer or initial enrollees not exposed to the strategies. Strategies reflected interventions reviewed in the Guide to Community Preventive Services. Those recommended to increase demand and use of mammography included (1) client reminders; (2) small media; (3) one-to-one education; (4) removal of structural barriers to rescreening; and (5) group education-and one that lacked sufficient evidence to warrant a recommendation (6) client incentives. RESULTS Among 86 organizations, 96% used three or more intervention strategies. The most common strategies were group education (91%) and client reminders (83%). The overall crude-percentage of recent mammography use was 84%. This percentage was similar for clinical sites and nonclinical sites, despite the disproportionate enrollment of medically underserved women in nonclinical sites. CONCLUSIONS The wide use of evidence-based strategies among Avon BHOP-funded organizations and high percentage of recent mammography use among women exposed to the strategies suggests that medically underserved women are benefiting from effective interventions to increase use of mammography.
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Allen JD, Othus MKD, Hart A, Mohllajee AP, Li Y, Bowen D. Do men make informed decisions about prostate cancer screening? Baseline results from the "take the wheel" trial. Med Decis Making 2010; 31:108-20. [PMID: 20484092 DOI: 10.1177/0272989x10369002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Baseline data from a randomized trial in 12 worksites were analyzed. Men aged 45+ (n = 812) completed surveys documenting screening history, screening preferences and decisions, CaP knowledge, decision self-efficacy, and decisional consistency. Psychosocial and demographic correlates of IDM were also assessed. RESULTS Approximately half of the sample had a prior PSA test, although only 35% reported having made an explicit screening decision. Across the sample, CaP knowledge was low (mean = 56%), although decision self-efficacy was high (mean = 78%), and the majority of men (81%) made decisions consistent with their stated values. Compared with those who were undecided, men who made an explicit screening decision had significantly higher levels of knowledge, greater decisional self-efficacy, and were more consistent in terms of making a decision in alignment with their values. They tended to be white, have high levels of income and education, and had discussed screening with their health care provider. CONCLUSIONS Many men undergo CaP screening without being fully informed about the decision. These findings support the need for interventions aimed at improving IDM about screening, particularly among men of color, those with lower levels of income and education, and those who have not discussed screening with their provider.
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Affiliation(s)
- Jennifer D Allen
- Dana-Farber Cancer Institute, Boston, MA (JDA, APM, YL),Harvard Medical School, Boston, MA (JDA)
| | | | - Alton Hart
- Virginia Commonwealth University, Richmond, VA (AH)
| | | | - Yi Li
- Dana-Farber Cancer Institute, Boston, MA (JDA, APM, YL),Harvard School of Public Health, Boston, MA (MKDO, YL)
| | - Deborah Bowen
- Boston University School of Public Health, Boston, MA (DB)
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Pinquart M, Duberstein PR. Associations of social networks with cancer mortality: a meta-analysis. Crit Rev Oncol Hematol 2009; 75:122-37. [PMID: 19604706 DOI: 10.1016/j.critrevonc.2009.06.003] [Citation(s) in RCA: 281] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 06/09/2009] [Accepted: 06/10/2009] [Indexed: 11/29/2022] Open
Abstract
This meta-analysis integrates results of 87 studies on the associations of perceived social support, network size, and marital status with cancer survival. In controlled studies, having high levels of perceived social support, larger social network, and being married were associated with decreases in relative risk for mortality of 25%, 20%, and 12%, respectively. Moderator analyses revealed that never married patients had higher mortality rates than widowed and divorced/separated patients. Associations of social network with mortality were stronger in younger patients, and associations of marital status with mortality were stronger in studies with shorter time intervals, and in early-stage cancer. Relationships varied by cancer site, with stronger associations of social support observed in studies of patients with leukemia and lymphomas and stronger associations of network size observed in studies of breast cancer. Further randomized intervention studies are needed to test causal hypotheses about the role of social support and social network for cancer mortality.
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Affiliation(s)
- Martin Pinquart
- Department of Psychology, Philipps University, Gutenbergstrasse 18, 35032 Marburg, Germany.
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Abstract
There is a growing interest in community-level characteristics such as social capital and its relationship to health care access. To assess the rigor with which this construct has been empirically applied in research on health care access, a systematic review was conducted. A total of 2,396 abstracts were reviewed, and 21 met the criteria of examining some measure of social capital and its effects on health care access. The review found a lack of congruence in how social capital was measured and interpreted and a general inconsistency in findings, which made it difficult to draw firm conclusions about the effects of social capital on health care access. Insights from the social network literature can help improve the conceptual and measurement problems. Future work should distinguish among bonding, bridging, and linking social capital and their sources and benefits, and examine whether three dimensions of social capital actually exist: cognitive, behavioral, and structural.
