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Tung WC, Chen Y. Breast Cancer Knowledge and Mammography Use Among Asian American Women Aged 40 and Older: Using the Transtheoretical Model Approach. J Immigr Minor Health 2024; 26:140-147. [PMID: 37556031 DOI: 10.1007/s10903-023-01529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
Mammography screening rates remain low among Asian American women (AAW). The aims of our study were to: (a) assess breast cancer knowledge and mammography screening behaviors, and (b) identify the factors related to the transtheoretical model (TTM) stages of change in relation to mammography utilization among AAW aged 40 and older. Using a cross-sectional design, a convenience sample of 714 AAW completed a structured questionnaire in 2021. Participants demonstrated a moderate level of knowledge regarding breast cancer and mammography. Only 34.2% of the participants reported obtaining regular mammograms. The ordinal logistic regression indicated that age, birthplace, health perception, breast biopsy history, breast cancer knowledge, self-efficacy, and perceived barriers were correlated with TTM stages of change. Our results highlight the need for implementing effective interventions aimed at increasing knowledge and screening rates for breast cancer among AAW. Additional TTM studies with AAW are needed to determine the relationships among TTM constructs and develop theory-based programs to improve adherence to screening guidelines. Future research using a mixed-method design may provide opportunities to explore complex phenomena associated with breast cancer screening behaviors. Finally, further assessments of the Breast Cancer Knowledge Scale's psychometric properties are necessary to improve this instrument.
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Affiliation(s)
- Wei-Chen Tung
- The Valley Foundation School of Nursing, San Jose State University, One Washington Square, Health Building #403, San Jose, CA, 95192, USA.
| | - Yinghan Chen
- Department of Mathematics and Statistics, University of Nevada-Reno, Reno, NV, 89557, USA
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Cudjoe J, Budhathoki C, Roter D, Gallo JJ, Sharps P, Han HR. Exploring Health Literacy and the Correlates of Pap Testing Among African Immigrant Women: Findings from the AfroPap Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:441-451. [PMID: 32410109 PMCID: PMC7666038 DOI: 10.1007/s13187-020-01755-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
African immigrant (AI) women have low rates of Pap testing. Health literacy plays a pivotal role in health behaviors. Sources and types of health information could shape health literacy and inform the Pap testing behaviors of AI women. However, the influences of health literacy, sources, and types of health information along with cultural and psychosocial correlates on the Pap testing behaviors of AI women are poorly understood. To examine how sources and types of health information impact health literacy, and in turn, how health literacy and cultural and psychosocial factors influence the Pap testing behaviors of AI women. An adapted Health Literacy Skills Framework guided the selection of variables for this cross-sectional study. Convenience sampling was used to recruit 167 AI women, 21-65 years. Multivariate logistic regression was used to assess correlates of Pap testing after adjusting for covariates (age, education, English proficiency, employment, income, health insurance, access to primary care, marital status, and healthcare provider recommendation). Most participants (71%) had received a Pap test in the past and used multiple (two or more) sources (65%) and types (57%) of health information. Using multiple sources of health information (aOR 0.11, p < 0.01) but not types of health information was associated with Pap testing. Having negative cultural beliefs (aOR 0.17, p = 0.01) and having high self-efficacy (aOR 9.38, p < 0.01) were significantly associated with Pap testing after adjusting for covariates. High health literacy (OR 3.23, p < 0.05) and high decisional balance (OR 5.28, p < 0.001) were associated with Pap testing in bivariate models but did not remain significant after controlling for covariates. Cultural beliefs was a significant correlate of AI women's Pap testing behaviors regardless of other known social determinants of health (education, English proficiency, age, access to primary care). Disseminating health information through various sources has the potential to promote Pap testing among AI women. Larger studies which utilize a robust sampling strategy and include a diverse group of AI women are needed in order to optimize health interventions aimed at improving Pap test screening behaviors among AI women.
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Affiliation(s)
- Joycelyn Cudjoe
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
- Inova Health System, 8110 Gatehouse Road Suite 200W, Falls Church, VA, 22042, USA.
