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Narine D, Yamashita T, Mair CA. An Intersectional Approach to Examining Breast Cancer Screening among Subpopulations of Black Women in the United States. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01781-5. [PMID: 37702971 DOI: 10.1007/s40615-023-01781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
This study examines breast cancer screening behavior among subpopulations of Black women in the United States. Binary logistic regression was used to analyze breast cancer screening among a nationally-representative sample (n = 9,783) of Black women-US-born, non-US-born Caribbean, and non-US-born African-from the 2011-2017 National Health Interview Survey dataset. Non-US-born African Black women were less likely to have breast cancer screening, compared to US-born Black women. Among non-US-born Black women, non-US-born Caribbean Black women were more likely to have had breast cancer screening. Differential healthcare access associated with nativity differences among Black women can be informing their breast cancer screening behaviors. Efforts to improve breast cancer outcomes among Black women can benefit from interventions that account for differential access to healthcare and breast cancer screening behaviors among subgroups of Black women.
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Affiliation(s)
- Donnette Narine
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA.
- Gerontology Doctoral Program, University of Maryland Baltimore County, Baltimore, MD, USA.
| | - Takashi Yamashita
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA
- Gerontology Doctoral Program, University of Maryland Baltimore County, Baltimore, MD, USA
| | - Christine A Mair
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA
- Center for Health, Equity, and Aging, University of Maryland Baltimore County, Baltimore, MD, USA
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2
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Allen JD, Priebe Rocha L, Rose R, Hoch A, Porteny T, Fernandes A, Galvão H. Intention to obtain a COVID-19 vaccine among Brazilian immigrant women in the U.S. PLoS One 2022; 17:e0274912. [PMID: 36156603 PMCID: PMC9512217 DOI: 10.1371/journal.pone.0274912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/06/2022] [Indexed: 11/19/2022] Open
Abstract
Background COVID-19 has disproportionately impacted low-income immigrant communities. There is concern that the current uptake of COVID-19 vaccines is suboptimal and that this may be contributing to COVID-19 inequities. However, little is known about the acceptability of COVID-19 vaccines among immigrants in the U.S. Our goal was to gauge COVID-19 vaccine intentions among Brazilian immigrant women living in the U.S. Methods We conducted an online survey between July and August 2020 offered in Portuguese and English languages among a convenience sample of Brazilian immigrant women ages 18 years and older. Women were recruited through online advertisements by community-based organizations and social media groups to complete a survey that assessed intention to get a COVID-19 vaccine, attitudes toward vaccines, and perceptions about the pandemic. Results Of the total sample (N = 353), most (70.8%) indicated they intended to get a COVID-19 vaccine. In bivariate analyses, vaccine intentions were significantly associated with perceptions about the severity of the pandemic, trusted sources of health information, and the number of years lived in the U.S. Multinomial logistic regression models revealed that those who did not intend to be vaccinated had lived a longer time in the U.S. (OR: -0.12 95% CI: -0.19, -0.05), perceived the pandemic to be a minor issue (OR: 1.52, 95% CI: 0.62, 2.42), and trusted information from social networks (OR: -1.94, 95% CI: -3.25, -0.63) or private news sources (OR: -1.71, 95% CI: -2.78, -0.63). Conclusions While most women reported they would get a COVID-19 vaccine, efforts to reach those who may be hesitant should target those who have lived in the U.S. for longer periods of time and do not perceive the pandemic to be a major crisis. Healthcare providers may be particularly suited to deliver this information given high levels of trust.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University, Medford, MA, United States of America
- * E-mail:
| | - Leticia Priebe Rocha
- Department of Community Health, Tufts University, Medford, MA, United States of America
| | - Rebecca Rose
- Department of Community Health, Tufts University, Medford, MA, United States of America
| | - Annmarie Hoch
- Department of Community Health, Tufts University, Medford, MA, United States of America
| | - Thalia Porteny
- Department of Occupational Health, Tufts University, Medford, MA, United States of America
| | - Adriana Fernandes
- Office of Immigrant Affairs, City of Somerville, Somerville, MA, United States of America
| | - Heloisa Galvão
- Brazilian Women’s Center, Brighton, MA, United States of America
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3
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Nair RG, Lee SJC, Berry E, Argenbright KE, Tiro JA, Skinner CS. Long-term Mammography Adherence among Uninsured Women Enrolled in the Breast Screening and Patient Navigation (BSPAN) Program. Cancer Epidemiol Biomarkers Prev 2022; 31:77-84. [PMID: 34750203 PMCID: PMC8755604 DOI: 10.1158/1055-9965.epi-21-0191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/10/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Breast Screening and Patient Navigation (BSPAN) Program provides access to no-cost breast cancer screening services to uninsured women in North Texas. Using data from the longitudinal BSPAN program (2012-2019), we assessed prevalence and correlates of (i) baseline adherence and (ii) longitudinal adherence to screening mammograms. METHODS Outcomes were baseline adherence (adherent if women received second mammogram 9-30 months after the index mammogram) and longitudinal adherence (assessed among baseline adherent women and defined as being adherent 39 months from the index mammogram). We used multivariable logistic regression and multivariable Cox proportional hazards model to assess associations of sociodemographic and clinical characteristics with baseline and longitudinal adherence, respectively. RESULTS Of 19,292 women, only 5,382 (27.9%) were baseline adherent. Baseline adherence was more likely among women who were partnered, preferred speaking Spanish, had poor reading ability, had prior Papanicolaou (PAP) testing, and prior screening mammograms, compared with women who were non-partnered, preferred speaking English, had good reading ability, had no prior PAP testing, and no prior screening mammograms, respectively. Of those who were baseline adherent, 4,364 (81.1%) women demonstrated longitudinal adherence. Correlates of longitudinal adherence were similar to those from baseline adherence. CONCLUSIONS A large proportion of baseline adherent women (>80%) achieved longitudinal adherence, which highlights the importance of concentrating resources during the second mammogram in the progression toward continued adherence. IMPACT Results from our unique dataset provide realistic mammography adherence rates and may be generalizable to other areas introducing no-cost screening to low-income women, independent of any regular patient-centered medical home.
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Affiliation(s)
- Rasmi G Nair
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Simon J Craddock Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Emily Berry
- Moncrief Cancer Institute, University of Texas Southwestern, Fort Worth, Texas
| | - Keith E Argenbright
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
- Moncrief Cancer Institute, University of Texas Southwestern, Fort Worth, Texas
| | - Jasmin A Tiro
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Celette Sugg Skinner
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
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Feng GC, Lin Z, Ou W, Su X, Yan Q. A Model-Based Meta-Analysis of Willingness to Participate in Cancer Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2580. [PMID: 33806652 PMCID: PMC7967393 DOI: 10.3390/ijerph18052580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022]
Abstract
Although early screening tests are beneficial for the detection and treatment of cancers, many people have failed to participate in screening tests. The present study aims to explore the theoretical underpinning of low participation in screening programs using the method of meta-analytic structural equation modeling. It was found that the health belief model is the most adopted theoretical framework. Moreover, the intended uptake of screening was positively predicted only by cues to action, health literacy, and perceived susceptibility. As a result, a health intention model, including the three significant variables, is proposed. The practical implications of the findings are that health communication campaigns should focus on enlightening and engaging the public through all necessary means to raise awareness and transfer knowledge in relation to screening procedures as well as cancers per se.
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Affiliation(s)
| | - Zhiliang Lin
- School of Literature and Media, Nanfang College of Sun Yat-sen University, Guangzhou 510970, China;
| | - Wanhua Ou
- College of Communication, Shenzhen University, Shenzhen 518600, China; (W.O.); (X.S.)
| | - Xianglin Su
- College of Communication, Shenzhen University, Shenzhen 518600, China; (W.O.); (X.S.)
| | - Qing Yan
- School of Journalism and Communication, Jinan University, Guangzhou 510610, China;
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Ghirimoldi F, Sanchez-Soto G. Immigrant assimilation and profiles of breast cancer screening behaviors among U.S. immigrant women. Health Care Women Int 2020; 42:213-234. [PMID: 32779966 DOI: 10.1080/07399332.2020.1797034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previous researchers have shown that despite increased prevention and cancer risk awareness, many immigrant women do not receive cancer screenings in a timely manner. We use data from the National Health Interview Survey and Latent Class Analysis to characterize immigrant women in the U.S. in accordance to their risk of engaging in breast cancer prevention. We identify three latent profiles based on use of cancer screenings, sociodemographic characteristics, family cancer history, and immigrant acculturation. Our results show that cancer screening behaviors of immigrants are consistent with patterns of both classic and segmented assimilation, as well as with greater immigrant diversity.