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Allen JD, Stoddard AM, Sorensen G. Do social network characteristics predict mammography screening practices? HEALTH EDUCATION & BEHAVIOR 2008; 35:763-76. [PMID: 17620665 PMCID: PMC2859725 DOI: 10.1177/1090198107303251] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many breast cancer outreach programs assume that dissemination of information through social networks and provision of social support will promote screening. The authors prospectively examined the relationship between social network characteristics and adherence to screening guidelines. METHOD Employed women age 40 years and older completed baseline and 2-year follow-up assessments (N=1,475) as part of an intervention trial. The authors modeled screening adherence at follow-up as a function of social network characteristics at baseline. RESULTS Baseline adherence explained most of the variation in adherence at follow-up. For women age 40 to 51 years, having a mammogram at follow-up was predicted by encouragement by family and/or friends and subjective norms at baseline (odds ratio=2.20 and 1.18, respectively). For women age 52 years and older, the perception that screening was normative was related to adherence at follow-up (odds ratio=1.46). CONCLUSIONS Previous mammography use is strongly predictive of future screening. Social network characteristics have a modest impact on screening. Outreach efforts should focus on those who have previously underutilized mammography.
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Cancer Fatalism and Its Demographic Correlates Among African American and Hispanic Women. J Psychosoc Oncol 2008. [DOI: 10.1300/j077v22n04_03] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Network analysis is an approach to research that is uniquely suited to describing, exploring, and understanding structural and relational aspects of health. It is both a methodological tool and a theoretical paradigm that allows us to pose and answer important ecological questions in public health. In this review we trace the history of network analysis, provide a methodological overview of network techniques, and discuss where and how network analysis has been used in public health. We show how network analysis has its roots in mathematics, statistics, sociology, anthropology, psychology, biology, physics, and computer science. In public health, network analysis has been used to study primarily disease transmission, especially for HIV/AIDS and other sexually transmitted diseases; information transmission, particularly for diffusion of innovations; the role of social support and social capital; the influence of personal and social networks on health behavior; and the interorganizational structure of health systems. We conclude with future directions for network analysis in public health.
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Affiliation(s)
- Douglas A Luke
- Department of Community Health, School of Public Health, Saint Louis University, St. Louis, MO 63104, USA.
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40
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Magai C, Consedine N, Neugut AI, Hershman DL. Common psychosocial factors underlying breast cancer screening and breast cancer treatment adherence: a conceptual review and synthesis. J Womens Health (Larchmt) 2007; 16:11-23. [PMID: 17324093 DOI: 10.1089/jwh.2006.0024] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this paper, we review the literature on psychosocial influences on breast cancer screening and treatment adherence with an eye to identifying common cognitive, emotional, and social network factors that may lead to poor screening adherence and suboptimal treatment in the case of diagnosed breast cancer. Nonadherence to breast cancer screening and treatment guidelines can significantly and negatively impact the prospects for prevention and control of breast cancer. Psychosocial factors are an especially important focus for research, inasmuch as belief structures and psychosocial characteristics (such as patterns of emotion regulation and the quality of social relations) are modifiable and are, thus, eminently suitable to intervention.
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Affiliation(s)
- Carol Magai
- Department of Psychology, Long Island University, Brooklyn, New York 11201, USA.
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Messina CR, Lane DS, Glanz K, West DS, Taylor V, Frishman W, Powell L. Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative. Health Psychol 2005; 23:582-94. [PMID: 15546226 DOI: 10.1037/0278-6133.23.6.582] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.
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Affiliation(s)
- Catherine R Messina
- Stony Brook University, Department of Preventive Medicine, Stony Brook, NY 11794-8036, USA.
