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Rosenfeld M, Goldblatt H, Greenblatt-Kimron L, Cohen M. "There is a God or There is No God-It is in the Hands of God:" Fatalistic Beliefs Among Israeli People About Cancer and Their Impact on Behavioral Outcomes. JOURNAL OF RELIGION AND HEALTH 2023; 62:2033-2049. [PMID: 36738394 DOI: 10.1007/s10943-023-01751-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
This qualitative study examined fatalistic beliefs and cancer causal attributions among people without cancer. Participants were 30 Israeli women and men aged 51-70 from diverse sociocultural backgrounds who participated in four focus groups. Three main themes emerged, referring to the variability in fatalistic beliefs of cancer occurrence and cancer outcome, the duality in attributing causality to divine providence and mere luck or chance, and the connection between distinct fatalistic beliefs and health behaviors. Data analysis enabled an expansion of the understanding of cancer fatalism as a multidimensional structure, whereby interactions between causality attribution and different fatalistic beliefs are related to prevention and screening behaviors.
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Affiliation(s)
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
| | | | - Miri Cohen
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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2
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Augustin J, Andrees V, Walsh D, Reintjes R, Koller D. Spatial Aspects of Health-Developing a Conceptual Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1817. [PMID: 36767185 PMCID: PMC9914219 DOI: 10.3390/ijerph20031817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Numerous studies and models address the determinants of health. However, in existing models, the spatial aspects of the determinants are not or only marginally taken into account and a theoretical discussion of the association between space and the determinants of health is missing. The aim of this paper is to generate a framework that can be used to place the determinants of health in a spatial context. A screening of the current first serves to identify the relevant determinants and describes the current state of knowledge. In addition, spatial scales that are important for the spatial consideration of health were developed and discussed. Based on these two steps, the conceptual framework on the spatial determinants of health was derived and subsequently discussed. The results show a variety of determinants that are associated with health from a spatial point of view. The overarching categories are global driving forces, policy and governance, living and physical environment, socio-demographic and economic conditions, healthcare services and cultural and working conditions. Three spatial scales (macro, meso and micro) are further subdivided into six levels, such as global (e.g., continents), regional (e.g., council areas) or neighbourhood (e.g., communities). The combination of the determinants and spatial scales are presented within a conceptual framework as a result of this work. Operating mechanisms and pathways between the spatial levels were added schematically. This is the first conceptual framework that links the determinants of health with the spatial perspective. It can form the working basis for future analyses in which spatial aspects of health are taken into account.
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Affiliation(s)
- Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - David Walsh
- Glasgow Centre for Population Health, Glasgow G40 2QH, UK
| | - Ralf Reintjes
- Department of Health Sciences, Faculty of Life Sciences, Hamburg University of Applied Sciences, 20999 Hamburg, Germany
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
| | - Daniela Koller
- IBE—Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
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3
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Lau J, Lim TZ, Jianlin Wong G, Tan KK. The health belief model and colorectal cancer screening in the general population: A systematic review. Prev Med Rep 2020; 20:101223. [PMID: 33088680 PMCID: PMC7567954 DOI: 10.1016/j.pmedr.2020.101223] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer screening saves lives and is cost-effective. It allows early detection of the pathology, and enables earlier medical intervention. Despite clinical practice guidelines promoting screening for average risk individuals, uptake remains suboptimal in many populations. Few studies have examined how sociobehavioural factors influence screening uptake in the context of behaviour change theories such as the health belief model. This systematic review therefore examines how the health belief model’s constructs are associated with colorectal cancer screening. Four databases were systematically searched from inception to September 2019. Quantitative observational studies that used the health belief model to examine colorectal screening history, intention or behaviour were included. A total of 30 studies met the criteria for review; all were of cross-sectional design. Perceived susceptibility, benefits and cues to action were directly associated with screening history or intention. Perceived barriers inversely associated with screening history or intention. The studies included also found other modifying factors including sociodemographic and cultural norms. Self-report of screening history, intention or behaviour, convenience sampling and lack of temporality among factors were common limitations across studies. The health belief model’s associations with colorectal cancer screening uptake was consistent with preventive health behaviours in general. Future studies should examine how theory-based behavioural interventions can be tailored to account for the influence of socioecological factors.
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Affiliation(s)
- Jerrald Lau
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tian-Zhi Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gretel Jianlin Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Dominic OG, Chinchilli V, Wasserman E, Curry WJ, Kambic DM, Caicedo CH, Ramirez AG, Ochoa JA, Lengerich EJ. Impact of Social Support on Colorectal Cancer Screening among Adult Hispanics/Latinos: A Randomized Community-based Study in Central Pennsylvania. Cancer Prev Res (Phila) 2020; 13:531-542. [PMID: 32127350 DOI: 10.1158/1940-6207.capr-19-0333] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/22/2019] [Accepted: 02/27/2020] [Indexed: 11/16/2022]
Abstract
In the United States, the five-year survival rate of colorectal cancer for Latinos is lower than it is for White, non-Latinos. Differences in survival are due, in part, to Latinos being diagnosed at a later stage. An ethnic gap in the use of colorectal cancer screening contributes to the difference in survival. We developed, implemented, and evaluated a targeted colorectal cancer screening intervention to increase colorectal cancer screening uptake by sex, ethnicity, and geography. We measured actual colorectal cancer screening uptake in both arms as a method to determine completion rates. We used a randomized, community-based, participatory design to test the impact of social support (intervention) on completion of a provider-recommended, take-home fecal immunochemical test (FIT) kit screening test among average-risk, urban, and rural Pennsylvania Latino adults age 50 and older not currently adherent to national colorectal cancer screening guidelines (n = 264). Participants in each arm attended a community-based educational program offered at eight sites. Among the 264 participants, 154 (58%) returned a completed usable FIT kit screening test. A higher return rate was observed among participants in the social support arm (66.0%) compared with the control (47.2%). Participants in the social support arm were statistically significant 2.67 times as likely to return a completed FIT kit. Of these, 27 (17.5%) had a positive FIT kit screening test result. The results of this study suggest that social support is an effective method to increase colorectal cancer screening rates among Latinos. Future studies should examine dissemination and implementation of community-based strategies among Latinos that include social support.