| | - Chakra Budhathoki
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Debra Roter
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Joseph J Gallo
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Phyllis Sharps
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
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Jin SW, Lee J, Lee HY. Analyzing factors associated with decisional stage of adopting breast cancer screening among Korean American women using precaution adoption process model. ETHNICITY & HEALTH 2021; 26:431-447. [PMID: 30326735 PMCID: PMC6531354 DOI: 10.1080/13557858.2018.1520813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 08/30/2018] [Indexed: 06/08/2023]
Abstract
Background: Korean American (KA) women have experienced higher prevalence and lower survival rates of breast cancer (BC) than other ethnic groups in the United States. However, BC screening rates for KA women remain significantly lower than the national target (81.1%) specified by Healthy People 2020. Few studies have explained how the decision to adopt BC screening occurs and progresses and what factors contribute to this decision among KA women. This study used Weinstein's Precaution Adoption Process Model (PAPM) as a theoretical framework to examine characteristics and factors associated with the decisional stage of mammography adoption.Methods: A cross-sectional self-report survey was administered among KA women (N = 308) ages 50-80 from the Atlanta metropolitan area. A total of 281 KA women completed the survey, answering questions about socio-demographics, health-related information, mammography history, doctor recommendation, BC screening knowledge, self-efficacy for BC screening, decisional balance scores on attitudes and beliefs pertaining to mammography, and the seven-stage PAPM.Results: KA women reported a low rate of mammography uptake with about 24% and 35% of the participants undergoing mammography within the last year and two years, respectively. KA women in stages 5 (decided yes), 6 (action), and 7 (maintenance) were likely to have increased screening-related knowledge, positive decisional balance, and regular medical check-up compared to those in stages 1 (unaware), 2 (unengaged), and 3 (deciding).Conclusion: This study highlights important factors that could potentially facilitate BC screening among KA women in Georgia. The findings also provide implications for interventions and practice for increasing mammography screening among medically underserved populations.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 226 McCord Hall. Memphis, TN 38152. Tel: 901-678-2616, Fax:
901-678-2981. ()
| | - Jongwook Lee
- candidate and a Research Professional, Department of Applied Economics, University of Minnesota, 218G Ruttan Hall,
1994 Buford Avenue, St. Paul, MN 55108. Tel: 612-624-4218. ()
| | - Hee Yun Lee
- Associate Dean for Research, Endowed Academic Chair on Social Work (Health), School of Social Work, University of
Alabama, Tuscaloosa, 1022 Little Hall, Box 870314, Tuscaloosa, AL 35487. Tel: 205-348-6553.
()
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Austin JD, Shelton RC, Lee Argov EJ, Tehranifar P. Older Women’s Perspectives Driving Mammography Screening Use and Overuse: a Narrative Review of Mixed-Methods Studies. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00244-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Purpose of Review
Examining what older women know and perceive about mammography screening is critical for understanding patterns of under- and overuse, and concordance with screening mammography guidelines in the USA. This narrative review synthesizes qualitative and quantitative evidence around older women’s perspectives toward mammography screening.
Recent Findings
The majority of 43 identified studies focused on promoting mammography screening in women of different ages, with only four studies focusing on the overuse of mammography in women ≥ 70 years old. Older women hold positive attitudes around screening, perceive breast cancer as serious, believe the benefits outweigh the barriers, and are worried about undergoing treatment if diagnosed. Older women have limited knowledge of screening guidelines and potential harms of screening.
Summary
Efforts to address inequities in mammography access and underuse need to be supplemented by epidemiologic and interventional studies using mixed-methods approaches to improve awareness of benefits and harms of mammography screening in older racially and ethnically diverse women. As uncertainty around how best to approach mammography screening in older women remains, understanding women’s perspectives along with healthcare provider and system-level factors is critical for ensuring appropriate and equitable mammography screening use in older women.
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Naimi E, Mirzaei-Alavijeh M, Ahmadi-Jouybari T, Ataee M, Aghaei A, Ahmadi Jouybari H. Stage of Breast Cancer Screening Adoption; The Role of Cognitive Predictors. Asian Pac J Cancer Prev 2019; 20:2373-2378. [PMID: 31450908 PMCID: PMC6852829 DOI: 10.31557/apjcp.2019.20.8.2373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Indexed: 11/25/2022] Open
Abstract
Breast cancer is the most common cancer among women. The present study investigated the stage of breast cancer screening adoption and the role of some of the cognitive predictors in a sample of Iranian married women. There were a total of 334 married women clients of eight health centers in Kermanshah city, the west of Iran, were randomly selected to participate voluntarily. Women filled out a self-report questionnaire. Data were analyzed by SPSS version 20 using One-way ANOVA, χ2-test, Fisher’s exact test, and bivariate correlations statistical tests at 95% significant level. The mean age was 39.75 years [SD: 7.73]. Nearly 58.4%, 26.9%, 3%, 9.6%, and 2.1% of the respondents were reported pre-contemplation, contemplation, preparation, action, and maintenance of breast cancer screening adoption, respectively. There was a significant association between age (P=0.005), and positive family history of breast cancer (P=0.037), perceived susceptibility (P=0.005), perceived severity (P=0.001) and knowledge of symptoms (P=0.018) with breast cancer stage of screening adoption. Our findings can provide better knowledge for the development and implementing of stage-targeted breast cancer screening adoption promotion programs. We conclude that it seems that the focus of health planner should be to rise to perceived severity; perceived susceptibility and knowledge of symptoms of breast cancer about the promotion of breast cancer screening adoption an Iranian woman.