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Kinney AY, Bloor LE, Martin C, Sandler RS. Social Ties and Colorectal Cancer Screening among Blacks and Whites in North Carolina. Cancer Epidemiol Biomarkers Prev 2005. [DOI: 10.1158/1055-9965.182.14.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Few studies have examined the relationship between social networks and colorectal cancer screening in diverse populations. Prior research suggests that the type of social support as well as the amount or frequency of support available from one's social network may be associated with health outcomes. Therefore, the current study examined relationships between both structural (i.e., quantitative aspects of the social network, such as number of ties and frequency of contact with ties) and functional (i.e., functions provided by social network ties, such as offering emotional or instrumental support) aspects of social ties and utilization of colorectal cancer screening tests. Analyses included 697 randomly selected Blacks and Whites ages 51 to 80 years enrolled as controls in the North Carolina Colon Cancer Study. Social tie and screening information was obtained from face-to-face interviews. Forty-seven percent of participants (40% Blacks and 51% Whites) reported use of one of the options for colorectal cancer screening according to the guidelines at that time. Compared with those with the fewest social connections, those who were most socially connected were more likely to report recent use of colorectal cancer screening [odds ratio (OR), 3.2; 95% confidence interval (95% CI), 1.7-6.2]. This association was stronger among Blacks (OR, 3.8; 95% CI, 1.3-10.7) than Whites (OR, 2.9; 95% CI, 1.2-6.9; P for interaction = 0.006). There were also positive associations between being a church group (OR, 1.9; 95% CI, 1.4-2.7) and other group member (OR, 1.6; 95% CI, 1.1-2.2) and screening. Neither emotional (e.g., offering reassurance that one is cared for) nor instrumental (e.g., giving material assistance) support was associated with screening behavior. These data suggest that structural rather than functional aspects of social ties may be important in influencing colorectal cancer screening behavior.
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Affiliation(s)
| | - Lindsey E. Bloor
- 2Huntsman Cancer Institute, and
- 3Department of Psychology, University of Utah, Salt Lake City, Utah and
| | - Christopher Martin
- 4Division of Digestive Diseases and Nutrition, Center for Gastrointestinal Biology,
- 5Department of Epidemiology, School of Public Health, and
| | - Robert S. Sandler
- 4Division of Digestive Diseases and Nutrition, Center for Gastrointestinal Biology,
- 5Department of Epidemiology, School of Public Health, and
- 6Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Finney Rutten LJ, Iannotti RJ. Health beliefs, salience of breast cancer family history, and involvement with breast cancer issues: adherence to annual mammography screening recommendations. ACTA ACUST UNITED AC 2004; 27:353-9. [PMID: 14585322 DOI: 10.1016/s0361-090x(03)00133-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Involvement in breast cancer (BC) issues, and the degree to which family history of BC influences perceived risk (salience of family history), have been proposed as additions to the Health Belief Model as applied to mammography adherence. Barriers and benefits of mammography, perceived susceptibility, severity, cues to action, salience of family history, and issue involvement with respect to BC were examined in adherent (n=97) and non-adherent (n=213) women. Adherent women with positive family histories reported greater benefits of mammography, greater response to cues to action, and higher salience of family history than women with negative family histories. Non-adherent women with positive family histories reported fewer benefits of mammography and greater issue involvement, and perceived BC as less severe than those with negative family histories. Benefits (OR=1.51), susceptibility (OR=1.41), issue involvement (OR=1.59), severity (OR=0.66), and cues to action (OR=0.75) were significantly associated with adherence. Results have implications for evidence-based interventions.
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Affiliation(s)
- Lila J Finney Rutten
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Department of Health and Human Services, 20892-7326, Bethesda, MD, USA
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Varnell SP, Murray DM, Janega JB, Blitstein JL. Design and analysis of group-randomized trials: a review of recent practices. Am J Public Health 2004; 94:393-9. [PMID: 14998802 PMCID: PMC1448264 DOI: 10.2105/ajph.94.3.393] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2003] [Indexed: 11/04/2022]
Abstract
We reviewed group-randomized trials (GRTs) published in the American Journal of Public Health and Preventive Medicine from 1998 through 2002 and estimated the proportion of GRTs that employ appropriate methods for design and analysis. Of 60 articles, 9 (15.0%) reported evidence of using appropriate methods for sample size estimation. Of 59 articles in the analytic review, 27 (45.8%) reported at least 1 inappropriate analysis and 12 (20.3%) reported only inappropriate analyses. Nineteen (32.2%) reported analyses at an individual or subgroup level, ignoring group, or included group as a fixed effect. Hence increased vigilance is needed to ensure that appropriate methods for GRTs are employed and that results based on inappropriate methods are not published.