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Affiliation(s)
- Oralia G Dominic
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania. .,Department of Biobehavioral Health, The Pennsylvania State University, College of Health and Human Development, University Park, Pennsylvania
| | - Vern Chinchilli
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Emily Wasserman
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - William J Curry
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Daniel M Kambic
- Kambic Family Clinic, Steelton, Pennsylvania.,Pinnacle Health System, Harrisburg, Pennsylvania
| | | | - Amelie G Ramirez
- Institute for Health Promotion Research, Health Disparities Research, UT Health Science Center at San Antonio, San Antonio, Texas
| | - John A Ochoa
- Department of Spanish, Italian and Portuguese, College of Health and Human Development, The Pennsylvania State University, State College, Pennsylvania
| | - Eugene J Lengerich
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Biobehavioral Health, The Pennsylvania State University, College of Health and Human Development, University Park, Pennsylvania.,Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.,Penn State Cancer Institute, The Pennsylvania State University, State College, Pennsylvania
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5
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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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6
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Leal IM, Kao LS, Karanjawala B, Escamilla RJ, Ko TC, Millas SG. Understanding Patients' Experiences of Diagnosis and Treatment of Advanced Colorectal Cancer in a Safety-Net Hospital System: A Qualitative Study. Dis Colon Rectum 2018. [PMID: 29521833 DOI: 10.1097/dcr.0000000000000967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Greater understanding of barriers to screening of colorectal cancer among lower socioeconomic, particularly Hispanic, patients is needed to improve disparities in care. OBJECTIVE This study aimed to explore patients' perceptions and experiences of care seeking for colorectal cancer to identify barriers to early diagnosis and treatment. DESIGN This explorative qualitative study was conducted as a focused ethnography of patients diagnosed with advanced-stage colorectal cancer. SETTINGS This study was conducted at an urban safety-net hospital. PARTICIPANTS Thirty lower-income, primarily minority, patients diagnosed with stage III and IV colorectal cancer without prior colorectal cancer screening were selected. MAIN OUTCOME MEASURES The primary outcomes measured were participants' perceptions and experiences of colorectal cancer and barriers they faced in seeking diagnosis and treatment RESULTS:: Data analysis yielded 4 themes consistently influencing participants' decisions to seek diagnosis and treatment: 1) limited resources for accessing care (structural barriers, including economic, health care and health educational resources); 2) (mis)understanding of symptoms by patients; misdiagnosis of symptoms, by physicians; 3) beliefs about illness and health, such as relying on faith, or self-care when symptoms developed; and 4) reactions to illness, including maintenance of masculinity, confusing interactions with physicians, embarrassment, and fear. These 4 themes describe factors on the structural, health care system, provider and patient level, that interact to make engaging in prevention foreign among this population, thus limiting early detection and treatment of colorectal cancer. LIMITATIONS This study was limited by selection bias and the lack of generalizability. CONCLUSION Improving screening rates among lower-income populations requires addressing barriers across the multiple levels, structural, personal, health care system, that patients encounter in seeking care for colorectal cancer. Acknowledging the complex, multilevel influences impacting patient health care choices and behaviors allows for the development of culturally tailored interventions, and educational, financial, and community resources to decrease disparities in cancer screening and care and improve outcomes for these at-risk patients. See Video Abstract at http://links.lww.com/DCR/A473.
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Affiliation(s)
- Isabel M Leal
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas.,Department of Psychological, Health and Learning Sciences, University of Houston, Houston, Texas
| | - Lillian S Kao
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas.,Center for Surgical Trials and Evidence-based Practice, The University of Texas Health Science Center, Houston, Texas
| | - Burzeen Karanjawala
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas
| | - Richard J Escamilla
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas
| | - Tien C Ko
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas
| | - Stefanos G Millas
- Department of General Surgery, The University of Texas Health Science Center, Houston, Texas
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Lumpkins CY, Mabachi N, Lee J, Pacheco C, Greiner KA, Geana M. A Prescription for Internet Access: Appealing to Middle-Aged and Older Racial and Ethnic Minorities Through Social Network Sites to Combat Colorectal Cancer. HEALTH COMMUNICATION 2017; 32:916-920. [PMID: 27435103 DOI: 10.1080/10410236.2016.1195679] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The popularity and usage of social media networks or SNS (social networking sites) among American Internet users age 50 and over doubled between 2009 and 2010 and has steadily climbed. Part of this increased access may be the result of older adults who are living with a chronic disease and are reaching out for online support. Colorectal cancer (CRC) risk is among those concerns, particularly among middle-age and older minority populations where disparities exist. This exploratory study investigates information seeking behavior related to cancer factors (e.g. testing for colon cancer, cancer fatalism) and current social media usage among racial and ethnic minority groups (African American and Latinos) and Whites age 50 and older. The secondary data from the 2012 Health Information National Trends Survey (HINTS) was analyzed to compare these populations. Results show that African Americans and Latinos were only slightly more likely to use social network sites to seek out cancer information compared to Whites. However, Whites were more likely to use the Internet to seek health information compared to African Americans and Latinos. In this sample, Whites were also more likely to be informed by a physician about CRC testing (p <.01). Whites were also more fatalistic about CRC (p<.001) and more likely to have self-reported receiving a positive diagnosis (p <.001). Implications of this study suggest that use of both traditional health information sources (physician) and the Internet (social media networks, Internet sites) have increased among older Americans and can serve as critical channels for cancer information and education.
