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Okopie T, Calderon-Mora J, Shokar N, Molokwu J. Effect of a Theory-Based Narrative Video on Colorectal Cancer Screening Intention, Knowledge, and Psychosocial Variables Among a Predominantly Hispanic Population. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02442-9. [PMID: 38777997 DOI: 10.1007/s13187-024-02442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
Colorectal cancer (CRC) remains the third leading cause of cancer death in the USA. Latinx adults are overrepresented in late-stage CRC diagnosis as CRC screening utilization remains low among Latinx-identifying individuals. This study aims to evaluate the effect of a theory-based narrative video following a culturally appropriate storyline on CRC screening intention, knowledge, and psychosocial variables along the U.S.-Mexico border. We designed and analyzed a non-randomized pre-posttest evaluation of a narrative, culturally tailored video embedded within a community program. The study is set in the U.S.-Mexico border community. Outreach provided a link or QR code to access the survey. In all, 458 participants started the survey, and 304 completed the survey. Participants were recruited through flyers distributed throughout various community events by the program's community health workers and via social media. The intervention evaluated changes in participant's knowledge, perceived barriers, perceived susceptibility, self-efficacy, and perceived benefits and intention to screen. Participants were a mean age of 39 and identified mainly as female (72.7%) and Hispanic/Latinx (88.49%). After viewing the narrative video, participants had significantly improved perceived susceptibility, self-efficacy, and benefits, while perceived barriers and sense of fatalism significantly decreased. Paradoxically, this was associated with a significant decrease in knowledge scores. Results from this intervention suggest that a theory-based narrative video following a culturally appropriate storyline effectively improves psychosocial variables and intention to carry out CRC screening in a predominantly Hispanic border population.
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Affiliation(s)
- Tobi Okopie
- Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, Worthy Street, El Paso, TX, 79924, USA
| | - Jessica Calderon-Mora
- Department of Population Health, Dell Medical School, The University of Texas at Austin, 1601 Trinity StBLDG B STOP Z0500, Austin, TX, 78712-1872, USA
| | - Navkiran Shokar
- Department of Population Health, Dell Medical School, The University of Texas at Austin, 1601 Trinity StBLDG B STOP Z0500, Austin, TX, 78712-1872, USA
| | - Jennifer Molokwu
- Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, Worthy Street, El Paso, TX, 79924, USA.
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2
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Yeh PG, Choh AC, Fisher-Hoch SP, McCormick JB, Lairson DR, Reininger BM. The association of cancer-preventive lifestyle with colonoscopy screening use in border Hispanic adults along the Texas-Mexico border. Cancer Causes Control 2024:10.1007/s10552-024-01885-1. [PMID: 38743343 DOI: 10.1007/s10552-024-01885-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE The relationship between engaging in two domains of cancer-preventive behaviors, lifestyle behaviors and colonoscopy screening, is unknown in Hispanic adults. Accordingly, the study examined the association between lifestyle and colonoscopy screening in Hispanic adults along the Texas-Mexico border, where there is suboptimal colorectal cancer prevention. METHODS Lifestyle behavior adherence and compliance with colonoscopy screening schedules were assessed using 2013-2023 data from the Cameron County Hispanic Cohorta population-based sample of Hispanic adults living along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized healthy lifestyle engagement. Multivariable logistic regression quantified the association between lifestyle behaviors and colonoscopy screening. RESULTS Among 914 Hispanic adults, there was a mean adherence score of 2.5 out of 7 for recommended behaviors. Only 33.0% (95% CI 25.64-41.39%) were up-to-date with colonoscopy. Complete adherence to fruit and vegetable (AOR [adjusted odds ratio] 5.2, 95% CI 1.68-16.30; p = 0.004), fiber (AOR 2.2, 95% CI 1.06-4.37; p = 0.04), and ultra-processed foods (AOR 2.8, 95% CI 1.30-6.21; p = 0.01) consumption recommendations were associated with up-to-date colonoscopy screening. Having insurance versus being uninsured (AOR 10.8, 95% CI 3.83-30.62; p < 0.001) and having local medical care versus in Mexico (AOR 7.0, 95% CI 2.26-21.43; p < 0.001) were associated with up-to-date colonoscopy. CONCLUSIONS Adherence to dietary lifestyle recommendations was associated with being up-to-date with colonoscopy screenings. Those with poor dietary behavior are at risk for low-colonoscopy use. Improving lifestyle behaviors may complement colonoscopy promotion interventions. Healthcare accessibility influences up-to-date colonoscopy prevalence. Our findings can inform cancer prevention strategies for the Hispanic population.