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Stark A, Prince A, Kucera G, Lu M, Raju U, Nathanson D. Evaluating post-treatment screening in women with breast cancer. CANCER PRACTICE 2002; 10:228-33. [PMID: 12236835 DOI: 10.1046/j.1523-5394.2002.105001.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The objective of this study was to evaluate the 5-year post-treatment use rate for screening mammography and clinical breast examination (CBE) among women treated for atypical hyperplasia (AH) or carcinoma in situ (CIS). DESCRIPTION OF STUDY A total of 103 women, who had received diagnoses and had been treated for primary AH or CIS, were observed for 5 years through a review of medical records and electronic databases. Adequate screening use was defined as the patient undergoing one mammography examination and at least one CBE per year. RESULTS Multivariate logistic regression showed that screening activity declined significantly with time. During the first year, 83.5% and 80.6%, respectively, of women were screened by CBE and mammography. By year 2, CBE screening had dropped by 25.2% (P <.01) and mammography screening by 9.7% (P =.08). Attrition in CBE and mammography screening continued for each consecutive year and was significant (P <.01). During the first year, 70.9% of women received both methods of screening, which declined to 9.7% by year 5. Women who had received diagnoses of CIS and those married with children were more likely to use post-treatment screening, while fee-for-service insurance was negatively associated with screening. CLINICAL IMPLICATIONS The reasons for the observed decline in the annual post-treatment screening are not known. Negative findings from follow-up screenings might have lowered the perception of cancer susceptibility and promoted the decline in screening use. A communication gap between physicians and patients might have reinforced this perception. The importance of annual screening may be verbally emphasized at each clinic visit, and reminder notes and telephone calls may be used to remind patients of upcoming screenings. Additional studies are planned to evaluate the effect of various intervention strategies in improving post-treatment screening use.
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Affiliation(s)
- Azadeh Stark
- Division of Cancer Epidemiology and Prevention, Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan 48202, USA
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46
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The Impact of Family History of Breast Cancer on Women's Health Beliefs, Salience of Breast Cancer Family History, and Degree of Involvement in Breast Cancer Issues. Women Health 2001. [DOI: 10.1300/j013v33n03_02] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Allen JD, Stoddard AM, Mays J, Sorensen G. Promoting breast and cervical cancer screening at the workplace: results from the Woman to Woman Study. Am J Public Health 2001; 91:584-90. [PMID: 11291370 PMCID: PMC1446631 DOI: 10.2105/ajph.91.4.584] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This article reports findings from a peer-delivered intervention designed to increase use of breast and cervical cancer screening. METHODS Twenty-six worksites were randomly assigned to the intervention or comparison group. The 16-month intervention consisted of group discussions, outreach, and educational campaigns. Data were collected from a random sample of women employees stratified by age (baseline n = 2943; final n = 2747). Cross-sectional analyses were conducted to evaluate the impact of the intervention on screening behaviors. RESULTS Relative to comparison worksites, the intervention group experienced greater increases in the percentage of women who reported a recent mammogram (7.2% vs 5.6%), clinical breast examination (5.8% vs 2.1%), and Papanicolaou (Pap) test (4.7% vs 1.9%). After worksite cluster and age strata were controlled for, the observed increase in Pap tests was significantly greater in the intervention group (odds ratio [OR] = 1.28; 95% confidence interval [CI] = 1.01, 1.62); however, differences in mammography screening rates (OR = 1.14; 95% CI = 0.90, 1.44) and clinical breast examination (OR = 1.19; 95% CI = 0.96, 1.49) were not statistically significant. CONCLUSIONS Intervention activities produced a modest increase in cervical cancer screening, but they did not accelerate breast cancer screening rates above the observed secular trend.
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Affiliation(s)
- J D Allen
- Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney St, Boston, MA 02115, USA.
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Allen JD, Sorensen G, Stoddard AM, Colditz G, Peterson K. Intention to have a mammogram in the future among women who have underused mammography in the past. HEALTH EDUCATION & BEHAVIOR 1998; 25:474-88. [PMID: 9690105 DOI: 10.1177/109019819802500406] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated associations between confidence in one's ability to discuss mammography with health providers and to obtain regular mammograms (self-efficacy), social network members' attitudes toward mammograms (social influence), mammography experiences, and intention to have a mammogram in the next 1 to 2 years among women who were not in adherence with screening guidelines. Data were collected as part of a baseline assessment for a work site intervention study. Women 52 years and older completed a self-administered survey. Those not in compliance with screening guidelines (n = 194) were included in the analyses. Logistic regression revealed that self-efficacy and strong supportive social influences were significantly associated with mammography intention (odds ratio [OR] = 2.50, OR = 2.22, respectively), adjusting for prior mammography use. Findings suggest that interventions designed to promote mammography should build women's confidence in their ability to discuss mammography with health providers and to obtain regular mammograms. Intervention among social networks may also be an effective means of promoting mammography.
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Affiliation(s)
- J D Allen
- Dana-Farber Cancer Institute, Division of Cancer Epidemiology and Control, Boston, MA 02115, USA.
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