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Affiliation(s)
- Ebrahim Naimi
- Department of Public Health, Faculty of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Touraj Ahmadi-Jouybari
- Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mari Ataee
- Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Aghaei
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan, Iran
| | - Hadi Ahmadi Jouybari
- Infectious Disease and Tropical Medicine Center, Health Research Institute, Babol University of Medical Science, Babol, Iran.
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Jin SW, Yun Lee H, Lee J. Analyzing factors enabling colorectal cancer screening adherence in Korean Americans using the Andersen's Behavioral Model of Health Services Utilization. J Psychosoc Oncol 2019; 37:729-745. [PMID: 31328688 DOI: 10.1080/07347332.2019.1608347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpose/objectives: Korean Americans (KAs) report suboptimal colorectal cancer (CRC) screening adherence. This study investigated factors that enable KAs to adhere to CRC screening guidelines using the Andersen's Behavioral Model of Health Services Utilization. Design: Cross-sectional survey using self-reported measures of CRC screening behaviors. Sample and methods: Purposive sampling was used to recruit 433 KAs aged 50-75 from the Atlanta metropolitan area who completed questionnaires measuring predisposing (i.e., gender, age, marital status, and educational attainment), enabling (income, health insurance, regular annual health checkups, doctor's recommendation English proficiency, CRC knowledge, self-efficacy for CRC screening, and decisional balance in CRC screening), and need (family cancer history and self-reported health status) factors associated with CRC screening. Findings: A multiple logistic regression model including all 14 predictor variables revealed that several enabling factors (i.e., income, regular annual health checkups, doctor's recommendation, self-efficacy, and decisional balance) independently predicted increased CRC screening adherence in KAs. No predisposing or need factors independently predicted CRC screening. Conclusions and implications for psychosocial providers or policy: To increase CRC screening adherence among KAs, psychosocial interventions should target on improving their self-efficacy and decisional balance regarding CRC screening, while policy interventions should focus on promoting health providers' CRC screening recommendations during routine health checkups.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis , Memphis , Tennessee , USA
| | - Hee Yun Lee
- Endowed Academic Chair on Social Work (Health), School of Social Work, University of Alabama , Tuscaloosa , Alabama , USA
| | - Jongwook Lee
- Department of Applied Economics, University of Minnesota , St. Paul , Minnesota , USA
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Jin SW, Lee HY, Lee J. Analyzing Factors of Breast Cancer Screening Adherence among Korean American Women Using Andersen's Behavioral Model of Healthcare Services Utilization. Ethn Dis 2019; 29:427-434. [PMID: 31308615 DOI: 10.18865/ed.29.s2.427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives Regular uptake of mammography screening reduces the risk of advanced stage diagnosis of breast cancer (BC). However, BC screening rates remain suboptimal among Korean American (KA) women. Using the Andersen's Behavioral Model of Healthcare Services Utilization, this study examined factors associated with mammography screening among KA women aged 50 to 80 years in the state of Georgia, USA. Methods We used purposive sampling to recruit study participants in the Atlanta metropolitan area from May 2015 to February 2016. A total of 303 KA women completed a cross-sectional, self-report survey about their sociodemographics, health care access information, knowledge, self-efficacy, decisional balance, and mammography history. Results Descriptive analyses confirmed low rates of mammography screening in the participants. Multiple logistic regression analyses showed that having a mammogram within the past year was associated with greater BC knowledge, higher scores of decisional balance and fewer annual health check-ups among KA women without any cancer history. Conclusions The findings offer implications for health policy aimed at increasing BC screening by leveraging enabling factors among medically underserved KA women at both structural and cultural levels.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, University of Memphis, Memphis, TN
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL
| | - Jongwook Lee
- Department of Applied Economics, University of Minnesota, St. Paul, MN
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Reder M, Berens EM, Spallek J, Kolip P. Development of the Informed Choice in Mammography Screening Questionnaire (IMQ): factor structure, reliability, and validity. BMC Psychol 2019; 7:17. [PMID: 30890190 PMCID: PMC6423759 DOI: 10.1186/s40359-019-0291-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/22/2019] [Indexed: 12/29/2022] Open
Abstract