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Affiliation(s)
- Crystal Y Lumpkins
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Natabhona Mabachi
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Jaehoon Lee
- b Institute for Measurement, Methodology, Analysis and Policy , Texas Tech University
| | | | - K Allen Greiner
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Mugur Geana
- d William Allen White School of Journalism and Mass Communications , University of Kansas
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8
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Cadet TJ, Stewart K, Howard T. Psychosocial correlates of cervical cancer screening among older Hispanic women. SOCIAL WORK IN HEALTH CARE 2017; 56:124-139. [PMID: 27960632 PMCID: PMC5890332 DOI: 10.1080/00981389.2016.1263268] [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] [Indexed: 06/06/2023]
Abstract
Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women's participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Kathleen Stewart
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Tenial Howard
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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9
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Martinsen RP, Morris CR, Pinheiro PS, Parikh-Patel A, Kizer KW. Colorectal Cancer Trends in California and the Need for Greater Screening of Hispanic Men. Am J Prev Med 2016; 51:e155-e163. [PMID: 27476382 DOI: 10.1016/j.amepre.2016.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) incidence and mortality rates have decreased dramatically since 1990, both nationally and in California, except among Hispanic men. This study examined trends in CRC incidence, mortality, and survival to determine likely contributing factors for the differential trends between Hispanic and non-Hispanic white men in California. METHODS California Cancer Registry data were used to identify 23,157 Hispanic and 114,944 white men diagnosed with CRC between 1990 and 2012. Joinpoint trends in incidence, mortality, and 5-year relative survival were examined by age, stage at diagnosis, and tumor location. Data used in the study were extracted from the California Cancer Registry database and analyzed in 2015. RESULTS Both incidence and mortality rates decreased substantially among white men between 1990 and 2012, but no corresponding decrease was observed among Hispanic men. Both groups experienced similar trends in survival and stage at diagnosis over time. White men had greater declines in CRC incidence and mortality in all age groups, particularly those aged >50 years. Hispanic men had a significantly higher proportion (65%) of tumors in the distal colon than white men (59%). CONCLUSIONS CRC incidence and mortality rates have decreased among white men since 1990, but not among Hispanic men. Results from this study suggest lower screening rates may be an important reason why CRC rates in California did not decline in Hispanic men. Effective strategies aimed at both Hispanics and their healthcare providers are needed to increase CRC screening among Hispanic men and reduce their CRC burden.
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Affiliation(s)
- Robert P Martinsen
- California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California
| | - Cyllene R Morris
- California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California.
| | - Paulo S Pinheiro
- Epidemiology and Biostatistics, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada
| | - Arti Parikh-Patel
- California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California
| | - Kenneth W Kizer
- California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California
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Vallet F, Guillaume E, Dejardin O, Guittet L, Bouvier V, Mignon A, Berchi C, Salinas A, Launoy G, Christophe V. Influence of a screening navigation program on social inequalities in health beliefs about colorectal cancer screening. J Health Psychol 2016; 21:1700-10. [DOI: 10.1177/1359105314564018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The aim of the study was to test whether a screening navigation program leads to more favorable health beliefs and decreases social inequalities in them. The selected 261 noncompliant participants in a screening navigation versus a usual screening program arm had to respond to health belief measures inspired by the Protection Motivation Theory. Regression analyses showed that social inequalities in perceived efficacy of screening, favorable attitude, and perceived facility were reduced in the screening navigation compared to the usual screening program. These results highlight the importance of health beliefs to understand the mechanism of screening navigation programs in reducing social inequalities.
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Affiliation(s)
- Fanny Vallet
- Unity of Cognitives and Affectives Sciences (URECA) Lille 3 University, France
| | - Elodie Guillaume
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Olivier Dejardin
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Lydia Guittet
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Véronique Bouvier
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Astrid Mignon
- Unity of Cognitives and Affectives Sciences (URECA) Lille 3 University, France
| | - Célia Berchi
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Agnès Salinas
- EA 3918 CERReV (Centre d’Etude et de Recherche sur les Risques et les Vulnérabilités), University of Caen, France
| | - Guy Launoy
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
| | - Véronique Christophe
- Unity of Cognitives and Affectives Sciences (URECA) Lille 3 University, France
- U1086 INSERM UCBN “Cancers & Préventions”, University Hospital of Caen, France
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Braschi CD, Sly JR, Singh S, Villagra C, Jandorf L. Increasing colonoscopy screening for Latino Americans through a patient navigation model: a randomized clinical trial. J Immigr Minor Health 2015; 16:934-40. [PMID: 23736964 DOI: 10.1007/s10903-013-9848-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Latinos have a higher rate of mortality and lower rate of colorectal cancer (CRC) screening than most racial groups in the United States. This study examines the predictors of screening colonoscopy (SC) for CRC among Latinos in a patient navigation (PN) intervention. Participants were randomized to either a culturally-targeted PN group (n = 225) or a standard PN group (n = 167). Each completed an interview assessing sociodemographic and intrapersonal information. There was no difference in SC completion between PN groups (80.9 and 79.0 %). Logistic regression revealed that low language acculturation (OR = 2.22) and annual income above $10,000 (OR = 1.97) were independent predictors of completion. Both standard and culturally-targeted PN successfully increased SC completion by nearly 30 % above the recent estimation for physician-referred patients. Our findings suggest a need to further reduce barriers to SC in low income and highly acculturated Latino groups.
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Affiliation(s)
- Caitlyn D Braschi
- Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
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12
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Atkinson TM, Salz T, Touza KK, Li Y, Hay JL. Does colorectal cancer risk perception predict screening behavior? A systematic review and meta-analysis. J Behav Med 2015; 38:837-50. [PMID: 26280755 DOI: 10.1007/s10865-015-9668-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 08/07/2015] [Indexed: 01/22/2023]
Abstract
Although health behavior theories postulate that risk perception should motivate colorectal cancer (CRC) screening, this relationship is unclear. This meta-analysis aims to examine the relationship between CRC risk perception and screening behavior, while considering potential moderators and study quality. A search of six databases yielded 58 studies (63 effect sizes) that quantitatively assessed the relationship between CRC risk perception and screening behavior. Most included effect sizes (75 %) reported a positive association between CRC risk perception and screening behavior. A random effects meta-analysis yielded an overall effect size of z = 0.13 (95 % CI 0.10-0.16), which was heterogeneous (I (2) = 99 %, τ(2) = 0.01). Effect sizes from high-quality studies were significantly lower than those from lower quality studies (z = 0.02 vs. 0.16). We found a small, positive relationship between CRC risk perception and reported screening behavior, with important identified heterogeneity across moderators. Future studies should focus on high quality study design.