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Affiliation(s)
- Federico Ghirimoldi
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Kaucher S, Khil L, Kajüter H, Becher H, Reder M, Kolip P, Spallek J, Winkler V, Berens EM. Breast cancer incidence and mammography screening among resettlers in Germany. BMC Public Health 2020; 20:417. [PMID: 32228537 PMCID: PMC7106878 DOI: 10.1186/s12889-020-08534-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 03/16/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. METHODS Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. RESULTS Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. CONCLUSIONS MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.
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Affiliation(s)
- Simone Kaucher
- Unit of Epidemiology & Biostatistics, Institute of Global Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Laura Khil
- Federal Cancer Registry of North Rhine-Westphalia, Bochum, Germany
| | - Hiltraud Kajüter
- Federal Cancer Registry of North Rhine-Westphalia, Bochum, Germany
| | - Heiko Becher
- Unit of Epidemiology & Biostatistics, Institute of Global Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Reder
- Institute of Psychology, University of Hildesheim, Hildesheim, Germany
- Department of Prevention and Health Promotion, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Petra Kolip
- Department of Prevention and Health Promotion, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Volker Winkler
- Unit of Epidemiology & Biostatistics, Institute of Global Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Eva-Maria Berens
- Department of Health Services Research and Nursing Science, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
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Volkman HR, Walz EJ, Wanduragala D, Schiffman E, Frosch A, Alpern JD, Walker PF, Angelo KM, Coyle C, Mohamud MA, Mwangi E, Haizel-Cobbina J, Nchanji C, Johnson RS, Ladze B, Dunlop SJ, Stauffer WM. Barriers to malaria prevention among immigrant travelers in the United States who visit friends and relatives in sub-Saharan Africa: A cross-sectional, multi-setting survey of knowledge, attitudes, and practices. PLoS One 2020; 15:e0229565. [PMID: 32163426 PMCID: PMC7067457 DOI: 10.1371/journal.pone.0229565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite achievements in the reduction of malaria globally, imported malaria cases to the United States by returning international travelers continue to increase. Immigrants to the United States from sub-Saharan Africa (SSA) who then travel back to their homelands to visit friends and relatives (VFRs) experience a disproportionate burden of malaria illness. Various studies have explored barriers to malaria prevention among VFRs and non-VFRs-travelers to the same destinations with other purpose for travel-but few employed robust epidemiologic study designs or performed comparative analyses of these two groups. To better quantify the key barriers that VFRs face to implement effective malaria prevention measures, we conducted a comprehensive community-based, cross-sectional, survey to identify differences in malaria prevention knowledge, attitudes, and practices (KAP) among VFRs and others traveling to Africa and describe the differences between VFRs and other types of international travelers. METHODS AND FINDINGS Three distinct populations of travelers with past or planned travel to malaria-endemic countries of SSA were surveyed: VFRs diagnosed with malaria as reported through a state health department; members of the general VFR population (community); and VFR and non-VFR travelers presenting to a travel health clinic, both before their pretravel consultation and again, after return from travel. A Community Advisory Board of African immigrants and prior qualitative research informed survey development and dissemination. Across the three groups, 489 travelers completed surveys: 351 VFRs and 138 non-VFRs. VFRs who reported taking antimalarials on their last trip rated their concern about malaria higher than those who did not. Having taken five or more trips to SSA was reported more commonly among VFRs diagnosed with malaria than community VFRs (44.0% versus 20.4%; p = 0.008). Among travel health clinic patients surveyed before and after travel, VFR travelers were less successful than non-VFRs in adhering to their planned use of antimalarials (82.2% versus 98.7%; p = 0.001) and employing mosquito bite avoidance techniques (e.g., using bed nets: 56.8% versus 81.8%; p = 0.009). VFRs who visited the travel health clinic were more likely than VFR respondents from the community to report taking an antimalarial (83.0% versus 61.9%; p = 0.009), or to report bite avoidance behaviors (e.g., staying indoors when mosquitoes were out: 80.9% versus 59.5%; p = 0.009). CONCLUSIONS We observed heterogeneity in malaria prevention behaviors among VFRs and between VFR and non-VFR traveler populations. Although VFRs attending the travel health clinic appear to demonstrate better adherence to malaria prevention measures than VFR counterparts surveyed in the community, specialized pretravel care is not sufficient to ensure chemoprophylaxis use and bite avoidance behaviors among VFRs. Even when seeking specialized pretravel care, VFRs experience greater barriers to the use of malaria prevention than non-VFRs. Addressing access to health care and upstream barrier reduction strategies that make intended prevention more achievable, affordable, easier, and resonant among VFRs may improve malaria prevention intervention effectiveness.
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Affiliation(s)
- Hannah R Volkman
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Emily J Walz
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St Paul, MN, United States of America
| | | | | | - Anne Frosch
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- Hennepin Healthcare, Minneapolis, MN, United States of America
| | | | - Patricia F Walker
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- HealthPartners Institute, Bloomington, MN, United States of America
| | - Kristina M Angelo
- Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Christina Coyle
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States of America
| | - Mimi A Mohamud
- Minnesota Department of Health, St Paul, MN, United States of America
| | - Esther Mwangi
- Minnesota Department of Health, St Paul, MN, United States of America
| | | | - Comfort Nchanji
- Minnesota Department of Health, St Paul, MN, United States of America
| | - Rebecca S Johnson
- Sierra Leone Community in Minnesota, Minneapolis, MN, United States of America
| | - Baninla Ladze
- Minnesota Cameroon Community, Minneapolis, MN, United States of America
| | - Stephen J Dunlop
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- Hennepin Healthcare, Minneapolis, MN, United States of America
| | - William M Stauffer
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
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Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health 2019; 21:606-658. [PMID: 30117005 DOI: 10.1007/s10903-018-0794-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.
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Affiliation(s)
- Georges Adunlin
- McWhorter School of Pharmacy, Samford University, 2100 Lakeshore Dr, Homewood, AL, 35229, USA.
| | - John W Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Richmond, VA, 23298-0430, USA
| | - Matthew Asare
- Department of Public Health, Baylor University, One Bear Place #97313, Waco, TX, 76798-7313, USA
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, USA
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Abstract
African-born immigrants are among the fastest growing immigrant groups in the US, yet they are underrepresented in healthcare research, particularly, cancer research and tend to be categorized as African American or Black, obscuring any cultural nuances that exist. A survey designed to provide insight on the barriers to healthcare, knowledge of common cancers, and cancer risks was utilized during a health fair. Data analyses included descriptive statistics to examine participant demographics and other study variables of interest. Most of the participants reported African origin (approximately 97%), were males (59%), were aged 18-40 years (49%), had a minimum of some college education (78%), a household income of >$50,000 (35%) and were mostly uninsured (45%). The cost of medical treatment 19 (45.2%) was reported as a major barrier to healthcare access. The Health Fair presented the opportunity to provide free health screenings, education/awareness, and referral to follow-up resources. The findings are evidence of the importance and impact of health fairs in communities of greatest need.