Background Informed choice is of ethical and practical importance in mammography screening. To assess the level to which decisions regarding such screening are informed is thus imperative, but no specific instrument has been available to measure informed choice in the German mammography screening programme. The aims of this study were to develop the Informed Choice in Mammography Screening Questionnaire (IMQ) and to find first evidence for the factor structure, reliability and validity of its different components. Methods The IMQ was sent to 17.349 women aged 50 in Westphalia-Lippe, Germany. The instrument has been developed after consideration of (1) the results of qualitative interviews on decision making in the mammography screening programme, (2) relevant literature on other informed choice instruments and (3) a qualitative study on influencing factors. The IMQ comprises 3 scales (attitude, norms, and barriers), 1 index (knowledge) and singular items covering intention to participate and sociodemographic variables. To assess the psychometric properties of the components of the IMQ, confirmatory factor and item response theory analyses were conducted. Additionally, reliability, validity and item statistics were assessed. Results 5.847 questionnaires were returned (response rate 33.7%). For attitude, the confirmatory factor analysis supported a one-factor structure. For norms, the model fit was not acceptable. Reliability levels were good with a Cronbach‘s α of.793 for attitude (4 items) and.795 for norms (5 items). For barriers, 9 items were deleted because of low discrimination indices; 6 items remained. The hypothesised assumption-subscale and the importance-subscale were confirmed, but these subscales showed poor reliabilities with Cronbach‘s α=.525 (4 items) and.583 (2 items). For the knowledge index, item response theory analysis showed that 6 out of 7 items were suitable. Hypotheses concerning the correlations between the different components were confirmed, which supported their convergent and divergent validity. Conclusion The results of this study demonstrated that the IMQ is a multidimensional instrument. Further development of the barriers and norms scales is necessary. The IMQ can be utilised to assess the level of informed choices as well as influencing factors. Electronic supplementary material The online version of this article (10.1186/s40359-019-0291-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maren Reder
- Bielefeld University, School of Public Health, Department of Prevention and Health Promotion, Universitätsstraße 25, Bielefeld, 33615, Germany. .,University of Hildesheim, Institute of Psychology, Universitätsplatz 1, Hildesheim, 31142, Germany.
| | - Eva-Maria Berens
- Bielefeld University, School of Public Health, Department of Health Services Research and Nursing Science, Universitätsstraße 25, Bielefeld, 33615, Germany
| | - Jacob Spallek
- Brandenburg University of Technology Cottbus-Senftenberg, Department of Public Health, Universitätsplatz 1, Senftenberg, 01968, Germany
| | - Petra Kolip
- Bielefeld University, School of Public Health, Department of Prevention and Health Promotion, Universitätsstraße 25, Bielefeld, 33615, Germany
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Jin SW, Lee Y, Dia DA. Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model. PATIENT EDUCATION AND COUNSELING 2019; 102:416-423. [PMID: 30448041 DOI: 10.1016/j.pec.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM). METHODS A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables. RESULTS OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy. CONCLUSION The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs. PRACTICE IMPLICATIONS Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
| | - Yeonggeul Lee
- Department of Social Welfare, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, South Korea.
| | - David A Dia
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
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Tung WC, Granner M, Lu M, Sohn J. Demographics, self-efficacy, benefits/barriers, stages of adopting pap testing among Korean American women. J OBSTET GYNAECOL 2019; 39:510-515. [PMID: 30773963 DOI: 10.1080/01443615.2018.1525693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Korean American women (KAW) experience the third highest incidence rate of cervical cancer among nine major Asian Americans. This study examined cervical cancer screening among KAW using constructs from the transtheoretical model (TTM). Using a cross-sectional survey design, 102 KAW aged 21-65 years of age were recruited through convenience sampling. Twenty-seven per cent of participants reported of never receiving a Pap smear. Women who were older and married were more likely to report being in the action/maintenance stages; women who perceived themselves to be in poor health were less likely to be in the action/maintenance stages. Higher self-efficacy and lower perception of barriers were significantly associated with more advanced TTM stages. The perceived benefits were not statistically different across TTM stages of change. A special attention should be given to young and unmarried KAW to increase screening participation. Impact statement What is already known on this subject? The utilisation of Pap test among Korean American women (KAW) was low. Using the transtheoretical model (TTM) approach has the potential to increase a screening adherence. What do the results of this study add? This is the first study to examine the association between TTM constructs related to Pap testing among KAW. Younger and unmarried women reported the lowest levels of screening attitudes or behaviours; and tailored efforts may be beneficial in increasing the screening among these women. What are the implications of these findings for clinical practice and/or further research? Increasing the self-efficacy and decreasing the barriers to obtaining Pap screening are critical to move Korean women to the advanced TTM stages. Further investigation is needed with KAW to fully understand the relationships between TTM constructs.