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Affiliation(s)
- Thomas M Atkinson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA.
| | - Talya Salz
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA.
| | - Kaitlin K Touza
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY, 10022, USA.
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13
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Consedine NS, Tuck NL, Ragin CR, Spencer BA. Beyond the black box: a systematic review of breast, prostate, colorectal, and cervical screening among native and immigrant African-descent Caribbean populations. J Immigr Minor Health 2015; 17:905-24. [PMID: 24522436 DOI: 10.1007/s10903-014-9991-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cancer screening disparities between black and white groupings are well-documented. Less is known regarding African-descent subpopulations despite elevated risk, distinct cultural backgrounds, and increasing numbers of Caribbean migrants. A systematic search of Medline, Web of Science, PubMed and SCOPUS databases (1980-2012) identified 53 studies reporting rates of breast, prostate, cervical, and colorectal screening behavior among immigrant and non-immigrant Caribbean groups. Few studies were conducted within the Caribbean itself; most work is US-based, and the majority stem from Brooklyn, New York. In general, African-descent Caribbean populations screen for breast, prostate, colorectal, and cervical cancers less frequently than US-born African-Americans and at lower rates than recommendations and guidelines. Haitian immigrants, in particular, screen at very low frequencies. Both immigrant and non-immigrant African-descent Caribbean groups participate in screening less frequently than recommended. Studying screening among specific Caribbean groups of African-descent may yield data that both clarifies health disparities between US-born African-Americans and whites and illuminates the specific subpopulations at risk in these growing immigrant communities.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland, New Zealand,
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Fernández ME, Savas LS, Wilson KM, Byrd TL, Atkinson J, Torres-Vigil I, Vernon SW. Colorectal cancer screening among Latinos in three communities on the Texas-Mexico border. HEALTH EDUCATION & BEHAVIOR 2015; 42:16-25. [PMID: 24786793 PMCID: PMC4214900 DOI: 10.1177/1090198114529592] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess colorectal cancer screening (CRCS) prevalence and psychosocial correlates of CRCS among Latinos in South Texas. METHOD Using multivariable analyses, we examined the association of perceived susceptibility, self-efficacy, pros and cons, subjective norms, knowledge and fatalism on CRCS among 544 Latinos (50 years and older). RESULTS In this socioeconomically disadvantaged population, 40% had never heard of any CRCS test, only 34% reported ever completing any type of CRCS, and only 25% were adherent to CRCS guidelines. Insurance status, gender, perceived cons, CRCS self-efficacy, and CRCS norms were significantly associated with CRCS. CONCLUSION CRCS interventions in this population should focus on improving access, increasing self-efficacy and perceived norms, and decreasing negative perceptions of CRCS.
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Affiliation(s)
| | - Lara S Savas
- University of Texas School of Public Health, Houston, TX, USA
| | | | - Theresa L Byrd
- Department of Family and Community Medicine, Texas Tech Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - John Atkinson
- University of Texas School of Public Health, Houston, TX, USA
| | - Isabel Torres-Vigil
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA Dorothy I. Height Center for Health Equity & Evaluation Research, University of Houston Graduate College of Social Work, Houston, TX, USA
| | - Sally W Vernon
- University of Texas School of Public Health, Houston, TX, USA
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Leyva B, Allen JD, Tom LS, Ospino H, Torres MI, Abraido-Lanza AF. Religion, fatalism, and cancer control: a qualitative study among Hispanic Catholics. Am J Health Behav 2014; 38:839-49. [PMID: 25207510 PMCID: PMC4424042 DOI: 10.5993/ajhb.38.6.6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To assess cancer perceptions among churchgoers and to examine the potential influence of fatalism and religious beliefs on the use of cancer screening tests. METHODS Eight semi-structured focus groups were conducted among 67 Hispanic Catholics in Massachusetts. RESULTS In this sample, there were few references to fatalistic beliefs about cancer and nearly universal endorsement of the utility of cancer screening for cancer early detection. Most participants reported that their religious beliefs encouraged them to use health services, including cancer-screening tests. Although participants agreed that God plays an active role in health, they also affirmed the importance of self-agency in determining cancer outcomes. CONCLUSIONS Our findings challenge the assumption that fatalism is an overriding perspective among Hispanics. Catholic religious beliefs may contribute to positive health attitudes and behaviors.
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Affiliation(s)
- Bryan Leyva
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | | | - Laura S Tom
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Hosffman Ospino
- Boston College School of Theology and Ministry, Chestnut Hill, MA, USA
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Abstract
Fatalism has been shown to predict several health behaviors, but researchers often find inconsistent results for the same behaviors across studies. This may be partially attributable to the diversity of fatalism measures that have been used in previous studies. A review of the literature revealed 51 different scales, all purported to measure fatalism, but often with heterogeneous content (Esparza 2005). A study done by Esparza (2005) retrieved 29 scales, including the most frequently used scales, and performed an exploratory factor analysis, obtaining as a result five factors: fatalism, helplessness, internality, luck, and divine control. The purpose of this study was to develop a multidimensional fatalism scale based on the previous findings by Esparza (2005). This scale was developed simultaneously in English and Spanish in order to linguistically “decenter” item content. The factor structure was cross-validated and measurement invariance was assessed across language versions. According to the measurement invariance analysis, this test is invariant across English and Spanish in its factor structure, loadings, variances, and covariances. This study results suggest that this scale may be used interchangeably in both English and Spanish.