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Green JC, Schoening A, Vaughn MG. Duvalier Regime in Haiti and Immigrant Health in the United States. Ann Glob Health 2018; 84:603-611. [PMID: 30779507 DOI: 10.9204/aogh.2366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Haitians immigrate to the United States for many reasons, including the opportunity to escape political violence. The extant literature on Haitian immigrant health focuses on post-migration, rather than pre-migration, environments and experiences. Objective: In this study, we analyze health outcomes data from a nationally representative sample of Haitian immigrants in the United States from 1996 to 2015. We estimate age-adjusted associations between pre-migration residence in Haiti during the repressive regimes and generalized terror of Francois and Jean-Claude Duvalier, who ran Haiti from 1957 to 1986. METHODS We used ordered probit regression models to quantify age-adjusted associations between the duration of pre-migration residence in Haiti during the Duvalier regime, and the distribution of post-migration health status among Haitian immigrants in the United States. Findings: Our study sample included 2,438 males and 2,800 females ages 15 and above. The mean age of males was 43.5 (standard deviation, 15.5) and the mean age of females was 44.7 (standard deviation, 16.6). Each additional decade of pre-migration residence in Haiti during the Duvalier regime is associated with a 2.9 percentage point decrease (95% confidence interval 0.6 to 5.3) in excellent post-migration health for males, and a 2.8 percentage point decrease (95% confidence interval, 0.8 to 4.8) for females. Within the subsample of Haitian immigrants with any pre-migration residence in Haiti during the Duvalier regime, each additional decade since the regime is associated with a 3.3 percentage point increase (95% confidence interval, 1.2 to 5.5) in excellent post-migration health for males, and a 2.3 percentage point increase (95% confidence interval, 0.5 to 4.1) for females. CONCLUSIONS Overall, we found statistically significant and negative associations between the Duvalier regime and the post-migration distribution of health status 10 to 57 years later. We found statistically significant and positive associations between the length of time since the Duvalier regime and post-migration health.
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Affiliation(s)
- Jeremy C Green
- Saint Louis University, Department of Health Management and Policy, US
| | - Amanda Schoening
- Saint Louis University, Department of Health Management and Polcy, US
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11
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Green JC, Schoening A, Vaughn MG. Duvalier Regime in Haiti and Immigrant Health in the United States. Ann Glob Health 2018. [PMID: 30779507 PMCID: PMC6748271 DOI: 10.29024/aogh.2366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Haitians immigrate to the United States for many reasons, including the opportunity to escape political violence. The extant literature on Haitian immigrant health focuses on post-migration, rather than pre-migration, environments and experiences. Objective: In this study, we analyze health outcomes data from a nationally representative sample of Haitian immigrants in the United States from 1996 to 2015. We estimate age-adjusted associations between pre-migration residence in Haiti during the repressive regimes and generalized terror of Francois and Jean-Claude Duvalier, who ran Haiti from 1957 to 1986. Methods: We used ordered probit regression models to quantify age-adjusted associations between the duration of pre-migration residence in Haiti during the Duvalier regime, and the distribution of post-migration health status among Haitian immigrants in the United States. Findings: Our study sample included 2,438 males and 2,800 females ages 15 and above. The mean age of males was 43.5 (standard deviation, 15.5) and the mean age of females was 44.7 (standard deviation, 16.6). Each additional decade of pre-migration residence in Haiti during the Duvalier regime is associated with a 2.9 percentage point decrease (95% confidence interval 0.6 to 5.3) in excellent post-migration health for males, and a 2.8 percentage point decrease (95% confidence interval, 0.8 to 4.8) for females. Within the subsample of Haitian immigrants with any pre-migration residence in Haiti during the Duvalier regime, each additional decade since the regime is associated with a 3.3 percentage point increase (95% confidence interval, 1.2 to 5.5) in excellent post-migration health for males, and a 2.3 percentage point increase (95% confidence interval, 0.5 to 4.1) for females. Conclusions: Overall, we found statistically significant and negative associations between the Duvalier regime and the post-migration distribution of health status 10 to 57 years later. We found statistically significant and positive associations between the length of time since the Duvalier regime and post-migration health.
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Affiliation(s)
- Jeremy C Green
- Saint Louis University, Department of Health Management and Policy, US
| | - Amanda Schoening
- Saint Louis University, Department of Health Management and Polcy, US
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12
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Reynolds MM, Childers TB. Cardiovascular Disease Screening Among Immigrants from Eight World Regions. J Immigr Minor Health 2018; 21:820-829. [PMID: 30056583 DOI: 10.1007/s10903-018-0796-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inequalities between native-born and foreign-born individuals in screening rates for a variety of conditions have been well-documented in literature on immigrant health. A preponderance of this research focuses on the Latin American case and on cancer-specific screening. This study seeks to expand knowledge of such preventative-health screening differences by analyzing screening rates for blood sugar, blood pressure, and serum cholesterol among nine groups overall and (for immigrants) at various stages of US residency. Using nationally representative data from the National Health Interview Survey, we find that immigrants from eight geographic regions receive preventative care at lower rates than US-born Whites and that preventative screening is generally higher after 15 years than during the first 4 years of residency in the United States. Importantly, our data also show that screening patterns and trends vary based on region of origin and outcome. These findings improve our understanding of immigrant health and health care use in the United States.
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Affiliation(s)
- Megan M Reynolds
- Department of Sociology, University of Utah, 390 1530 E, Salt Lake City, UT, 84112, USA.
| | - Trenita B Childers
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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13
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Breast and Colorectal Cancer Screening Barriers Among Immigrants and Refugees: A Mixed-Methods Study at Three Community Health Centres in Toronto, Canada. J Immigr Minor Health 2018; 21:473-482. [DOI: 10.1007/s10903-018-0779-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kartal M, Ozcakar N, Hatipoglu S, Tan MN, Guldal AD. The Importance of Family History in Breast Cancer Patients in Primary Care Setting: a Cross-sectional Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:602-609. [PMID: 28573518 DOI: 10.1007/s13187-017-1237-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Screening recommendations of physicians are important for women to raise awareness about their risk factors and to promote appropriate screening behaviors. However, it seems challenging for primary care physicians (PCPs) to balance disease prevention and diagnosis, treatment. The objective of this study was to describe physicians' breast cancer consultancy practice including family history, cancer prevention issues for the women they care. This cross-sectional study included 577 women aged above 45 years, free of breast cancer, during their visits to their PCPs. Nearly half of the women reported their visit to PCPs for an annual examination during the year. Among them, 36.1% had first-degree relatives with cancer and 7.3% with breast cancer. But they reported to be asked about family history of cancer and informed about cancer prevention issues 35.1 and 26.4%, respectively. Cancer still seems to be a hard issue to be discussed, even with women visiting PCPs for annual examination. Asking first-degree relative with breast cancer can give PCPs the chance of determining women with increased risk and support women's appropriate understanding of their own risk in relation to their family history. This routine can make shared-decision making for developing person-centered approach for breast cancer screening possible. Further studies are needed for better understanding of loss of consultancy leadership of physicians for breast cancer.
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Affiliation(s)
- Mehtap Kartal
- Family Medicine Department of Dokuz Eylul University, Inciralti, 35340,, Izmir, Turkey.
| | - Nilgun Ozcakar
- Family Medicine Department of Dokuz Eylul University, Inciralti, 35340,, Izmir, Turkey
| | - Sehnaz Hatipoglu
- Medicine Specialist, Ministry of Health, 24th Family Health Center, Izmir, Turkey
| | - Makbule Neslisah Tan
- Family Medicine Department of Dokuz Eylul University, Inciralti, 35340,, Izmir, Turkey
| | - Azize Dilek Guldal
- Family Medicine Department of Dokuz Eylul University, Inciralti, 35340,, Izmir, Turkey
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Bowser D, Marqusee H, El Koussa M, Atun R. Health system barriers and enablers to early access to breast cancer screening, detection, and diagnosis: a global analysis applied to the MENA region. Public Health 2017; 152:58-74. [PMID: 28843410 DOI: 10.1016/j.puhe.2017.07.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/11/2017] [Accepted: 07/19/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify barriers and enablers that impact access to early screening, detection, and diagnosis of breast cancer both globally and more specifically in the Middle East and North Africa (MENA) region (with a specific focus on Egypt, Jordan, Oman, Saudi Arabia, United Arab Emirates [UAE], and Kuwait) with a specific focus on the health system. STUDY DESIGN A systematic review of literature. METHODS We conducted a systematic reviewing using the PRISMA methodology. We searched PubMed, Global Index Medicus, and EMBASE for studies on 'breast cancer', 'breast neoplasm,' or 'screening, early detection, and early diagnosis' as well as key words related to the following barriers: religion, culture, health literacy, lack of knowledge/awareness/understanding, attitudes, fatalism/fear, shame/embarrassment, and physician gender from January 1, 2000 until September 1, 2016. Two independent reviewers screened both titles and abstracts. The application of inclusion and exclusion criteria yielded a final list of articles. A conceptual framework was used to guide the thematic analysis and examine health system barriers and enablers to breast cancer screening at the broader macro health system level, at the health provider level, and the individual level. The analysis was conducted globally and in the MENA region. RESULTS A total of 11,936 references were identified through the initial search strategy, of which 55 were included in the final thematic analysis. The results found the following barriers and enablers to access to breast cancer screening at the health system level, the health provider level, and the individual level: health system structures such as health insurance and care coordination systems, costs, time concerns, provider characteristics including gender of the provider, quality of care issues, medical concerns, and fear. In addition, the following seven barriers and enablers were identified at the health system or provider level as significantly impacting screening for breast cancer: (1) access to insurance, (2) physician recommendation, (3) physician gender, (4) provider characteristics, (5) having a regular provider, (6) fear of the system or procedure, and (7) knowledge of the health system. More specifically, the largest increased odds for having a mammogram was from having insurance, having a physician recommendation, type of provider (mainly gynecologist), and having regular contact with a physician. Clinical breast examinations were increased by having insurance and having regular contact with a physician. The eight studies identified from the MENA region identified barriers to breast cancer screening related to service quality, fear of pain and of cancer itself, female versus male provider, having a physician recommend the screen, cost issues as well as time and convenience of the services. CONCLUSIONS There are a number of system changes that can be made to remove barriers to breast cancer screening. Some of these system changes apply directly to MENA countries. A larger health system assessment of a country is warranted to determine which health system changes should be made to most efficiently and effectively improve access to breast cancer screening.