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Affiliation(s)
- Wei-Chen Tung
- a Orvis School of Nursing , University of Nevada , Reno , NV , USA
| | - Michelle Granner
- b School of Community Health Sciences , University of Nevada , Reno , NV , USA
| | - Minggen Lu
- b School of Community Health Sciences , University of Nevada , Reno , NV , USA
| | - Jeeyun Sohn
- c Memorial Hermann Memorial City Medical Center , Memorial City , TX , USA
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Salinas-Martínez AM, Castañeda-Vásquez DE, García-Morales NG, Oliva-Sosa NE, de-la-Garza-Salinas LH, Núñez-Rocha GM, Ramírez-Aranda JM. Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1230-1238. [PMID: 28612325 DOI: 10.1007/s13187-017-1236-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (n = 240), contemplation (n = 243), action (n = 205), maintenance (n = 311), and relapse (n = 348). We only considered those ≥40 years with no cancer history. We measured the pros, cons, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (p < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.
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Affiliation(s)
- Ana María Salinas-Martínez
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Ave. Lincoln S/N esquina Ma. Jesús Candia. Col. Valle Verde, 2° sector, Monterrey, N.L., CP 64360, Mexico.
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico.
| | | | | | - Norma Edith Oliva-Sosa
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Ave. Lincoln S/N esquina Ma. Jesús Candia. Col. Valle Verde, 2° sector, Monterrey, N.L., CP 64360, Mexico
| | | | | | - José Manuel Ramírez-Aranda
- School of Medicine, Family Medicine Department, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico
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Kim K, Xue QL, Walton-Moss B, Nolan MT, Han HR. Decisional balance and self-efficacy mediate the association among provider advice, health literacy and cervical cancer screening. Eur J Oncol Nurs 2017; 32:55-62. [PMID: 29353633 DOI: 10.1016/j.ejon.2017.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Health literacy has emerged as a potential determinant of cancer screening, yet limited literature has investigated the pathways which health literacy influences Pap tests among immigrant women who experience a higher incidence of cervical cancer. This study aimed to test a health literacy-focused sociocognitive model which proposes motivational (knowledge, decisional balance) and volitional (self-efficacy) factors mediating the association between health literacy and triennial Pap tests. METHODS Using structural equation modeling, we conducted a secondary analysis of baseline data obtained from a randomized controlled trial to promote breast and cervical cancer screenings among 560 Korean American women 21-65 years of age. They were interviewed on demographics such as education and English proficiency, provider advice, health literacy, knowledge of cervical cancer, decisional balance for Pap tests, self-efficacy, and Pap test use. RESULTS Higher health literacy predicted high level of knowledge and high decisional balance score, and greater self-efficacy and then only decisional balance and self-efficacy affected Pap tests. High level of knowledge predicted Pap tests through its impact on the decisional balance score. Receiving provider advice both directly and indirectly predicted Pap tests through high level of health literacy, high level of decisional balance and greater self-efficacy. CONCLUSIONS Findings from this study suggest possible pathways through which provider advice and health literacy affect Pap tests. Interventions targeting immigrant women with limited English proficiency should consider skill-based approaches such as health literacy training, promoting patient-provider communications and emphasizing decisional balance and self-efficacy as potentially sustainable ways of promoting Pap tests.
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Affiliation(s)
- Kyounghae Kim
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Qian-Li Xue
- School of Medicine, Johns Hopkins University, 733 N Broadway, Baltimore, MD 21205, USA
| | - Benita Walton-Moss
- Department of Nursing, School of Social Work, University of Southern California, 1150 South Olive St. Suite T1100, Los Angeles, CA 90015, USA
| | - Marie T Nolan
- Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, 525 N Wolfe Street, Baltimore, MD 21205, USA
| | - Hae-Ra Han
- Department of Community-Public Health, School of Nursing, Johns Hopkins University, 525 N Wolfe Street, Baltimore, MD 21205, USA
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Bayık Temel A, Dağhan Ş, Kaymakçı Ş, Öztürk Dönmez R, Arabacı Z. Effect of structured training programme on the knowledge and behaviors of breast and cervical cancer screening among the female teachers in Turkey. BMC WOMENS HEALTH 2017; 17:123. [PMID: 29216918 PMCID: PMC5721587 DOI: 10.1186/s12905-017-0478-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 11/23/2017] [Indexed: 11/10/2022]
Abstract
Background Breast cancer and cervical cancer are the most common cancers among women in the world. Many studies on the early detection of cancer have been conducted among women worldwide, but few studies have been performed in the world on female teachers regarding breast self-examination (BSE), mammography (MMG) and Pap smear test (PST). As teachers interact with students, this could play an important role in health education and in developing healthy behavior such as cancer screening. The main objective of this study was to evaluate the effect of a structured teaching program on breast and cervical cancer screening on the knowledge and practice of teachers. The other objective was to encourage teachers to transfer this knowledge to the women who attended their courses. Methods Semi –experimental designs with pre-intervention, post-intervention and six month follow-up tests were used in this study. The data were collected from 37 volunteer teachers and their 64 volunteer students with a sociodemographic form, a questionnaire form for breast and cervical cancer, and a Transtheoretical Model of behavior change for BSE, MMG and PST. Behavior of the teachers related to BSE, MMG, PST was evaluated in pre-training and in the first, third and sixth months post-training, and the behavior of the students was evaluated with point follow-up in the sixth month. Results In post-training, it was determined that the teachers’ knowledge of breast cancer increased from 11.70 ± 2.80 to 14.81 ± 3.22 and their knowledge of cervical cancer increased from 7.75 ± 5.60 to 17.68 ± 3.79. For BSE behavior, 47.8% of teachers were in the action and maintenance stage in pre-training, but this ratio was 81.1% in the sixth month post-training. For MMG behavior, all of the teachers were in the precontemplation stage in pre-training, and 38.9% of them were in the action and maintenance stage in the sixth month post-training. For PST, while 24.3% were in the action and maintenance stage in pre-training, this ratio was 45.9% in the sixth month post-training. Conclusion It was determined that the behavior change for BSE, MMG, PST was positive. Similarly, knowledge transfer from teachers to students was also effective. Electronic supplementary material The online version of this article (10.1186/s12905-017-0478-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ayla Bayık Temel
- Department of Public Health Nursing, Ege University Nursing Faculty, 35100, İzmir, Turkey
| | - Şafak Dağhan
- Department of Public Health Nursing, Ege University Nursing Faculty, 35100, İzmir, Turkey.