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Yang D, Hillman SL, Harris AM, Sinicrope PS, Devens ME, Ahlquist DA. Patient perceptions of stool DNA testing for pan-digestive cancer screening: A survey questionnaire. World J Gastroenterol 2014; 20:4972-4979. [PMID: 24803808 PMCID: PMC4009529 DOI: 10.3748/wjg.v20.i17.4972] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 10/25/2013] [Accepted: 11/03/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore patient interest in a potential multi-organ stool-DNA test (MUST) for pan-digestive cancer screening.
METHODS: A questionnaire was designed and mailed to 1200 randomly-selected patients from the Mayo Clinic registry. The 29-item survey questionnaire included items related to demographics, knowledge of digestive cancers, personal and family history of cancer, personal concern of cancer, colorectal cancer (CRC) screening behavior, interest in MUST, importance of test features in a cancer screening tool, and comparison of MUST with available CRC screening tests. All responses were summarized descriptively. χ2 and Rank Sum Test were used for categorical and continuous variables, respectively.
RESULTS: Completed surveys were returned by 434 (29% aged 50-59, 37% 60-69, 34% 70-79, 52% women). Most participants (98%) responded they would use MUST. In order of importance, respondents rated multi-cancer detection, absence of bowel preparation, safety and noninvasiveness as most attractive characteristics. For CRC screening, MUST was preferred over colorectal-only stool-DNA testing (53%), occult blood testing (75%), colonoscopy (84%), sigmoidoscopy (91%), and barium enema (95%), P < 0.0001 for each. Among those not previously screened, most (96%) indicated they would use MUST if available. Respondents were confident in their ability to follow instructions to perform MUST (98%). Only 9% of respondents indicated that fear of finding cancer was a concern with MUST, and only 3% indicated unpleasantness of stool sampling as a potential barrier.
CONCLUSION: Patients are receptive to the concept of MUST, preferred MUST over conventional CRC screening modalities and valued its potential feature of multi-cancer detection.
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Allen JD, Leyva B, Torres AI, Ospino H, Tom L, Rustan S, Bartholomew A. Religious beliefs and cancer screening behaviors among Catholic Latinos: implications for faith-based interventions. J Health Care Poor Underserved 2014; 25:503-26. [PMID: 24858865 PMCID: PMC4162660 DOI: 10.1353/hpu.2014.0080] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although most U.S. Latinos identify as Catholic, few studies have focused on the influence of this religious tradition on health beliefs among this population. This study explores the role of Catholic religious teachings, practices, and ministry on cancer screening knowledge, attitudes, and behaviors among Latinos. Eight focus groups were conducted with 67 Catholic Latino parishioners in Massachusetts. Qualitative analysis provided evidence of strong reliance on faith, God, and parish leaders for health concerns. Parishes were described as vital sources of health and social support, playing a central role in the community's health. Participants emphasized that their religious beliefs promote positive health behaviors and health care utilization, including the use of cancer screening services. In addition, they expressed willingness to participate in cancer education programs located at their parishes and provided practical recommendations for implementing health programs in parishes. Implications for culturally appropriate health communication and faith-based interventions are discussed.
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Gimeno Garcia AZ, Hernandez Alvarez Buylla N, Nicolas-Perez D, Quintero E. Public awareness of colorectal cancer screening: knowledge, attitudes, and interventions for increasing screening uptake. ISRN ONCOLOGY 2014; 2014:425787. [PMID: 24729896 PMCID: PMC3963118 DOI: 10.1155/2014/425787] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 12/31/2013] [Indexed: 02/06/2023]
Abstract
Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake.
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Affiliation(s)
- Antonio Z Gimeno Garcia
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain ; Departamento de Gastroenterología, Hospital Universitario de Canarias, Unidad de Endoscopia, Ofra s/n, La Laguna, 38320 Tenerife, Spain
| | - Noemi Hernandez Alvarez Buylla
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
| | - David Nicolas-Perez
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
| | - Enrique Quintero
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
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Abstract
Colorectal cancer (CRC) screening is underused in the United States, and non-adherence with screening recommendations is high in some populations. This study describes the characteristics of people who have never been screened for CRC. In addition, we use the health belief model to examine the constructs associated with screening behavior. We used data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) to create three study outcomes: people who have been screened for CRC and are up-to-date with current recommendations, people who have been screened but are not up-to-date, and people who have never been screened. We used multivariate logistic regression modeling to calculate predicted marginal estimates examining the associations between the screening outcomes and demographic and Health Belief Model (HBM) characteristics. Overall 29% of respondents had never been screened for CRC. In the adjusted model, 36.6% of US adults age 50-59 years and 29.1% of US men reported never being screened for CRC. More Asian/Native Hawaiian/Pacific Islander, non-Hispanics (38.2%) reported never being screened than members of other racial and ethnic groups. Nearly 37% of people with less than a high school diploma reported never being screened. We found statistically significant differences among screening outcomes for all demographics and HBM constructs except could not see a doctor because of costs in the last 12 months, where approximately 29% reported no CRC screening. New interventions should focus on those subpopulations that have never been screened for CRC.
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Gonzalez SA, Ziebarth TH, Wang J, Noor AB, Springer DL. Interventions Promoting Colorectal Cancer Screening in the Hispanic Population: A Review of the Literature. J Nurs Scholarsh 2012; 44:332-40. [DOI: 10.1111/j.1547-5069.2012.01474.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Christou A, Thompson SC. Colorectal cancer screening knowledge, attitudes and behavioural intention among Indigenous Western Australians. BMC Public Health 2012; 12:528. [PMID: 22809457 PMCID: PMC3481427 DOI: 10.1186/1471-2458-12-528] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 06/26/2012] [Indexed: 12/31/2022] Open
Abstract
Background Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC) screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT) among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Methods Interviewer-administered surveys were carried out with a convenience sample (n = 93) of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Results Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p < 0.0001). Nearly two-thirds (63%; 58/92) of respondents reported intending to participate in screening, while a greater proportion (84%; 77/92) said they would participate on a doctor’s recommendation. Multivariate analysis with logistic regression demonstrated that independent predictors of screening intention were, greater perceived self-efficacy (OR = 19.8, 95% CI = 5.5-71.8), a history of cancer screening participation (OR = 6.8, 95% CI = 2.0-23.3) and being aged 45 years or more (OR = 4.5, 95% CI = 1.2-16.5). A higher CRC knowledge score (medium vs. low: OR = 9.9, 95% CI = 2.4-41.3; high vs. low: 13.6, 95% CI = 3.4-54.0) and being married or in a de-facto relationship (OR = 6.9, 95% CI = 2.1-22.5) were also identified as predictors of intention to screen with FOBT. Conclusions Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and reduce bowel cancer related deaths among Indigenous Australians.