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Affiliation(s)
- D Bowser
- Brandeis University, Heller School for Social Policy and Management, 415 South Street, Waltham, MA, USA.
| | - H Marqusee
- Brandeis University, Heller School for Social Policy and Management, 415 South Street, Waltham, MA, USA
| | - M El Koussa
- Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave., Boston, MA, USA
| | - R Atun
- Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Ave., Boston, MA, USA
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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 2016; 17:905-24. [PMID: 24522436 DOI: 10.1007/s10903-014-9991-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [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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Choi S. Experiencing Unmet Medical Needs or Delayed Care Because of Cost: Foreign-Born Adults in the U.S. by Region of Birth. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 46:693-711. [PMID: 27496545 DOI: 10.1177/0020731416662610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Healthy People 2020 in the United States highlights timely access to necessary health care as a major factor that can reduce health-related disparities. This study examined the prevalence of delaying/missing necessary health care because of cost among foreign-born adults (26+ years old) in the United States by their region of origin, after controlling for geographic clustering at the county and state levels. METHODS Using the pooled 2007-2011 National Health Interview Survey and linked state/county-level data, this study analyzed data on 61,732 foreign-born adults from nine regions of birth. Three-level multilevel modeling (state > county > individual) was conducted. The age-adjusted percentages of foreign-born adults who delayed/missed necessary health care because of cost varied by region of birth, ranging from 7.0% (Southeast Asia) and 11.9% (Europe) to 15.5% (Mexico/Central America/Caribbean) and 16.7% (the Middle East). However, after controlling for geographic clustering and other individual-level covariates (e.g., insurance), adults from Mexico/Central America/Caribbean were less likely to delay or not receive necessary care compared to their counterparts from all other parts of the world except for those from Asian regions. This study implies that disparities can be reduced if some known risk factors (e.g., insurance) are improved among foreign-born adults.
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Affiliation(s)
- Sunha Choi
- College of Social Work, The University of Tennessee, Knoxville, Tennessee, USA
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18
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Ojikutu B, Nnaji C, Sithole-Berk J, Bogart LM, Gona P. Barriers to HIV Testing in Black Immigrants to the U.S. J Health Care Poor Underserved 2016; 25:1052-66. [PMID: 25130224 DOI: 10.1353/hpu.2014.0141] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Late HIV testing is common among immigrants from sub Saharan Africa and the Caribbean. Since 2010, HIV testing is no longer a required component of immigrant screening examinations or mandatory for immigrants seeking long term residence in the US. Thus, barriers to HIV testing must be addressed. METHODS Five hundred and fifty-five (555) immigrants completed a barriers-to-HIV testing scale. Univariate and multivariate linear regression were performed to examine predictors of barriers. RESULTS In multivariate analysis, primary language other than English (β=2.9, p=.04), lower education (β=5.8, p=.03), low income [= below $20K/year] (β=4.6, p=.01), no regular provider (β=5.2, p=.002) and recent immigration (β=5.7, p=.0008) were independently associated with greater barriers. Barriers due to health care access, privacy, fatalism, and anticipated stigma were greater for recent versus longer term immigrants. DISCUSSION Immigrants from sub-Saharan Africa and the Caribbean face significant barriers to HIV testing. Interventions to improve access and timely entry into care are needed.
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Yao N, Hillemeier MM. Disparities in mammography rate among immigrant and native-born women in the U.S.: progress and challenges. J Immigr Minor Health 2016; 16:613-21. [PMID: 23430466 DOI: 10.1007/s10903-013-9798-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Disproportionately low mammography rates among U.S. immigrants have been of persistent concern. In light of policies to increase access to screening, this study identifies differences in factors associated with screening among immigrant and native-born women in 2000 and 2008. Data from immigrant and native-born women aged 40+ years in the 2000 and 2008 National Health Interview Surveys were included in descriptive and multivariate regression analyses. Mammography rates rose from 60.2 to 65.5 % among immigrant women, remaining lower than the 68.9 % rate among native-born in 2008. Among immigrants, short length of residency and lower education were associated with lower screening rates in 2000 but not in 2008, while public insurance coverage was positively associated with screening only in 2008. In contrast to immigrants, among the native-born education and income were associated with mammography receipt in 2008, and in both groups health care access was associated with greater screening rates. Policy initiatives aimed at increasing access to mammography may be positively affecting immigrant screening disparities. Access to primary care and public insurance coverage are likely to be very important in maintaining and furthering improvements in mammography rates.
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Affiliation(s)
- Nengliang Yao
- Department of Health Policy and Administration, The Pennsylvania State University, 604 Ford Building, University Park, PA, 16802, USA,
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20
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Gondek M, Shogan M, Saad-Harfouche FG, Rodriguez EM, Erwin DO, Griswold K, Mahoney MC. Engaging Immigrant and Refugee Women in Breast Health Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:593-598. [PMID: 25385693 PMCID: PMC4745125 DOI: 10.1007/s13187-014-0751-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This project assessed the impact of a community-based educational program on breast cancer knowledge and screening among Buffalo (NY) immigrant and refugee females. Program participants completed language-matched pre- and post-test assessments during a single session educational program; breast cancer screening information was obtained from the mobile mammography unit to which participants were referred. Pre- and post-test knowledge scores were compared to assess changes in responses to each of the six individual knowledge items, as well as overall. Mammogram records were reviewed to identify Breast Imaging Reporting and Data System (BI-RADS) scores. The proportion of correct responses to each of the six knowledge items increased significantly on the post-program assessments; 33 % of women >40 years old completed mammograms. The findings suggest that a health education program for immigrant and refugee women, delivered in community-based settings and involving interpreters, can enhance breast cancer knowledge and lead to improvements in mammography completion.
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Affiliation(s)
- Matthew Gondek
- Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA
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21
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Saadi A, Bond BE, Percac-Lima S. Bosnian, Iraqi, and Somali Refugee Women Speak: A Comparative Qualitative Study of Refugee Health Beliefs on Preventive Health and Breast Cancer Screening. Womens Health Issues 2015. [DOI: 10.1016/j.whi.2015.06.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Talley CH, Williams KP. Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women. Nurs Clin North Am 2015; 50:545-63. [PMID: 26333609 PMCID: PMC4559754 DOI: 10.1016/j.cnur.2015.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study examines the relationship between age, comorbidity, and breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N = 371) from Detroit, Michigan. The Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity on breast and cervical cancer literacy. The relationship between ACC and breast and cervical cancer screening, and group differences, were assessed. There was a statistically significant difference between breast cancer literacy scores. ACC had a greater impact on breast cancer literacy for African Americans.