| | - Şenay Kaymakçı
- Department of Nursing, Near East University, Lefkoşa, Turkish Republic of Northern Cyprus
| | - Renginar Öztürk Dönmez
- Department of Public Health Nursing, Ege University Nursing Faculty, 35100, İzmir, Turkey
| | - Zeynep Arabacı
- Department of Nursing, Kastamonu Universiy, Tosya Vocational School, Kastamonu, Turkey
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Shirzadi S, Nadrian H, Asghari Jafarabadi M, Allahverdipour H, Hassankhani H. Determinants of mammography adoption among iranian women: What are the differences in the cognitive factors by the stages of test adoption? Health Care Women Int 2017; 38:956-970. [PMID: 28586294 DOI: 10.1080/07399332.2017.1338705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our aim in this cross-sectional study was to investigate the predictors of the stages of change in mammography adoption (MA) based on Health Belief Model among Iranian women. Through multistage cluster sampling, we recruited and interviewed 1131 women older than 40. After statistical adjustment for other risk factors, perceived barriers (OR D 0.84, 95% CI D .81-.87) and benefits (OR D 1.17, 95% CI D 1.11-1.24) were significant predictors for MA. Majority of the women were in the pre-contemplation and contemplation stages of change for MA. Our findings are informative for the development of targeted interventions to foster MA among women.
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Affiliation(s)
- Shayesteh Shirzadi
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Haidar Nadrian
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari Jafarabadi
- b Road Traffic Injury Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,c Department of Biostatistics and Epidemiology , Faculty of Health, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Allahverdipour
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hadi Hassankhani
- d Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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Ghahremani L, mousavi Z, Kaveh MH, Ghaem H. Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran. Asian Pac J Cancer Prev 2016; 17:5133-5138. [PMID: 28122446 PMCID: PMC5454648 DOI: 10.22034/apjcp.2016.17.12.5133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran. This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group’s mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women’s health and reduce deaths due to breast cancer.
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Affiliation(s)
- Leila Ghahremani
- Department of health education and promotion, School of Health, Shiraz University of Medical Sciences ,Shiraz, Iran.