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Affiliation(s)
- Aliki Christou
- Centre for International Health, Curtin University, GPO Box U1987, Perth, Western Australia.
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Gonzalez P, Castaneda SF, Mills PJ, Talavera GA, Elder JP, Gallo LC. Determinants of breast, cervical and colorectal cancer screening adherence in Mexican-American women. J Community Health 2012; 37:421-33. [PMID: 21874364 DOI: 10.1007/s10900-011-9459-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Despite the effectiveness of cancer screening procedures, its utilization among Latinas remains low. Guided, in part, by the Behavioral Model for Vulnerable Populations, this study examined the associations between predisposing, enabling, and need factors with self-reported breast, cervical, and colorectal cancer screening adherence. Participants were 319 Mexican-American women, from a range of socioeconomic backgrounds, living near the United States-Mexico border. Women were adherent with breast cancer (BC) screening (≥42 years) if they had received at least one mammogram within the last 2 years, with cervical cancer (CC) screening (≥40 years) if they had received at least one Pap exam in the last 3 years, and with colorectal cancer (CRC) screening (≥52 years) if they had undergone one or more of the following: Fecal Occult Blood Test within the last year, or sigmoidoscopy in the last 5 years, or colonoscopy within the last 10 years. BC and CC screenings were higher in the current sample compared to national and state figures: 82% with mammography and 86% adherent with Pap exam screening. However, only 43% were adherent with CRC screening recommendations. Characteristics associated with mammography adherence included CC adherence and usual source of care. BC adherence was associated to CC adherence. Characteristics associated with CRC adherence included BC adherence, being premenopausal, and insurance coverage. A key correlate of cancer screening adherence was adherence to other preventive services. Results underscore the need for continued efforts to ensure that Latinas of all SES levels obtain regular and timely cancer screenings.
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Affiliation(s)
- Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 105, San Diego, CA 92123, USA.
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Cole SR, Zajac I, Gregory T, Mehaffey S, Roosa N, Turnbull D, Esterman A, Young GP. Psychosocial variables associated with colorectal cancer screening in South Australia. Int J Behav Med 2012; 18:302-9. [PMID: 20496170 DOI: 10.1007/s12529-010-9101-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Population screening reduces mortality from colorectal cancer, yet factors associated with uptake of screening are incompletely understood. PURPOSE The purpose of the study was to determine demographic and psychosocial factors associated with participation in faecal occult blood test (FOBT)-based colorectal cancer (CRC) screening in an average risk community programme in Adelaide, South Australia. METHOD A questionnaire consistent with the Preventive Health Model was used to determine demographic and psychosocial differences between previous FOBT-based screening participants (n = 413, response rate 93.2%) and non-participants (n = 481, response rate 47.9%). Results were analysed by univariate and multivariate generalised linear modelling, and factors associated with participation were identified. RESULTS Factor analysis of psychosocial items revealed an optimal three-factor solution (knowledge, faecal aversion, belief in the value of screening). Following multivariate analyses, two psychosocial and two demographic factors remained as predictors of FOBT screening behaviour: (1) items related to faecal aversion (Aversion), relative risk (RR) = 0.61, CI = 0.55-0.69, (2) perceptions about the value of screening (Value), RR = 1.45, CI = 1.13-1.85, (3) age band 65-69 (Age, five age bands, relative to age 50-54), RR = 1.43, CI = 1.16-1.76 and FOBT type (Test; three tests, Hemoccult, FlexSure, InSure randomly assigned, relative to Hemoccult: FlexSure: RR = 1.41, CI = 1.17-1.71, InSure: RR = 1.76, CI = 1.47-2.11. CONCLUSIONS The psychosocial factors associated with non-participation in FOBT-based CRC screening are amenable to interventions designed to improve participation. The small relative risks values associated with each predictor, however, raise the possibility that additional factors are likely to influence screening participation.
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Affiliation(s)
- Stephen R Cole
- Bowel Health Service, Repatriation General Hospital Daw Park, Daws Road, Daw Park, 5041 South Australia, Australia.
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Shelton RC, Jandorf L, Ellison J, Villagra C, DuHamel KN. The influence of sociocultural factors on colonoscopy and FOBT screening adherence among low-income Hispanics. J Health Care Poor Underserved 2011; 22:925-44. [PMID: 21841288 DOI: 10.1353/hpu.2011.0074] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Few studies have examined barriers and facilitators to colorectal cancer (CRC) screening among Hispanics, particularly sociocultural factors that may be relevant. This paper examines the influence of sociocultural factors on adherence to fecal occult blood testing (FOBT) and colonoscopy. A survey was conducted among a sample of 400 low-income Hispanics in East Harlem, New York. Fatalism and health literacy were both significantly associated with colonoscopy screening adherence in bivariate models, though fatalism became non-significant and health literacy became less significant in multivariable models. With respect to adherence to colonoscopy or FOBT, both fatalism and health literacy were associated in bivariate models, though only fatalism remained significant in multivariable models (p=.03; OR: .94; 95% CI: .881-.992). These findings suggest fatalism and health literacy may play a role in shaping CRC screening adherence among low-income Hispanics. Researchers should continue investigating how sociocultural factors influence screening adherence among Hispanics, using larger and more geographically diverse samples.
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Affiliation(s)
- Rachel C Shelton
- Columbia University, Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY 10032, USA.