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Affiliation(s)
- Costellia H Talley
- College of Nursing, Michigan State University, 1355 Bogue Street, Room C-247, East Lansing, MI 48824, USA.
| | - Karen Patricia Williams
- Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, 965 East Fee Road, Room A626, East Lansing, MI 48824, USA
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23
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Dallo FJ, Kindratt TB. Disparities in vaccinations and cancer screening among U.S.- and foreign-born Arab and European American non-Hispanic White women. Womens Health Issues 2014; 25:56-62. [PMID: 25498764 DOI: 10.1016/j.whi.2014.10.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/27/2014] [Accepted: 10/08/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Disparities in vaccinations and cancer screening exist when comparing foreign-born and U.S.-born women collectively and disaggregated by race and ethnicity. The purpose of this study was to estimate and compare the age-adjusted prevalence of not receiving a flu or pneumonia vaccine, clinical breast examination, mammogram or Pap smear among U.S.- and foreign-born White women by region of birth and examine associations while controlling for potential confounders. METHODS We pooled 12 years of National Health Interview Survey data (n = 117,893). To approximate an "Arab-American" ethnicity, we identified 15 "Arab" countries from the Middle East region that comprise the Arab Nations. Data was requested from the National Center for Health Statistics Research Data Center. We used the χ(2) statistic to compare descriptive statistics and odds ratios (ORs) with 95% CIs were used for inferential statistics. FINDINGS Compared to U.S.-born, foreign-born Whites from the Arab Nations had higher estimates of not receiving recommended vaccinations and cancer screenings. In crude and adjusted analyses, foreign-born Arab-American women were less likely to report receiving a flu vaccine (OR, 0.34; 95% CI, 0.21-0.58), pneumonia vaccine (OR, 0.14; 95% CI, 0.06-0.32), Pap smear (OR, 0.13; 95% CI, 0.05-0.31), or clinical breast examination (OR, 0.16; 95% CI, 0.07-0.37) compared with U.S.-born White women. There were no differences for mammography. CONCLUSIONS This national study examining uptake of flu and pneumonia vaccines and preventive cancer screenings suggests that estimates are lower for foreign-born Arab-American women compared with U.S.-born White women. Future studies should collect qualitative data that assess the cultural context surrounding prevention and screening behaviors among Arab-American women.
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Affiliation(s)
- Florence J Dallo
- Wellness, Health Promotion and Injury Prevention, School of Health Sciences, Oakland University, Rochester, Michigan.
| | - Tiffany B Kindratt
- Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, Dallas, Texas
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Consedine NS, Chentsova-Dutton YE, Krivoshekova YS. Emotional Acculturation Predicts Better Somatic Health: Experiential and Expressive Acculturation Among Immigrant Women From Four Ethnic Groups. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.10.867] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Ho SSM, Choi KC, Wong CL, Chan CWH, Chan HYL, Tang WPY, Lam WWT, Shiu ATY, Goggins WB, So WKW. Uptake of breast screening and associated factors among Hong Kong women aged ≥50 years: a population-based survey. Public Health 2014; 128:1009-16. [PMID: 25443128 DOI: 10.1016/j.puhe.2014.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 05/23/2014] [Accepted: 09/03/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the uptake of breast screening and its associated factors among Hong Kong Chinese women aged ≥50 years. STUDY DESIGN Cross-sectional population-based survey. METHODS A sample of Hong Kong Chinese women was recruited through telephone random-digit dialling. The survey consisted of six sections: perceived health status, use of complementary medicine, uptake of breast screening, perceived susceptibility to cancer, family history of cancer and demographic data. The factors associated with uptake of breast screening were analysed using logistic regression analysis. RESULTS In total, 1002 women completed the (anonymous) telephone survey. The mean age was 63.5 (standard deviation 10.6) years. The uptake rate of breast screening among Hong Kong Chinese women aged ≥50 years was 34%. The primary reasons for undertaking breast screening were as part of a regular medical check-up (74%), prompted by local signs and symptoms (11%) and a physician's recommendation (7%). Higher educational level, married or cohabiting, family history of cancer, frequent use of complementary therapies, regular visits to a doctor or Chinese herbalist, and the recommendation of a health professional were all independently and significantly associated with increased odds of having had a mammogram. CONCLUSIONS This study provides community-based evidence of the need for public health policy to promote broader use of mammography services among this target population, with emphasis on the active involvement of health care professionals, through the development and implementation of appropriate evidence-based and resource-sensitive strategies.
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Affiliation(s)
- S S M Ho
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - K C Choi
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - C L Wong
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - C W H Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - H Y L Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W P Y Tang
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W W T Lam
- Centre for Psycho-oncology Research and Training, School of Public Health, The University of Hong Kong, Sassoon Road, Hong Kong, China
| | - A T Y Shiu
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - W K W So
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
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Ekechi C, Olaitan A, Ellis R, Koris J, Amajuoyi A, Marlow LA. Knowledge of cervical cancer and attendance at cervical cancer screening: a survey of Black women in London. BMC Public Health 2014; 14:1096. [PMID: 25339243 PMCID: PMC4216339 DOI: 10.1186/1471-2458-14-1096] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/15/2014] [Indexed: 11/15/2022] Open
Abstract
Background Women from ethnic minority backgrounds are less likely to attend cervical screening, but further understanding of ethnic inequalities in cervical screening uptake is yet to be established. This study aimed to explore the socio-demographic and ethnicity-related predictors of cervical cancer knowledge, cervical screening attendance and reasons for non-attendance among Black women in London. Methods A questionnaire was completed by women attending Black and ethnic hair and beauty specialists in London between February and April 2013. A stratified sampling frame was used to identify Black hair specialists in London subdivisions with >10% Black population (including UK and foreign-born). Fifty-nine salons participated. Knowledge of cervical cancer risk factors and symptoms, self-reported screening attendance and reasons for non-attendance at cervical screening were assessed. Results Questionnaires were completed by 937 Black women aged 18–78, describing themselves as being predominantly from African or Caribbean backgrounds (response rate 26.5%). Higher educational qualifications (p < .001) and being born in the UK (p = .011) were associated with greater risk factor knowledge. Older age was associated with greater symptom knowledge (p < .001). Being younger, single, African (compared to Caribbean) and attending religious services more frequently were associated with being overdue for screening. Women who had migrated to the UK more than 10 years ago were less likely to be overdue than those born in the UK. Of those overdue for screening who endorsed a barrier (67/133), ‘I meant to go but didn’t get round to it’ (28%), fear of the test procedure (18%) and low risk perception (18%) were the most common barriers. Conclusions Ethnicity, migration and religiosity play a role in predicting cervical screening attendance among women from Black backgrounds. African women, those born in the UK and those who regularly attend church are most likely to put off attending. Additional research is needed to explore the attitudes, experiences and beliefs that explain why these groups might differ. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1096) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | - Laura Av Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, University College London, Gower Street, London WC1E 6BT, England.
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Jerome-D'Emilia B, Suplee PD. Mammogram Use and Self-Efficacy in an Urban Minority Population. Public Health Nurs 2014; 32:287-97. [DOI: 10.1111/phn.12162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Bonnie Jerome-D'Emilia
- School of Nursing - Camden; Rutgers, The State University of New Jersey; Camden New Jersey
| | - Patricia Dunphy Suplee
- School of Nursing - Camden; Rutgers, The State University of New Jersey; Camden New Jersey
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28
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Addressing cancer control needs of African-born immigrants in the US: a systematic literature review. Prev Med 2014; 67:89-99. [PMID: 25034729 PMCID: PMC4203373 DOI: 10.1016/j.ypmed.2014.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 04/03/2014] [Accepted: 07/07/2014] [Indexed: 12/31/2022]
Abstract
Compared to non-Hispanic Whites, African immigrants have worse cancer outcomes. However, there is little research about cancer behaviors and/or interventions in this growing population as they are generally grouped with populations from America or the Caribbean. This systematic review examines cancer-related studies that included African-born participants. We searched PsycINFO, Ovid Medline, Pubmed, CINHAL, and Web of Science for articles focusing on any type of cancer that included African-born immigrant participants. Twenty articles met study inclusion criteria; only two were interventions. Most articles focused on one type of cancer (n=11) (e.g., breast cancer) and were conducted in disease-free populations (n=15). Studies included African participants mostly from Nigeria (n=8) and Somalia (n=6). However, many papers (n=7) did not specify nationality or had small percentages (<5%) of African immigrants (n=5). Studies found lower screening rates in African immigrants compared to other subpopulations (e.g. US-born). Awareness of screening practices was limited. Higher acculturation levels were associated with higher screening rates. Barriers to screening included access (e.g. insurance), pragmatic (e.g. transportation), and psychosocial barriers (e.g. shame). Interventions to improve cancer outcomes in African immigrants are needed. Research that includes larger samples with diverse African subgroups including cancer survivors is necessary to inform future directions.
