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Oh KM, An K, Lee M, Shin C, Steves SL. Colorectal cancer screening disparities in Asian Americans: the influences of patient-provider communication and social media use. Cancer Causes Control 2023:10.1007/s10552-023-01720-z. [PMID: 37266764 PMCID: PMC10237058 DOI: 10.1007/s10552-023-01720-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE We examined the role of patient-provider communication (PPC) during in-person visits and via electronic communication and social media use on colorectal cancer (CRC) screening among Asian Americans (AAs) and Non-Hispanic Whites (NHWs) aged 50 and older. METHODS Health Information National Trends Survey 2017-2020 data were analyzed. RESULTS AAs tended to evaluate the quality of PPC during their in-person visits to a health care provider lower than NHWs. AAs' CRC screening rate was lower than the rate of NHWs (78.8% vs. 84.4%). After adjusting for sociodemographics, healthcare access, and health status, the quality of PPC was the only significant predictor associated with a lower probability of CRC screening among AAs (Adjusted OR 0.74; 95% CI 0.56, 0.96); while the Internet to communicate with a health care provider was the only significant predictor of CRC screening among NHWs (Adjusted OR 1.76; CI 1.11, 2.79). AAs were more likely to use YouTube to watch a health-related video than NHWs (43.5% vs, 24%). However, social media use was not associated with CRC screening in both AAs and NHWs. CONCLUSION Use of electronic communication technology may contribute to improve health information literacy and reduce the disparity. On-line communication may empower the culturally and linguistically diverse AAs by improving their confidence in communication with health care providers. Thus, communication technologies need to be strategically utilized and tailored to better meet the communication needs of racial/ethnic minorities. Online communication technologies may reduce the disparities in PPC related to cancer screening and cancer burden experienced by AAs.
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, Fairfax, VA, USA.
| | - Kyungeh An
- Graduate School of Biomedical Sciences & School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Moonju Lee
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Chanam Shin
- College of Nursing, Texas Woman's University, Denton, TX, USA
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Kindratt TB, Allicock M, Atem F, Dallo FJ, Balasubramanian BA. Email Patient-Provider Communication and Cancer Screenings Among US Adults: Cross-sectional Study. JMIR Cancer 2021; 7:e23790. [PMID: 34328421 PMCID: PMC8367146 DOI: 10.2196/23790] [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: 08/31/2020] [Revised: 04/12/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background The growth of electronic medical records and use of patient portals have allowed for patients and health care providers to communicate via email and direct messaging between health care visits. Email patient-provider communication (PPC) may enhance traditional face-to-face PPC by allowing patients to ask questions, receive clear explanations, engage in shared decision-making, and confirm their understanding between in-person visits. Despite increasing trends in the use of email PPC since the early 2000s, few studies have evaluated associations between email PPC and the uptake of preventive services. Objective The objective of this study was to determine associations between the use of email PPC and the likelihood of undergoing breast, cervical, and colon cancer screenings among adults who have received health care in the past 12 months. Methods Secondary, cross-sectional data from the 2011-2015 National Health Interview Survey were combined and analyzed. For each cancer screening, inclusion criteria were based on the age of screening recommendations and prior history of cancer diagnosis (n=35,912 for breast, n=48,512 for cervical, and n=45,884 for colon). The independent variable was whether adults used email PPC in the past 12 months (yes or no). The dependent variables were whether (1) women (aged ≥40 years) received a mammogram in the past 12 months; (2) women (aged 21-65 years) received a Pap test in the past 12 months; and (3) individuals (aged ≥50 years) received a colon cancer screening in the past 12 months. Bivariate and multivariable logistic regression analyses were conducted. Results Adults who reported receiving all three cancer screenings in the past 12 months were more likely to be non-Hispanic White; be married or living with a partner; have a bachelor’s degree or higher education level; have health insurance coverage; and perceive their health as excellent, very good, or good (all P<.001). Men were more likely to receive colon cancer screenings than women (P<.001). Multivariable logistic regression models showed women who used email to communicate with their health care providers had greater odds of receiving breast (odds ratio [OR] 1.32, 95% CI 1.20-1.44) and cervical (OR 1.11, 95% CI 1.02-1.20) cancer screenings than women who did not use email PPC. Adults who used email to communicate with their health care providers had 1.55 times greater odds (95% CI 1.42-1.69) of receiving a colon cancer screening than those who did not use email PPC. Conclusions Our results demonstrate that email PPC is a marker of increased likelihood of adults completing age-appropriate cancer screenings, particularly breast, cervical, and colon cancer screenings. More research is needed to examine other factors related to the reasons for and quality of email PPC between patients and health care providers and determine avenues for health education and intervention to further explore this association.