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Tung WC, Smith-Gagen J, Lu M, Warfield M. Application of the Transtheoretical Model to Cervical Cancer Screening in Latina Women. J Immigr Minor Health 2016; 18:1168-1174. [DOI: 10.1007/s10903-015-0183-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Tung WC, Granner M, Lu M, Qiu X. Predictors of cervical cancer screening for Chinese American women. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- W.-C. Tung
- Orvis School of Nursing; University of Nevada; Reno NV USA
| | - M. Granner
- School of Community Health Sciences; University of Nevada; Reno NV USA
| | - M. Lu
- School of Community Health Sciences; University of Nevada; Reno NV USA
| | - X. Qiu
- University of California; Davis CA USA
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González-Ramírez LP, De la Roca-Chiapas JM, Daneri-Navarro A, Colunga-Rodríguez C, Contreras AM, Martínez-Arriaga R, del Toro-Valero A, Oceguera-Villanueva A. Consejo genético oncológico: las aplicaciones de la Psicooncología. GACETA MEXICANA DE ONCOLOGÍA 2016. [DOI: 10.1016/j.gamo.2016.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Taymoori P, Berry T, Roshani D. Differences in health beliefs across stage of adoption of mammography in Iranian women. Cancer Nurs 2015; 37:208-17. [PMID: 23624601 DOI: 10.1097/ncc.0b013e31829194bc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. OBJECTIVES The aims of this study were to (a) examine the relationships between related beliefs and (b) to determine to what extent women in stages of mammography adoption differ in their agreement of individual perceived health beliefs. METHODS A sample of 686 Iranian women completed a questionnaire including selected constructs of the Health Belief Model and stages of mammography adoption. RESULTS Proportions of participants who were in the preadoption and adoption stages were 75% and 17.8%, respectively. Precontemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than did those in other adoption stages. In terms of specific items, women in the relapse and maintenance stages endorsed greatest agreement for the barrier items "not knowing how to get a mammogram" and "forget to schedule," respectively. Common barriers for women in preadoption stages were being painful, taking much time, and embarrassing. CONCLUSION Iranian women are less likely than other Asian women to be in the maintenance and action stages. Identifying the associations between perceived related beliefs items and stages of mammography adoption may provide detailed information to allow for future research and guide the development of interventions not only for Iranian women but also for similar cultural and immigrant groups that have been neglected to date in the breast cancer literature. IMPLICATIONS FOR PRACTICE Examining the interactions between perceived related beliefs items and other beliefs such as perceived control and self-efficacy to having a mammography is warranted.
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Affiliation(s)
- Parvaneh Taymoori
- Author Affiliations: Kurdistan Research Center for Social Determinants of Health, School of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Taymooi); Department of Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada (Dr Berry); and Kurdistan Research Center for Social Determinants of Health, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Roshani)
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MacLaughlin KL, Swanson KM, Naessens JM, Angstman KB, Chaudhry R. Cervical cancer screening: a prospective cohort study of the effects of historical patient compliance and a population-based informatics prompted reminder on screening rates. J Eval Clin Pract 2014; 20:136-43. [PMID: 24237657 DOI: 10.1111/jep.12098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2013] [Indexed: 11/24/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to assess the impact of historical screening compliance with the effectiveness of patient reminder letters on cervical cancer screening rates. METHOD Using population-based informatics systems, women with no cervical cancer screening in the prior 3 years were identified in two primary care clinics, Mayo Family Clinic Northeast (NE; n = 1613) and Northwest (NW; n = 1088). Patients were divided into two compliance groups: overdue/unknown screening status at study start or previously compliant. The NE Clinic sent reminder letters over a 6 months window to patients eligible for screening at the study start or during the study that were also identified as employees/dependents (E/D). There were 795 intervention (NE Clinic E/D patients) and 1906 control subjects. Using an intent-to-treat analysis, differences in screening rates were assessed. RESULTS A higher unadjusted screening rate was observed for the E/D group than the non-E/D group at both sites (32.7 versus 18.2% at NW, P < 0.001; 39.0 versus 14.7% at NE, P < 0.001). For the historically compliant group, unadjusted screening rates were higher for those who received letters (E/D subjects at NE) versus those who did not (E/D subjects at NW; 56.1 versus 44.5%, P = 0.01). No difference was observed between E/D subjects at NE (received letters) and NW (no letters) for the overdue/unknown group (27.4 versus 25.9%, P = 0.62). There was no difference in screening rates for non-E/D subjects at NE versus at NW (none of whom received letters) for both the compliant (24.2 versus 30.6%, P = 0.18) and the overdue/unknown groups (11.9 versus 13.0%, P = 0.59). Multivariate logistic regression models showed a significant overall effect of E/D status (P = 0.006), compliance group (P < 0.001), and the interaction between clinic site and E/D status (P = 0.04). CONCLUSION Among insured women, reminder letters appear to improve cervical cancer screening rates for those with a history of screening compliance. Reminder letters appear insufficient to motivate women if screening is overdue. Further investigation of the cohort of women overdue for screening is needed to develop interventions to successfully target this group.
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Moodi M, Rezaeian M, Mostafavi F, Sharifirad GR. Mammography stage of adoption among Iranian women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2012; 1:37. [PMID: 23555140 PMCID: PMC3577405 DOI: 10.4103/2277-9531.102050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Stage of Change and Health Belief Models are two the most common models that have been applied in mammography screening behaviors. The purpose of this study was to identify women in different stages of mammography adoption and to examine association between women's beliefs by stage of change among Iranian women. METHODS In this population-based study, mammography screening behavior determined using the Rakoweski stage of change scale, and women beliefs were determined by Farsi version of Champion's Health Belief Model scale (CHBMS). The obtained data were analyzed by SPSS (version 16.0) using statistical analysis of variance and Chi-square tests that used to determine relation between socio-demographic variables and HBM scales with stage of mammography. In all of the tests, a significant level α = 0.05 was considered. RESULTS According to stages of change distributions for mammography screening behavior, 36.2% were in pre-contemplation, 21.1% in contemplation, 4.2% in action, 6.2% in maintenance, and 32.3% were in relapse stage. There were significant differences in mammography stage by age, education, married status, family monthly income, husband job, information about breast cancer, and history of breast problems. ANOVA test showed significant differences by stages for all HBM scales, except to perceived severity. CONCLUSION The findings indicated that women in pre-contemplation, relapse, and contemplation stages are more likely need to educational intervention, which emphasizes the benefits and barriers of mammography, health motivation, and self-efficacy. Furthermore, examining individuals' beliefs about breast cancer and mammography screening by stage of mammography adoption is especially important in order to development of effectiveness interventions, which targeted to stage of change and promote mammography screening behavior.