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Beyond demographics: differences in patient activation across new immigrant, diverse language subgroups. J Community Health 2014; 39:40-9. [PMID: 23918645 DOI: 10.1007/s10900-013-9738-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The federal government promotes "patient-centered medical homes" to plan care with respect to patients' cultures and values and support patients' self-care efforts. To promote self-care, the medical home would be best utilized by activated, engaged patients. The objective of this study was to measure and compare patient activation scores in English-, Spanish-, and Haitian Creole-speaking patients seen at an inner-city hospital ambulatory care practice. Patient activation was measured using the patient activation measure (PAM). Mean PAM scores and activation levels differed according to survey language (p < 0.001). US-born participants had higher mean PAM scores than persons born outside of the US. Participants living in the US longer had higher mean PAM scores than participants newer to the US. Levels of activation and mean PAM scores increased with greater comfort reading, speaking, and thinking in English. The mean PAM (SD) score of 61.5 (16.5) for Haitian Creole-speaking Caribbean Blacks was significantly lower than the mean PAM score of 68.8 (15.6) for English-speaking Caribbean Blacks (p value = 0.006). Although mean PAM scores did not significantly differ between Haitian Creole and Spanish speakers, PAM stages differed according to language of survey completion (p < 0.001), with a greater percentage of Haitian Creole speakers being categorized as stage 1 (least activated) as well as stage 4 (most activated). Spanish and Haitian Creole speakers have lower mean PAM scores than English speakers. Mean PAM scores did not differ between Hispanics and non-Hispanics or according to race, illustrating the need to examine the role of language and culture on patient activation.
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Weber MF, Chiew M, Feletto E, Kahn C, Sitas F, Webster L. Cancer Screening among immigrants living in urban and regional Australia: results from the 45 and up study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8251-66. [PMID: 25153460 PMCID: PMC4143860 DOI: 10.3390/ijerph110808251] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/30/2014] [Accepted: 08/06/2014] [Indexed: 12/23/2022]
Abstract
Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006-2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening.
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Affiliation(s)
- Marianne F Weber
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - May Chiew
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Eleonora Feletto
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Freddy Sitas
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Lucy Webster
- School of Biomedical Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, NSW 2650, Australia.
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Hasnain M, Menon U, Ferrans CE, Szalacha L. Breast cancer screening practices among first-generation immigrant muslim women. J Womens Health (Larchmt) 2014; 23:602-12. [PMID: 24865517 PMCID: PMC4089017 DOI: 10.1089/jwh.2013.4569] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. METHODS A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internal-consistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. RESULTS Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. CONCLUSIONS This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women's participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women's self-efficacy, as well as systems-level considerations for ensuring access to primary care providers.
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Affiliation(s)
- Memoona Hasnain
- Department of Family Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Usha Menon
- College of Nursing, The Ohio State University, Columbus, Ohio
| | | | - Laura Szalacha
- Center for Research and Transdisciplinary Scholarship, College of Nursing, The Ohio State University, Columbus, Ohio
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Illness Perception Differences Between Russian- and Hebrew-Speaking Israeli Oncology Patients. J Clin Psychol Med Settings 2014; 21:33-40. [DOI: 10.1007/s10880-013-9384-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Change in self-reported health status among immigrants in the United States: associations with measures of acculturation. PLoS One 2013; 8:e76494. [PMID: 24098515 PMCID: PMC3788132 DOI: 10.1371/journal.pone.0076494] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 08/28/2013] [Indexed: 12/03/2022] Open
Abstract
Although acculturation may have positive effects for immigrants, including better socioeconomic profiles and increased occupational opportunities, their health profiles deteriorate with longer duration in the U.S. Prior research indicates that increasing acculturation is associated with some poorer health outcomes among immigrants in the U.S. However, most of these studies have used length of stay or English language proficiency as proxies for acculturation, and have mainly examined self-reported “current” health outcomes. This study advances knowledge on associations between acculturation and health among immigrants by explicitly examining self-reported “change” in health since immigration, in relation to acculturation-related variables. We use data from the New Immigrant Survey (NIS; 2003-2004), a cross-sectional study of legal immigrants to the U.S. In addition to testing more conventionally examined proxies of acculturation (length of stay and English proficiency), we also examine English language use and self-reported change in diet. Multivariable logistic regression analyses on 5,982 participants generally supported previous literature indicating a deleterious impact of acculturation, with increasing duration of stay and greater self-reported change in diet being associated with a poorer change in health since moving to the U.S. Although English language proficiency and use were associated with greater odds of reporting a worse change in health when examined individually, they were non-significant in multivariable models including all acculturation measures. Findings from this study suggest that when taking into account multiple measures of acculturation, language may not necessarily indicate unhealthy assimilation and dietary change may be a pathway leading to declines in immigrant health. Increasing duration in the U.S. may also reflect the adoption of unhealthy behaviors, as well as greater exposure to harmful sources of psychosocial stress including racial and anti-immigrant discrimination. Our study suggests that multiple indicators of acculturation may be useful in examining the effect of acculturation on changes in health among immigrants.
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Andreeva VA, Pokhrel P. Breast cancer screening utilization among Eastern European immigrant women worldwide: a systematic literature review and a focus on psychosocial barriers. Psychooncology 2013; 22:2664-75. [PMID: 23824626 DOI: 10.1002/pon.3344] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 05/28/2013] [Accepted: 05/31/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Many countries host growing Eastern European immigrant communities whose breast cancer preventive behaviors are largely unknown. Thus, we aimed to synthesize current evidence regarding secondary prevention via breast cancer screening utilized by that population. METHODS All observational, general population studies on breast cancer screening with Eastern European immigrant women and without any country, language, or age restrictions were identified. Screening modalities included breast self-examination, clinical breast examination, and mammography. RESULTS The selected 30 studies were published between 1996 and 2013 and came from Australia, Canada, Denmark, Germany, Israel, the Netherlands, Spain, Switzerland, the UK, and the USA. The reported prevalence of monthly breast self-examination was 0-48%; for yearly clinical breast examination 27-54%; and for biennial mammography 0-71%. The substantial methodologic heterogeneity prevented a meta-analysis. Nonetheless, irrespective of host country, healthcare access, or educational level, the findings consistently indicated that Eastern European immigrant women underutilize breast cancer screening largely because of insufficient knowledge about early detection and an external locus of control regarding decision making in health matters. CONCLUSIONS This is a vulnerable population for whom the implementation of culturally tailored breast cancer screening programs is needed. As with other underscreened immigrant/minority groups, Eastern European women's inadequate engagement in prevention is troublesome as it points to susceptibility not only to cancer but also to other serious conditions for which personal action and responsibility are critical.
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Somanchi M, Juon HS, Rimal R. Predictors of screening mammography among Asian Indian American women: a cross-sectional study in the Baltimore-Washington metropolitan area. J Womens Health (Larchmt) 2013; 19:433-41. [PMID: 20141384 DOI: 10.1089/jwh.2008.0873] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess adherence to screening mammography guidelines and examine predictors of having a mammogram in the past 2 years among immigrant Asian Indian women (AIW) aged > or = 40 years. METHODS Face-to-face surveys of 418 AIW in the Baltimore-Washington metropolitan area were conducted. Subjects were recruited through Asian Indian (AI) religious and other community-based organizations. RESULTS Of the 418 AIW surveyed, 83% had ever had a mammogram, and 70% had obtained a mammogram within the past 2 years. AIW who had lived in the United States for > 10 years had a higher rate of obtaining a mammogram (75.4%) within the past 2 years than did those who had lived in the United States for < or = 10 years (24.6%). In multiple logistic regression analysis, length of stay in the United States, marital status, knowledge of mammogram guidelines, age, having health insurance, physician recommendations, and number of relatives who had a mammogram were positively associated with having a mammogram within the past 2 years. Physician ethnicity and not having a healthcare provider were negatively associated with having a mammogram within the past 2 years. CONCLUSIONS This study lays a foundation for designing guidelines for interventions to improve mammography screening behaviors among AIW women. Increasing the use of mammogram to the levels recommended by guidelines will require a two-pronged approach directed at both AIW and AI physicians.