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Affiliation(s)
- Paul Gerardo Yeh
- Department of Management, Policy, and Community Health, University of Texas Health Science Center School of Public Health, 1200 Pressler Street RAS E-311, Houston, TX, 77030, USA.
| | - Audrey C Choh
- Department of Epidemiology, University of Texas Health Science Center School of Public Health, Brownsville Regional Campus, Brownsville, TX, USA
| | - Susan P Fisher-Hoch
- Department of Epidemiology, University of Texas Health Science Center School of Public Health, Brownsville Regional Campus, Brownsville, TX, USA
| | - Joseph B McCormick
- Department of Epidemiology, University of Texas Health Science Center School of Public Health, Brownsville Regional Campus, Brownsville, TX, USA
| | - David R Lairson
- Department of Management, Policy, and Community Health, University of Texas Health Science Center School of Public Health, 1200 Pressler Street RAS E-311, Houston, TX, 77030, USA
| | - Belinda M Reininger
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center School of Public Health, Brownsville Regional Campus, Brownsville, TX, USA
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3
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Montalvan-Sanchez EE, Beas R, Karkash A, Godoy A, Norwood DA, Dougherty M. Delays in Colorectal Cancer Screening for Latino Patients: The Role of Immigrant Healthcare in Stemming the Rising Global Incidence of Colorectal Cancer. Gastroenterology Res 2024; 17:41-51. [PMID: 38463144 PMCID: PMC10923253 DOI: 10.14740/gr1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
The significant global burden of colorectal cancer accentuates disparities in access to preventive healthcare in most low- and middle-income countries (LMICs) as well as large sections of underserved populations within high-income countries. The barriers to colorectal cancer screening in economically transitioning Latin America are multiple. At the same time, immigration from these countries to the USA continues to increase. This case highlights the delays in diagnosis experienced by a recent immigrant from a country with no established colorectal cancer screening program, to an immigrant population in the USA with similar poor screening coverage. We discuss common challenges faced by Latinos in their home countries and the USA, as well as strategies that could be implemented to improve screening coverage in US immigrant populations.
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Affiliation(s)
| | - Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ahmad Karkash
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ambar Godoy
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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4
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Agunwamba AA, Zhu X, Sauver JS, Thompson G, Helmueller L, Finney Rutten LJ. Barriers and facilitators of colorectal cancer screening using the 5As framework: A systematic review of US studies. Prev Med Rep 2023; 35:102353. [PMID: 37576848 PMCID: PMC10415795 DOI: 10.1016/j.pmedr.2023.102353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/20/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023] Open
Abstract
Despite clear evidence that regular screening reduces colorectal cancer (CRC) mortality and the availability of multiple effective screening options, CRC screening continues to be underutilized in the US. A systematic literature search of four databases - Ovid, Medline, EBSCHOhost, and Web of Science - was conducted to identify US studies published after 2017 that reported on barriers and facilitators to CRC screening adherence. Articles were extracted to categorize relevant CRC screening barriers or facilitators that were assessed against CRC screening outcomes using the 5As dimensions: Access, Affordability, Acceptance, Awareness, Activation. Sixty-one studies were included. Fifty determinants of screening within the 5As framework and two additional dimensions including Sociodemographics and Health Status were identified. The Sociodemographics, Access, and Affordability dimensions had the greatest number of studies included. The most common factor in the Access dimension was contact with healthcare systems, within the Affordability dimension was insurance, within the Awareness dimension was knowledge CRC screening, within the Acceptance dimension was health beliefs, within the Activation dimension was prompts and reminders, within the Sociodemographics dimension was race/ethnicity, and among the Health Status dimension was chronic disease history. Among all studies, contact with healthcare systems, insurance, race/ethnicity, age, and education were the most common factors identified. CRC screening barriers and facilitators were identified across individual, clinical, and sociocontextual levels. Interventions that consider multilevel strategies will most effectively increase CRC screening adherence.