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Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States.,Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Folefac Atem
- Department of Biostatistics and Data Science, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, United States
| | - Bijal A Balasubramanian
- Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Epidemiology, Human Genetics, and Environmental Health Sciences, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States
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3
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Kindratt TB, Atem F, Dallo FJ, Allicock M, Balasubramanian BA. The Influence of Patient-Provider Communication on Cancer Screening. J Patient Exp 2020; 7:1648-1657. [PMID: 33457626 PMCID: PMC7786660 DOI: 10.1177/2374373520924993] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Few studies have examined how different qualities and modes (face-to-face vs electronic) of patient–provider communication (PPC) influence cancer screening uptake. Our objective was to determine whether receiving a breast, cervical, and colorectal cancer screening is influenced by (1) qualities of face-to-face and (2) the use of e-mail PPC. We analyzed Health Information National Trends Survey 4, cycles 1 to 4 data. To assess qualities of face-to-face PPC, adults reported how often physicians spent enough time with them, explained so they understood, gave them a chance to ask questions, addressed feelings and emotions, involved them in decisions, confirmed understanding, and helped them with uncertainty. Adults reported whether they used e-mail PPC. We used multivariable logistic regression to evaluate the odds of receiving cancer screenings based on face-to-face and e-mail PPC. Adults whose health-care providers involved them in decision-making had highest odds of receiving breast (odds ratio [OR] = 1.38; 95% confidence interval [CI] = 1.11-1.71), cervical (OR = 1.30; 95% CI = 1.06-1.60), and colorectal (OR = 1.25; 95% CI = 1.03-1.51) cancer screenings. No significant associations were observed between e-mail PPC and cancer screenings. More research is needed to explore this association.
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Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Folefac Atem
- Department of Biostatistics and Data Science, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Center for Health Promotion and Prevention Research, UT Southwestern-Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Bijal A Balasubramanian
- Center for Health Promotion and Prevention Research, UT Southwestern-Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA.,Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Kindratt TB, Dallo FJ, Allicock M, Atem F, Balasubramanian BA. The influence of patient-provider communication on cancer screenings differs among racial and ethnic groups. Prev Med Rep 2020; 18:101086. [PMID: 32309115 PMCID: PMC7155227 DOI: 10.1016/j.pmedr.2020.101086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/09/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022] Open
Abstract
Our study aimed to estimate how associations between adults' perceptions of specific domains of PPC quality and their likelihood of receiving cancer screenings differed by race and ethnicity. We analyzed 2011-2015 Medical Expenditure Panel Survey (MEPS) data. Samples included 7337 women ages 50-74 (breast), 13,276 women ages 21-65 (cervical), and 9792 adults ages ≥50 years (colorectal). To examine individual domains of PPC quality (independent variables), adults reported how often providers: listened; showed respect; spent enough time; explained things; gave specific instructions; and demonstrated health literate practices (gave clear instructions and asked them to "teach-back" how they will follow instructions). Dependent variables were breast, cervical, and colorectal cancer screenings. Multivariable logistic regression was used to evaluate the odds of receiving cancer screenings using a composite measure of PPC quality and separate domains. Hispanic and non-Hispanic black adults who reported their providers always demonstrated PPC quality had higher odds of receiving colorectal cancer screenings compared to those whose providers did not. Adults' perceptions of whether or not their provider gave them specific instructions increased their odds of receiving breast (Hispanics OR = 1.65, 95% CI = 1.09, 2.51; non-Hispanic blacks OR = 1.54, 95% CI = 1.06, 2.24) and colorectal (non-Hispanic whites OR = 1.37, 95% CI = 1.13, 1.66; Hispanics OR = 1.29, 95% CI = 1.01, 1.66; non-Hispanic blacks OR = 1.92, 95% CI = 1.39, 2.65) cancer screenings. Non-Hispanic Asian women who reported their health care providers demonstrated "teach-back" had higher odds (OR = 2.25; 95% CI = 1.10, 4.62) of receiving cervical cancer screenings. Efforts to improve cancer screenings should focus on training providers to demonstrate health literate practices to improve cancer screenings.