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Affiliation(s)
- Meena Somanchi
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. J Immigr Minor Health 2012; 14:633-9. [PMID: 21901446 DOI: 10.1007/s10903-011-9520-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Since the Iraq war began in 2003, over 4 million Iraqis have been displaced. Little is known about preventive cancer care in this population, but stark disparities have been documented. The purpose of this study was to assess the perspectives of Iraqi women refugees on preventive care and perceived barriers to breast cancer screening. Interviews were conducted in Arabic with twenty Iraqi refugee women by a bilingual (English/Arabic) medical student, transcribed, translated and coded according to established qualitative content and thematic analysis procedures. Psychosocial barriers, culturally mediated beliefs, and health consequences of war were identified as major themes, ultimately showing what factors, alone and collectively, have impeded Iraqi refugee women's ability and motivation to obtain breast cancer screening. To improve cancer prevention and decrease disparities in care in this most vulnerable population, culturally appropriate health education and outreach programs, as well as further community-level targeted studies, are needed.
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Lee S, O'Neill A, Park J, Scully L, Shenassa E. Health insurance moderates the association between immigrant length of stay and health status. J Immigr Minor Health 2012; 14:345-9. [PMID: 22512006 DOI: 10.1007/s10903-010-9411-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Previous studies reported that immigrants’ health worsens with acculturation to US lifestyle; however, role of health insurance has not been investigated. We used crosssectional National Immigrant Survey (n = 6,381) to examine the potential moderating effect of health insurance on the association between time in the US and self reported changes in health (comparing health status before and after immigration)and current health status. Separate logistic regression models were fit to assess these associations among insured and uninsured immigrants, adjusting for covariates. Among uninsured immigrants there was a stronger negative association between length of stay and health, compared to immigrants with health insurance. Insured immigrants were almost two times more likely than uninsured immigrants to have received preventive screenings, such as a Pap smear or prostate exam. This suggests that health insurance may somewhat attenuate this association, and is an important resource for US immigrants.
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Affiliation(s)
- Sunmin Lee
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA.
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Mehrotra N, Gaur S, Petrova A. Health care practices of the foreign born Asian Indians in the United States. A community based survey. J Community Health 2012; 37:328-34. [PMID: 21811880 DOI: 10.1007/s10900-011-9449-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although successful utilization of medical and preventive care by members of the non-US born communities is an important public health concern, our knowledge regarding health practices of different ethnic subgroups is limited. In the present study, participants of the health fairs organized during South Asian cultural and religions events were asked anonymously to complete the South Asian Total Health Initiative (SATHI) health survey questionnaire to evaluate their health-related practices, self-health perception, and satisfaction with medical care. Among 1,250 surveyed, 1,016 foreign born Asian Indians adults that represented the fastest growing subgroups of the South Asian born nationals in the US were included in the analysis. We found that the majority reported healthy behavior (exercise activities and abstinence from alcohol or tobacco), high self-health perception, satisfaction with medical care, and compliance with annual routine medical examinations that was directly associated with the annual house income. Approximately 40% of women complied with breast and cervical cancer screenings and less than 20% of men complied with prostate cancer screening guidelines. Presence of chronic conditions (mostly cardiovascular pathology and/or diabetes) that were reported by approximately half of the participants negatively impacted their self-health perception. In conclusion, positive self-reported health perception and compliance with routine health examinations of the surveyed foreign born Asian Indians was reported along with an increased rate of chronic morbidity and underutilization of specific preventive services. Observed discrepancy between self-health perception and health status highlights the need to enhance utilization of preventive services among the non-US born Asian Indian community.
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Affiliation(s)
- Naveen Mehrotra
- Department of Pediatrics, UMDNJ/RWJMS, One Robert Wood Johnson Place, MEB-322, New Brunswick, NJ 08903-0019, USA.
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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: 37] [Impact Index Per Article: 3.1] [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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Effects of length of stay and language proficiency on health care experiences among immigrants in Canada and the United States. Soc Sci Med 2012; 74:1062-72. [PMID: 22326103 DOI: 10.1016/j.socscimed.2011.11.031] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 09/01/2011] [Accepted: 11/26/2011] [Indexed: 11/21/2022]
Abstract
This study sought to examine the influence of length of stay and language proficiency on immigrants' access to and utilization of care in Canada and the United States (U.S,). Data came from the 2007-2008 Canadian Community Health Survey and the National Health Interview Survey. Analyses were limited to foreign-born, non-elderly adults in each country (n = 12,870 in Canada and n = 7440 in the U.S.). Health care indicators included having a usual source of care; annual consultation with a health professional, dentist, and eye doctor; flu shot in the past year; and Pap test in the past 3 years. Logistic regression models were employed to estimate the relative odds of access or use of care, adjusting for need, demographic factors, socioeconomic status, and insurance coverage. In general, rates of health care access and utilization were higher in Canada than the U.S. among all immigrant groups. In both countries, adjusted analyses indicated that immigrants with shorter length of stay (less than 10 years) and limited language proficiency generally had lower rates of access/use compared with those with longer length of stay (10 years or more) and proficiency in each country's official language(s), respectively. There was one exception to this pattern in the U.S.: immigrants with limited English had higher odds of having a recent Pap test relative to English-proficient immigrants. The persistence of disparities in health care experiences based on length of stay and language proficiency in Canada suggests that universal health insurance coverage may not be sufficient for ensuring access to and utilization of primary and preventive care for this population.
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Beiki O, Hall P, Ekbom A, Moradi T. Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study. Breast Cancer Res 2012; 14:R5. [PMID: 22225950 PMCID: PMC3496120 DOI: 10.1186/bcr3086] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/23/2011] [Accepted: 01/06/2012] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality in low- and middle-income countries. We utilized Swedish nationwide registers to study breast cancer incidence and case fatality to disentangle the effect of socioeconomic position (SEP) and immigration from the trends in native Swedes. METHODS A nation-wide cohort of women in Sweden was followed between 1961 and 2007 and incidence rate ratio (IRR) and hazard ratio (HR) with 95% confidence intervals (CIs) were estimated using Poisson and Cox proportional regression models, respectively. RESULTS Incidence continued to increase; however, it remained lower among immigrants (IRR = 0.88, 95% CI = 0.86 to 0.90) but not among immigrants' daughters (IRR = 0.97, 95% CI = 0.94 to 1.01) compared to native Swedes. Case fatality decreased over the last decades and was similar in native Swedes and immigrants. However, case fatality was significantly 14% higher if cancer was diagnosed after age 50 and 20% higher if cancer was diagnosed in the most recent years among immigrants compared with native Swedes. Women with the highest SEP had significantly 20% to 30% higher incidence but had 30% to 40% lower case fatality compared with women with the lowest SEP irrespective of country of birth. Age at immigration and duration of residence significantly modified the incidence and case fatality. CONCLUSIONS Disparities found in case fatality among immigrants by age, duration of residence, age at immigration and country of birth emphasize the importance of targeting interventions on women that are not likely to attend screenings or are not likely to adhere to the therapy suggested by physicians. The lower risk of breast cancer among immigrant women calls for more knowledge about how the lifestyle factors in these women differ from those with high risk, so that preventative measures may be implemented.
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Affiliation(s)
- Omid Beiki
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Per Hall
- Department of Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden
| | - Anders Ekbom
- Unit of Clinical Epidemiology, Department of Medicine, SOLNA, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Tahereh Moradi
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
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Billmeier TM, Dallo FJ. Nativity status and mammography use: results from the 2005 National Health Interview Survey. J Immigr Minor Health 2011; 13:883-90. [PMID: 20204516 DOI: 10.1007/s10903-010-9334-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Disparities exist in mammography use based on nativity status. Using the 2005 National Health Interview Survey, we examined the link between nativity status and mammography use in the past 2 years among women (≥40 years) and investigated whether acculturation was associated with mammography use among foreign-born women using multivariate analyses. Foreign-born women were less likely (OR = 0.75; 95% CI = 0.65, 0.87) to report mammography use compared to US born women. After adjusting for selected covariates, results were no longer statistically significant. Foreign-born women (≥65 years) who were not US citizens (i.e. less acculturated) were less likely (OR = 0.17; 95% CI = 0.06, 0.46) to report mammography use compared to naturalized citizens. Based on our findings, mammography use did not differ between US and foreign-born women. Therefore, the disparities in incidence and mortality rates observed between these groups may be due to other factors.