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Affiliation(s)
- Mitra Moodi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Public Health, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Rezaeian
- Department of Community Medicine, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam R. Sharifirad
- Department of Health Education and Health Services, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community.
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Affiliation(s)
- Patrick T McGowan
- Centre on Aging, University of Victoria, Victoria, British Columbia, Canada.
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Taymoori P, Berry T, Farhadifar F. Predicting mammography stage of adoption among Iranian women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2012; 1:13. [PMID: 23555116 PMCID: PMC3577413 DOI: 10.4103/2277-9531.98571] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. The purposes of this study were to (1) identify the associations between individual characteristics, related health beliefs, and stages of mammography behavior and (2) examine the socio-demographic factors and the health beliefs that predicate stages of mammography behavior. DESIGN All health care centers were considered as clusters and 30 women were randomly selected from each of them. A sample of 689 Iranian women completed a questionnaire. MATERIALS AND METHODS The questionnaire used was based on Champion's revised Health Belief Model Scale (CHBMS). One-way analysis of covariance (ANCOVA) was used to assess differences in the outcome variables (perceived severity, susceptibility, benefits, and barriers) across the stages. Multinomial logistic regression was conducted to test multivariate relationships. RESULTS THE PERCENTAGE OF PARTICIPANTS IN EACH STAGE WAS: 40.1% in pre-contemplation, 34.7 in contemplation, 7.5% in relapse, 12% in action, and 5.7% in maintenance stage of mammography adoption. Older women were most likely to be in the pre-contemplation stage and action stage, and the youngest women were most likely to be in the relapse stage. Differences across stages of change were found for related beliefs for all participants except those in the relapse stage. CONCLUSION Iranian women are less likely to be in maintenance and action stages than ot er Asian women and this study identifies constructs that may be targeted in interventions.
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Affiliation(s)
- Parvaneh Taymoori
- Research Center for Environment Health and Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Pasdaran Street, Sanandaj, Iran
- Address for correspondence: Prof. Parvaneh Taymoori, Research Center for Environment Health and Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Pasdaran Street, P.O. Box 66177 13391, Sanandaj, Iran. E-mail:
| | - Tanya Berry
- Department of Faculty of Physical Education and Recreation, University of Alberta, E4-88 Van Vliet Centre, Edmonton, Alberta T6G 2H9, Canada
| | - Fariba Farhadifar
- Department of Gynecology, Kurdistan University of Medical Sciences, Pasdaran Street, Sanandaj, Iran
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Geller KS, Mendoza ID, Timbobolan J, Montjoy HL, Nigg CR. The decisional balance sheet to promote healthy behavior among ethnically diverse older adults. Public Health Nurs 2011; 29:241-6. [PMID: 22512425 DOI: 10.1111/j.1525-1446.2011.00987.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The rising health care costs and increasing older adult population in the United States make preventive medicine for this age group especially crucial. Regular physical activity and fruit and vegetable consumption may prevent or delay the onset of many chronic conditions that are common among older adults. The decisional balance sheet is a promotional tool targeting the perceived pros and cons of behavior adoption. The current study tested the efficiency and effectiveness of a single-day decisional balance sheet program, targeting increased physical activity and fruit and vegetable intake among older adults. DESIGN AND SAMPLE Participating adults (N = 21, age = 72.2) who represented a diverse population in Hawaii (Japanese = 5, Filipino = 4, Caucasian = 4, Native American = 1, Native Hawaiian = 1, Hispanic = 1, and Others = 5) were recruited from housing communities and randomized to a decisional balance sheet program adapted for physical activity or fruit and vegetable consumption. MEASURES Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form, and daily fruit and vegetable intake with the National Health and Nutrition Examination Survey single item instrument. Baseline and follow-up data were collected. RESULTS Both programs were implemented efficiently, and participants in both groups improved their daily physical activity. The decisional balance sheet for fruit and vegetable consumption appeared less effective. CONCLUSIONS Specific suggestions for similar programs are reported.
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