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Affiliation(s)
- Tiffany B Kindratt
- University of Texas at Arlington, Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, 500 West Nedderman Drive, Arlington, TX 76019-0259, United States
| | - Florence J Dallo
- Oakland University, Department of Public and Environmental Wellness, School of Health Sciences, United States
| | - Marlyn Allicock
- UT Health, The University of Texas Health Science Center at Houston, School of Public Health Dallas, Department of Health Promotion and Behavioral Sciences, United States
| | - Folefac Atem
- UT Health, The University of Texas Health Science Center at Houston, School of Public Health Dallas, Department of Biostatistics and Data Science, United States
| | - Bijal A Balasubramanian
- UT Health, The University of Texas Health Science Center at Houston, School of Public Health Dallas, Department of Epidemiology, Human Genetics, and Environmental Sciences, Center for Health Promotion and Prevention Research, UT Southwestern - Harold C. Simmons Comprehensive Cancer Center, United States
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Gonzalez JJ, Wahab A, Samalik J, Ramirez E, Saint-Phard T, Gonzalez E, Adekolujo OS. Barriers and Facilitators of Colorectal Cancer Screening Among a Hispanic Community in Michigan. J Racial Ethn Health Disparities 2019; 7:137-143. [PMID: 31664675 DOI: 10.1007/s40615-019-00643-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Colorectal cancer (CRC) is the third leading cause in the USA for cancer-related deaths. Hispanics demonstrate the lowest CRC screening (CRCS) rate and research suggests that causes of screening disparities differ among ethnic groups and geographic locations. The aim of this study was to determine the rate of CRCS and to identify barriers and facilitators to screening in the Hispanic population of Flint, Michigan METHODS: Cross-sectional study. Consenting participants completed a previously validated survey in their language of preference. Variables obtained included sociodemographic information, insurance status, language preference, primary care physician (PCP), language spoken by PCP, recommendation of CRCS, acculturation, and fatalism. Univariate and multivariate logistic regressions were performed to determine the association between predictors associated with previous CRCS. RESULTS Seventy subjects completed the survey. Overall previous CRCS rate was 60%. Multivariate results indicated that having a physician that speaks both English and Spanish significantly increases the likelihood of CRCS. It also indicated that those who have been living in the USA for equal or less than 30 years and those that physician had never recommended screening were less likely to have been screened. DISCUSSION Our study provides important preliminary data that may help improve CRCS among this Hispanic population. Interventions include providing a list of bilingual physicians in the community and to educate them regarding CRCS to mitigate the lack of physician recommendations. Notably, this study highlights the importance of cultural sensitivity and competence in preventive healthcare to promote inclusiveness of minority populations.