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Espinosa de los Monteros K, Gallo LC. The relevance of fatalism in the study of Latinas' cancer screening behavior: a systematic review of the literature. Int J Behav Med 2011; 18:310-8. [PMID: 20953916 PMCID: PMC3212691 DOI: 10.1007/s12529-010-9119-4] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fatalism has been identified as a dominant belief among Latinos and is believed to act as a barrier to cancer prevention. However, controversy exists over the utility of the construct in explaining health disparities experienced by disadvantaged populations above the influence of structural barriers such as low socioeconomic status (SES) and limited access to health care. PURPOSE This paper reviews the empirical research on fatalism and Latinas' participation in cancer screening in an attempt to determine whether fatalism predicts participation in cancer screening after accounting for structural barriers. METHOD Google Scholar, ERIC, CINAHL, Medline, PsychINFO, ProQuest, PubMed, and PsychARTICLES were searched for empirical studies published prior to February 25, 2010. RESULTS A total of 43 articles were obtained and 11 met the inclusion criteria. The majority of studies (64%) reported a statistically significant association between fatalism and utilization of cancer screening services after accounting for structural barriers. However, mixed findings and limitations in measurement and design across studies preclude clear conclusions about the nature of the relationship. CONCLUSION Preliminary evidence for an inverse association between fatalism and Latinas' utilization of cancer screening services after accounting for structural barriers was identified. However, additional research that addresses methodological limitations is warranted to advance our understanding of the utility of fatalism in explaining inequities in cancer burden experienced by this at-risk group.
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Affiliation(s)
- Karla Espinosa de los Monteros
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego State University, 9245 Sky Park Court Suite 115, San Diego, CA 92123 USA
| | - Linda C. Gallo
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego State University, 9245 Sky Park Court Suite 115, San Diego, CA 92123 USA
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Kiviniemi MT, Bennett A, Zaiter M, Marshall JR. Individual-level factors in colorectal cancer screening: a review of the literature on the relation of individual-level health behavior constructs and screening behavior. Psychooncology 2011; 20:1023-33. [PMID: 21954045 PMCID: PMC3038178 DOI: 10.1002/pon.1865] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 09/10/2010] [Accepted: 09/16/2010] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Compliance with colorectal cancer screening recommendations requires considerable conscious effort on the part of the individual patient, making an individual's decisions about engagement in screening an important contributor to compliance or noncompliance. The objective of this paper was to examine the effectiveness of individual-level behavior theories and their associated constructs in accounting for engagement in colorectal cancer screening behavior. METHODS We reviewed the literature examining constructs from formal models of individual-level health behavior as factors associated with compliance with screening for colorectal cancer. All published studies examining one or more constructs from the health belief model, theory of planned behavior, transtheoretical model, or social cognitive theory and their relation to screening behavior or behavioral intentions were included in the analysis. RESULTS By and large, results of studies supported the theory-based predictions for the influence of constructs on cancer screening behavior. However, the evidence base for many of these relations, especially for models other than the health belief model, is quite limited. CONCLUSIONS Suggestions are made for future research on individual-level determinants of colorectal cancer screening.
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Affiliation(s)
- Marc T Kiviniemi
- Department of Health Behavior, University at Buffalo, New York 14124, USA.
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GIBBISON GODFREYA, JOHNSON CDOUGLAS. Stages of Change in Physical Exercise and Social Support: An Integrated Socio-Psycho-Economic Approach. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2011. [DOI: 10.1111/j.1559-1816.2011.00801.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Taouqi M, Ingrand I, Beauchant M, Migeot V, Ingrand P. Determinants of participation in colonoscopic screening by siblings of colorectal cancer patients in France. BMC Cancer 2010; 10:355. [PMID: 20602807 PMCID: PMC2910691 DOI: 10.1186/1471-2407-10-355] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 07/06/2010] [Indexed: 12/24/2022] Open
Abstract
Background Targeted colonosocopic screening is recommended for first-degree relatives of colorectal cancer patients diagnosed before the age of 60 and offers the possibility of reducing morbidity and mortality, but participation remains too low. The objective of this study was to determine in a French population the factors that affect siblings' participation in screening, notably those relating to the individuals, their medical care, their family and their social network. Methods A cross sectional survey was conducted in siblings of index patients having undergone surgery for colorectal cancer between 1999 and 2002 in two French counties. Siblings were contacted during 2007 and 2008 through the index patient. The factors affecting participation in colonoscopic screening were studied by logistic regression taking into account family cluster effect. Results 172 siblings of 74 index cases were included. The declared rate of undergoing at least one colonoscopy among siblings was 66%; 95%CI 59-73%. Five variables were independently associated with colonoscopic screening: perceiving fewer barriers to screening (OR = 3.2; 95%CI 1.2-8.5), having received the recommendation to undergo screening from a physician (OR = 4.9; 1.7-13.7), perceiving centres practising colonoscopy as more accessible (OR = 3.2, 1.3-7.8), having discussed screening with all siblings (OR = 3.9; 1.6-9.6) and being a member of an association (OR = 2.6; 1.0-6.6). Conclusions The factors independently associated with participation in CRC screening by an individual at increased risk belonged to each of four dimensions relating to his individual psychosocial characteristics, to his relationship with a physician, within the family and social environment. The relevance of these results to clinical practice may help to improve compliance to recommendations in a global preventive strategy including all stages of the information pathway from the physician to the index patient and his relatives.
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Affiliation(s)
- Myriam Taouqi
- Public Health, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, 86005 Poitiers Cedex, France
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Baron-Epel O, Klin A. Cancer as Perceived by a Middle-Aged Jewish Urban Population in Israel. Oncol Nurs Forum 2009; 36:E326-34. [DOI: 10.1188/09.e326-e334] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Goldman RE, Diaz JA, Kim I. Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions. QUALITATIVE HEALTH RESEARCH 2009; 19:1559-68. [PMID: 19776255 PMCID: PMC3584335 DOI: 10.1177/1049732309349359] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were "bad food," digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening.