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Affiliation(s)
- Tiffany M Billmeier
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9165, USA.
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Consedine NS. The Demographic, System, and Psychosocial Origins of Mammographic Screening Disparities: Prediction of Initiation Versus Maintenance Screening Among Immigrant and Non-Immigrant Women. J Immigr Minor Health 2011; 14:570-82. [DOI: 10.1007/s10903-011-9524-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Baker D. Conceptual parameters of acculturation within the Asian and Pacific Islander American populations: applications for nursing practice and research. Nurs Forum 2011; 46:83-93. [PMID: 21517881 DOI: 10.1111/j.1744-6198.2011.00217.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
TOPIC Asian and Pacific Islander Americans (A&PIAs) are experiencing health inequities. For example, A&PIA is the only racial/ethnic group in America to experience cancer as their leading cause of death. Several studies within the A&PIA population have pointed to acculturation as a significant variable to explain their health and health-seeking behaviors. Acculturation is a key construct in understanding the health of the A&PIA population. OBJECTIVE The purpose of this concept analysis is to provide a current conceptual understanding of the relationship between acculturation and health, especially within the A&PIA populations, which will serve as a pragmatic guideline for nursing practice and research. Understanding the contemporary issues surrounding the conceptual application of acculturation will aid in the development of appropriate programs to reduce health inequities. METHODS Acculturation was explored using the Morse method of concept analysis. An iterative historical and contemporary literature review across the disciplines of anthropology, sociology, psychology, medicine, and nursing was completed. Analytical questions asked of the resultant data provided the theoretical definition, antecedents, key attributes, outcomes, and implications. RESULTS The concept analysis resulted in a new theoretical definition that includes multidimensional concepts of acculturation. Dilemmas in the measurement of key attributes of acculturation include unidirectional and bidirectional analysis, psychometric issues, and the appropriateness of proxy measurements. Outcomes of acculturation on health can be positive or negative and depend on an individual's or group's ability to navigate freely with necessary supports. Results of the conceptual analysis resulted in recommendations for nursing practice and future acculturation research. CONCLUSION While debate continues about the appropriate use and definition of acculturation, researchers agree that it is an important construct in understanding the health of migrating individuals and groups. Currently there is no testable framework that delineates the role of acculturation in health. Further research is indicated to clarify the relationship between acculturation and health.
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Affiliation(s)
- Dian Baker
- Betty Irene Moore School of Nursing, University of California Davis, USA.
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Massari V, Lapostolle A, Cadot E, Parizot I, Dray-Spira R, Chauvin P. Gender, socio-economic status, migration origin and neighbourhood of residence are barriers to HIV testing in the Paris metropolitan area. AIDS Care 2011; 23:1609-18. [DOI: 10.1080/09540121.2011.579940] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | | | | | | | | | - Pierre Chauvin
- a INSERM , Paris , France
- b UPMC Université , Paris , France
- e AP-HP, Hôpital Saint-Antoine , Paris , France
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Katiria Perez G, Cruess D. The impact of familism on physical and mental health among Hispanics in the United States. Health Psychol Rev 2011; 8:95-127. [PMID: 25053010 DOI: 10.1080/17437199.2011.569936] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The rapidly expanding number of Hispanics living in USA has increased the need for their inclusion in research on physical and mental health. Current studies that have explored health outcomes among Hispanics have often noted an 'epidemiological paradox', in which there is a discrepancy between their minority status and positive health outcomes when compared with other racial/ethnic groups. Certain socio-cultural variables, in particular the value placed on family, have been largely implicated in these findings. This review will provide a summary of the literature exploring familism within the structure of the Hispanic family and its potential impact on health. We will focus on research exploring the plausible impact that family and familism values may have on the physical health (particularly within the HIV, diabetes, and breast cancer literature) and also on health behaviours of Hispanics, as well as its effect on mental health (particularly related to acculturative stress and caregiver stress). Throughout the review, we highlight some of the potential mechanisms by which familism may impact on the health status of Hispanics. We conclude the review by noting some of the clinical and ethical implications of this research, and by offering suggestions for future work in this area.
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Affiliation(s)
- Giselle Katiria Perez
- a Department of Psychology , University of Connecticut , 406 Babbidge Road, Unit 1020, Storrs , CT 06269 , USA
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Pons-Vigués M, Puigpinós-Riera R, Serral G, Pasarín MI, Rodríguez D, Pérez G, Benet J, Casamitjana M, Borrell C. Knowledge, attitude and perceptions of breast cancer screening among native and immigrant women in Barcelona, Spain. Psychooncology 2011; 21:618-29. [DOI: 10.1002/pon.1940] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 01/12/2011] [Accepted: 01/24/2011] [Indexed: 11/10/2022]
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Denoth A, Pinget C, Wasserfallen JB. Citizens' preferences for brand name drugs for treating acute and chronic conditions: a pilot study. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2011; 9:81-87. [PMID: 21332252 DOI: 10.2165/11533030-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Generic drugs have been advocated to decrease the proportion of healthcare costs devoted to drugs, but are still underused. OBJECTIVE To assess citizens' preferences for brand name drugs (BNDs) compared with generic drugs for treating acute and chronic conditions. METHODS A questionnaire with eight hypothetical scenarios describing four acute and four chronic conditions was developed, with willingness to pay (WTP) determined using a payment card system randomized to ascending (AO) or descending order (DO) of prices. The questionnaire was distributed with an explanation sheet, an informed consent form and a pre-stamped envelope over a period of 3 weeks in 19 community pharmacies in Lausanne, Switzerland. The questionnaire was distributed to every third customer who also had health insurance, understood French and was aged ≥16 years (up to a maximum of ten customers per day and 100 per pharmacy). The main outcome measure was preferences assessed by WTP for BNDs as compared with generics, and impact of participants' characteristics on WTP. RESULTS Of the 1800 questionnaires, 991 were distributed and 393 returned (pharmacy participation rate = 55%, subject participation rate = 40%, overall response rate = 22%); 51.7% were AO and 48.3% DO. Participants were predominantly women (62.6%) and of median age 62 years (range 16-90). The majority (70%) declared no WTP for BNDs as compared with generics. WTP was higher in people with an acute disease than in those with a chronic disease, did not depend on the type of chronic disease, and was higher in people from countries other than Switzerland. CONCLUSIONS Most citizens visiting pharmacies attribute no added value to BNDs as compared with generics, although some citizen characteristics affected WTP. These results could be of interest to several categories of decision makers within the healthcare system.
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Affiliation(s)
- Arina Denoth
- Institute of Health Economics and Management, University of Lausanne, Lausanne, Switzerland
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The role of physician involvement in Latinas' mammography screening adherence. Womens Health Issues 2011; 21:165-70. [PMID: 21232975 DOI: 10.1016/j.whi.2010.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 09/02/2010] [Accepted: 09/02/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND Disparities in breast cancer (BC) screening continue to affect Latinas significantly, but the factors that explain these disparities remain unclear. OBJECTIVE The objective of this study was to investigate whether physician's instruction on breast examination and mammography recommendations predicted Latinas' adherence to mammography screening above and beyond other influential variables. METHODS A cross-sectional, descriptive design was utilized. Convenience and snowball sampling techniques were followed to recruit 344 Latinas aged 41 years and older from predominantly Latino neighborhoods in Denver, Colorado. MAIN OUTCOME MEASURES Latinas' adherence to mammography screening recommendations by the American Cancer Society. RESULTS Characteristics that were significantly associated with mammography adherence were age, Pap smear adherence, physician's breast examination instructions, and physician's mammography recommendations. CONCLUSION The study provides evidence that the BC screening disparities that significantly affect Latinas can be addressed by increasing physician's involvement through BC screening instruction and referral.
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Lee J, Jezewski MA, Wu YWB, Carvallo M. The relationship between acculturation and oral contraceptive use among Korean immigrant women. Res Nurs Health 2010; 34:91-102. [DOI: 10.1002/nur.20417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2010] [Indexed: 11/06/2022]
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