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Affiliation(s)
- Juan Jose Gonzalez
- Internal Medicine-Hospital Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
| | - Ahsan Wahab
- Hospital Medicine, Baptist Medical Center South, 2105 E South Blvd, Montgomery, AL, 36116, USA
| | - Joann Samalik
- Pediatric Residency Program, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Elizabeth Ramirez
- Family Medicine Residency Program, West Suburban Medical Center, 3 Erie St, Oak Park, IL, 60302, USA
| | - Tryphene Saint-Phard
- Internal Medicine Residency Program, McLaren Flint/Michigan State University, 401 S Ballenger Hwy, Flint, MI, 48532, USA
| | - Emelie Gonzalez
- Universidad Dr. Jose Matias Delgado, La Libertad, El Salvador
| | - Orimisan S Adekolujo
- Internal Medicine Residency Program, McLaren Flint/Michigan State University, 401 S Ballenger Hwy, Flint, MI, 48532, USA
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GPs' perspectives on colorectal cancer screening and their potential influence on FIT-positive patients: an exploratory qualitative study from a Dutch context. BJGP Open 2019; 3:bjgpopen18X101631. [PMID: 31049411 PMCID: PMC6480863 DOI: 10.3399/bjgpopen18x101631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 01/27/2023] Open
Abstract
Background In the Dutch colorectal cancer (CRC) screening programme, individuals receive a faecal immunochemical test (FIT) to do at home. After a positive FIT result, a follow-up colonoscopy is recommended to identify CRC or advanced adenomas (AA). GPs may influence their patients’ decisions on adherence to follow-up by colonoscopy. Aim To explore GPs’ perspectives on the CRC screening programme and their potential influence on FIT-positive patients to follow up with the recommended colonoscopy. Design & setting Semi-structured interviews among GPs in Amsterdam, the Netherlands. Method GPs were approached using purposive sampling. Analysis was performed on 11 interviews using open coding and constant comparison. Results All interviewed GPs would recommend FIT-positive patients without obvious contraindications to adhere to a follow-up colonoscopy. If patients were likely to be distressed by a positive FIT result, most GPs described using reassurance strategies emphasising a low cancer probability. Most GPs stressed the probability of false-positive FIT results. Some described taking a positive screening result in CRC screening less seriously than one in breast cancer screening. Most GPs underestimated CRC and AA probabilities after a positive FIT result. When told the actual probabilities, some stated that this knowledge might change the way they would inform patients. Conclusion These results imply that some of the interviewed GPs have too low a perception of the risk associated with a positive FIT result, which might influence their patients’ decision-making. Simply informing GPs about the actual rates of CRC and AA found in the screening programme might improve this risk perception.
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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: 29] [Impact Index Per Article: 4.8] [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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Şahin MK, Aker S. Family Physicians' Knowledge, Attitudes, and Practices Toward Colorectal Cancer Screening. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:908-913. [PMID: 27193411 DOI: 10.1007/s13187-016-1047-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to assess family physicians' knowledge, attitudes, and practices toward colorectal cancer (CRC) screening. The population in this cross-sectional study consisted of 290 family physicians working in Samsun, Turkey, contacted between 15 June and 15 July 2015 and agreeing to participate. A questionnaire prepared by the authors on the basis of the relevant literature was applied at face-to-face interviews. The first part of the questionnaire inquired into sociodemographic information, while the second contained questions evaluating family physicians' knowledge, attitudes, and practices toward CRC screening. Physicians completed the questionnaire in approximately 10 min. 65.9 % of the family physicians in the study were men. Mean age of the participants was 43.40 ± 6.54 years, and mean number of years in service was 18.43 ± 6.42. The average number of patients seen by physicians on a daily basis was 51-99. CRC screening was performed by 83.1 % of physicians. The fecal occult blood test (FOBT) was recommended at the correct frequency by 30.7 % of physicians and colonoscopy by 11.7 %. A further 68.6 % of physicians followed no CRC guideline. Only 3.8 % of those reporting using a guideline were able to name it. The great majority of physicians in this study apply CRC screening. However, family physicians lack sufficient information concerning the ages at which screening tests should be started and concluded and how frequently they should be performed. They also do not attach sufficient importance to CRC guidelines. This results in excessive demand for screening tests.