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Baron-Epel O. Attitudes and Beliefs Associated With Mammography in a Multiethnic Population in Israel. HEALTH EDUCATION & BEHAVIOR 2009; 37:227-42. [DOI: 10.1177/1090198109339460] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article highlights beliefs, attitudes, and barriers that are associated with mammography use in four distinct cultural and ethnic groups in Israel: veteran, ultra-orthodox, and immigrant Jewish and Arab women. A random telephone survey of 1,550 women was performed. Information from claims records concerning mammography use was obtained for each woman from Maccabi Health Services. Of the barriers studied, no one barrier was associated with mammography performance in all population groups. However, the combined measure was associated with mammography use in all groups. Subjective norms, fatalism, fear of breast cancer, and perceived effectiveness were associated with mammography in some of the population groups but not in others. Each population seems to have a unique set of variables predicting mammography use. It is not possible to generalize from one population to another and it implies that information concerning beliefs and attitudes should be studied in each subpopulation before planning interventions.
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Natale-Pereira A, Marks J, Vega M, Mouzon D, Hudson SV, Salas-Lopez D. Barriers and facilitators for colorectal cancer screening practices in the Latino community: perspectives from community leaders. Cancer Control 2008; 15:157-65. [PMID: 18376383 DOI: 10.1177/107327480801500208] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the United States and the third most commonly diagnosed cancer among Latinos. While Latinos represent one of the fastest-growing ethnic groups in the United States, their participation in cancer prevention and treatment trials is low. METHODS Thirty-six Latino community leaders participated in five focus groups that examined factors affecting CRC screening practices among Latinos. RESULTS The top four barriers identified were low knowledge and awareness of CRC, language barriers, lack of insurance, and undocumented legal status. Additional barriers included seeking health care only when sick, fatalism, fear, denial that CRC can occur, other needs more pressing than preventive care, and use of home remedies rather than biomedical care. Participants also described strategies that could be used to increase screening rates including mass media, screening reminders, educational programs using visual tools, and interventions tailored to various literacy levels. CONCLUSIONS To ensure that the specific needs and health beliefs of the Latino community are addressed, future research should incorporate community input to create more tailored and effective cancer educational programs for Latinos.
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Affiliation(s)
- Ana Natale-Pereira
- Department of Medicine, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103. USA.
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Guilfoyle S, Franco R, Gorin SS. Exploring older women's approaches to cervical cancer screening. Health Care Women Int 2008; 28:930-50. [PMID: 17987461 DOI: 10.1080/07399330701615358] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this qualitative study (N = 98, 11 focus groups) is to investigate how low-income, African American and Hispanic older women make decisions about cervical cancer screening. Using the health belief model to guide content analysis of transcripts, we found that primary barriers to screening were; embarrassment with, fear of, and pain from the test, difficulty in accessing screening, stigma associated with Medicaid coverage, and prior negative experiences with cancer detection. Women experienced cues to screening from their own bodies, in symptoms, and relied on spiritual beliefs to support them in coping with their health problems. Enhanced understanding of these factors could increase uptake of cervical cancer screening among the unscreened and underscreened.
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Affiliation(s)
- Sharon Guilfoyle
- Department of Health Policy and Management, Columbia University, New York, New York 10027, USA
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Gibbison GA, Johnson CD. Family history of chronic disease and participation in healthy behaviours. HEALTH ECONOMICS, POLICY, AND LAW 2007; 2:297-315. [PMID: 18634652 DOI: 10.1017/s1744133107004185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article presents an investigation into whether individuals incorporate information on their family genetic (health) endowment into decision making regarding participation in behaviours related to the production of health capital. Competing theoretical perspectives exist as to how genetic endowment should affect participation in health-related behaviours. There is also a growing consensus that the availability of genetic information holds important consequences for the individual in terms of investment in human capital, the pricing and availability of health insurance, and labour market opportunity. Therefore, the question of how individuals use the greater availability of genetic data is important. Our empirical results indicate that poor genetic endowment tends to be associated with a lower probability of participation in cigarette smoking, but also a lower probability of participation in regular exercise.
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Affiliation(s)
- Godfrey A Gibbison
- School of Economic Development, Georgia Southern University, Statesboro, GA 30460, USA.
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McQueen A, Vernon SW, Myers RE, Watts BG, Lee ES, Tilley BC. Correlates and predictors of colorectal cancer screening among male automotive workers. Cancer Epidemiol Biomarkers Prev 2007; 16:500-9. [PMID: 17372245 DOI: 10.1158/1055-9965.epi-06-0757] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Most studies examining factors associated with colorectal cancer (CRC) screening (CRCS) are cross-sectional and thus temporal relationships cannot be determined. Furthermore, less attention has been paid to psychosocial predictors of CRCS. We examined both cross-sectional correlates of prior CRCS and predictors of prospective CRCS initiation and maintenance during The Next Step Trial, a 2-year worksite behavioral intervention to promote regular CRCS and dietary change. METHOD The sample included 2,693 White male automotive workers at increased occupational risk for, but no history of, CRC who completed a baseline survey. Stratified analyses were conducted for three dependent variables (prior CRCS, CRCS initiation, and CRCS maintenance). We also assessed prior CRCS as a moderator in prospective analyses. Multivariable logistic regression analyses with generalized linear mixed models were used to adjust for cluster sampling. RESULTS Except for education, cross-sectional correlates of prior CRCS including older age, family history of CRC or polyps, personal history of polyps, self-efficacy, family support, and intention were also significant prospective predictors of increased CRCS during the trial. Despite differences in the patterns of association for CRCS initiation and maintenance in stratified analyses, the only associations with prospective CRCS that were significantly moderated by prior CRCS were family history and CRCS availability. CONCLUSIONS Correlates of prior CRCS that also were prospective predictors of CRCS may be suitable targets for intervention. Additionally, intervention messages addressing psychosocial constructs may be relevant for both CRCS initiation and maintenance. However, studies with more diverse samples are needed to replicate the results reported here.
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Affiliation(s)
- Amy McQueen
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2568, Houston, TX 77030, USA.
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