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Affiliation(s)
- Mustafa Kürşat Şahin
- Samsun Public Health Directorate, Canik Community Health Center, Gaziosmanpaşa Mah. Alaca Sok. No: 31, Canik, Samsun, Turkey.
| | - Servet Aker
- Samsun Public Health Directorate, Canik Community Health Center, Gaziosmanpaşa Mah. Alaca Sok. No: 31, Canik, Samsun, Turkey
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Street RL, Mazor KM, Arora NK. Assessing Patient-Centered Communication in Cancer Care: Measures for Surveillance of Communication Outcomes. J Oncol Pract 2016; 12:1198-1202. [PMID: 27650836 PMCID: PMC5455589 DOI: 10.1200/jop.2016.013334] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Richard L. Street
- Texas A&M University, College Station; Baylor College of Medicine, Houston, TX; Meyers Primary Care Institute, Worcester, MA; and Patient-Centered Care Research Outcomes Research Branch, Washington, DC
| | - Kathleen M. Mazor
- Texas A&M University, College Station; Baylor College of Medicine, Houston, TX; Meyers Primary Care Institute, Worcester, MA; and Patient-Centered Care Research Outcomes Research Branch, Washington, DC
| | - Neeraj K. Arora
- Texas A&M University, College Station; Baylor College of Medicine, Houston, TX; Meyers Primary Care Institute, Worcester, MA; and Patient-Centered Care Research Outcomes Research Branch, Washington, DC
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10
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Manning M, Burnett J, Chapman R. Predicting Incongruence between Self-reported and Documented Colorectal Cancer Screening in a Sample of African American Medicare Recipients. Behav Med 2016; 42:238-47. [PMID: 25961362 PMCID: PMC4641836 DOI: 10.1080/08964289.2015.1011600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Assessments of colorectal cancer (CRC) screening rates typically rely on self-reported screening data, which are often incongruent with medical records. We used multilevel models to examine health-related, socio-demographic and psychological predictors of incongruent self-reports for CRC screening among Medicare-insured African Americans (N = 3,740). Results indicated that living alone decreased, and income increased, the odds of congruently self-reporting endoscopic CRC screening. Being male and having greater number of comorbidities decreased, and having less than a high school education increased, the odds of congruently self-reported fecal occult blood tests. Living alone, age and income had the most robust effects across classifications into one of four mutually exclusive categories defined by screening status (screened/unscreened) and congruence of self-reports. The results underscore the clinical importance of gathering socio-demographic data via patient interviews, and the relevance of these data for judging the veracity of self-reported CRC screenings behaviors.
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Affiliation(s)
- Mark Manning
- Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R - MM03CB, Detroit, MI 48201
| | - Janice Burnett
- Josephine Ford Cancer Institute, Division of Hematology and Medical Oncology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202
| | - Robert Chapman
- Josephine Ford Cancer Institute, Division of Hematology and Medical Oncology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202
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11
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Plevinsky JM, Gumidyala AP, Fishman LN. Transition experience of young adults with inflammatory bowel diseases (IBD): a mixed methods study. Child Care Health Dev 2015; 41:755-61. [PMID: 25376979 DOI: 10.1111/cch.12213] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Outcomes following transition can be poor; many young adults are ill prepared to take responsibility for their health care, older adolescents report incomplete understanding of medications, and parents remain largely responsible for their care. Good patient-provider relationships are associated with better adherence; however, the role of the relationship between post-transition patients and their providers has not been explored. The current study aimed to understand transition of young adults with inflammatory bowel diseases (IBD), the impact of the paediatric patient-provider relationship and what determines the adult patient-provider relationship. METHODS This study examined the experience of young adults with Crohn's disease or ulcerative colitis (aged 18-30) after transition. Twenty-nine patients completed a 31-item online survey of their transition experience from paediatric to adult care. Responses were coded quantitatively and qualitatively, and qualitative responses were analysed by two independent raters. RESULTS Positive themes regarding adult providers included independence, autonomy and trust, while negative themes included initial discomfort and confusing logistics. Five of six patients who reported 'terrifying' first visit experiences with their adult providers reported overall positive relationships. The earlier the diagnosis age, the less involved in medical decisions they were as an adult (r = 0.41, P = .03). Those who had a more positive experience with their paediatric providers were more likely to bring up confusion with their adult providers (r = .45, P = .04), and those who had a more positive experience with their adult providers were more likely to endorse collaborative medical decision-making (r = .57, P < .001). CONCLUSIONS Patients diagnosed with IBD at a young age may need extra education and self-management strategies, as they were less likely to exhibit behaviours indicative of a successful transition to adult care. Additionally, transition programme development may benefit from the post-transition perspective across chronic illness populations.
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Affiliation(s)
- J M Plevinsky
- Psychology Department, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - A P Gumidyala
- Psychology Department, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - L N Fishman
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Cambridge, MA, USA
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12
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Kim SJ, Han KT, Park EC. Impact of Job Status on Accessibility of Cancer Screening. Cancer Res Treat 2015; 48:825-33. [PMID: 26194373 PMCID: PMC4843711 DOI: 10.4143/crt.2015.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/28/2015] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Cancer is a leading cause of death worldwide with approximately 75,000 cancer deaths in Korea alone in 2013. Cancer screening is an important method of prevention; however, only 63.4% of Koreans sought cancer screening in 2012 even though it was widely offered at no cost. We focused on part time workers because they often experience job instability and relative discrimination. Therefore, we investigated the correlation between job status and cancer screening. MATERIALS AND METHODS Data from the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) were used for selection of individuals who participated in the national cancer screening program. A total of 1,326 wage earners were selected for our study. The association between cancer screening and part time job status was examined using logistic regression models. RESULTS Of the 1,326 individuals selected for the study, 869 (64.5%) had participated in the cancer screening program; among these, 421 (48.4%) were part time workers and 448 (51.6%) were full time workers. Lower prevalence of cancer screening was observed for part time workers compared to full time workers (odds ratio, 0.72; confidence interval, 0.53 to 1.00; p=0.0495). Factors including age, marital status, private insurance, chronic disease, smoking, and residential area emerged as showed significant association with participation in screening programs. CONCLUSION We found that part time workers had difficulty participating in prevention programs. Change in the workplace environment as well as development of positive social programs targeted to part time workers is necessary in order to encourage participation of part time workers in prevention programs.
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Affiliation(s)
- Seung Ju Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Kyu-Tae Han
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Othman A, Ahram M, Al-Tarawneh MR, Shahrouri M. Knowledge, Attitudes and Practices of Breast Cancer Screening Among Women in Jordan. Health Care Women Int 2014; 36:578-92. [DOI: 10.1080/07399332.2014.926900] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lazure P, St-Germain F, Gryfe R, Trudeau M, Hayes SM. Communication – the foundation for collaborative relationships amongst providers, and between providers and patients: A case in breast and colorectal cancer. ACTA ACUST UNITED AC 2014. [DOI: 10.1179/1753807614y.0000000047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Christy SM, Mosher CE, Rawl SM. Integrating men's health and masculinity theories to explain colorectal cancer screening behavior. Am J Mens Health 2014; 8:54-65. [PMID: 23813927 PMCID: PMC3849215 DOI: 10.1177/1557988313492171] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cause of cancer deaths among men in the United States. Although CRC screening has been found to reduce CRC incidence and mortality, current screening rates among men are suboptimal due to various practical and psychosocial barriers. One potential barrier to CRC screening identified in qualitative studies with men is the threat to masculinity that endoscopic screening methods pose. Indeed, beliefs about masculinity have been predictive of other preventive health behaviors among men. In this review article, we propose a novel conceptual framework to explain men's CRC screening behavior that integrates masculinity norms, gender role conflict, men's health care experiences, behaviors, and beliefs, and social and background variables. This framework has the potential to guide future research on men's CRC screening behaviors and other health behaviors and may inform gender-sensitive interventions that target masculinity beliefs to increase preventive health behaviors.
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Affiliation(s)
- Shannon M Christy
- 1Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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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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