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Affiliation(s)
- Amenah A. Agunwamba
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Xuan Zhu
- Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jenny St. Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Lila J. Finney Rutten
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Exact Sciences Corporation, Madison WI, USA
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5
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Bechthold AC, Azuero A, Puga F, Ejem DB, Kent EE, Ornstein KA, Ladores SL, Wilson CM, Knoepke CE, Miller-Sonet E, Odom JN. What Is Most Important to Family Caregivers When Helping Patients Make Treatment-Related Decisions: Findings from a National Survey. Cancers (Basel) 2023; 15:4792. [PMID: 37835486 PMCID: PMC10572058 DOI: 10.3390/cancers15194792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/01/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Prioritizing patient values-who/what matters most-is central to palliative care and critical to treatment decision making. Yet which factors are most important to family caregivers in these decisions remains understudied. Using data from a U.S. national survey of cancer caregivers (N = 1661), we examined differences in factors considered very important by caregivers when partnering with patients in cancer treatment decision making by cancer stage and caregiver sociodemographics. Fifteen factors were rated on a 4-point Likert-scale from 'very unimportant' to 'very important.' Descriptive statistics were used to characterize caregiver factors and tabulate proportions of importance for each. Generalized linear mixed effect modeling was used to examine the importance of factors by cancer stage, and chi-square analyses were performed to determine associations between caregiver sociodemographics and the five most commonly endorsed factors: quality of life (69%), physical well-being (68%), length of life (66%), emotional well-being (63%), and opinions/feelings of oncology team (59%). Significant associations (all p's < 0.05) of small magnitude were found between the most endorsed factors and caregiver age, race, gender, and ethnicity, most especially 'opinions/feelings of the oncology team'. Future work is needed to determine the best timing and approach for eliciting and effectively incorporating caregiver values and preferences into shared treatment decision making.
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Affiliation(s)
- Avery C. Bechthold
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
| | - Deborah B. Ejem
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
| | - Erin E. Kent
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Katherine A. Ornstein
- Center for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Sigrid L. Ladores
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
| | - Christina M. Wilson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
- Division of Gynecologic Oncology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Christopher E. Knoepke
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - J. Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.B.)
- Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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Higashi RT, Tiro JA, Winer RL, Ornelas IJ, Bravo P, Quirk L, Kessler LG. Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients' comprehension and reporting of their cervical cancer screening behavior. Prev Med Rep 2023; 32:102169. [PMID: 36922960 PMCID: PMC10009194 DOI: 10.1016/j.pmedr.2023.102169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups' comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.
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Affiliation(s)
- Robin T Higashi
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX, 75235, USA
| | - Jasmin A Tiro
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX, 75235, USA
| | - Rachel L Winer
- University of Washington, Department of Epidemiology, Box 351619, 3980 15th Ave NE, Seattle, WA 98195, USA.,Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA
| | - India J Ornelas
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
| | - Perla Bravo
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
| | - Lisa Quirk
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390-9066, USA
| | - Larry G Kessler
- University of Washington, Department of Health Systems and Population Health, School of Public Health, 3980 15th Ave NE, UW Box 351621, Seattle, WA 98195, USA
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Espinoza‐Gutarra MR, Rawl SM, Maupome G, O'Leary HA, Valenzuela RE, Malloy C, Golzarri‐Arroyo L, Parker E, Haunert L, Haggstrom DA. Cancer-related knowledge, beliefs, and behaviors among Hispanic/Latino residents of Indiana. Cancer Med 2023; 12:7470-7484. [PMID: 36683200 PMCID: PMC10067073 DOI: 10.1002/cam4.5466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/28/2022] [Accepted: 11/11/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cancer is the leading cause of death for Hispanics in the USA. Screening and prevention reduce cancer morbidity and mortality. METHODS This study administered a cross-sectional web-based survey to self-identified Hispanic residents in the state of Indiana to assess their cancer-related knowledge, beliefs, and behaviors, as well as to identify what factors might be associated with cancer screening and prevention. Chi-square and Fisher's exact test were used to compare associations and logistic regression used to develop both univariate and multivariate regression models. RESULTS A total of 1520 surveys were completed, median age of respondents was 53, 52% identified as men, 50.9% completed the survey in Spanish, and 60.4% identified the USA as their country of birth. Most were not able to accurately identify ages to begin screening for breast, colorectal, or lung cancer, and there were significant differences in cancer knowledge by education level. US-born individuals with higher income and education more often believed they were likely to develop cancer and worry about getting cancer. Sixty eight percent of respondents were up-to-date with colorectal, 44% with breast, and 61% with cervical cancer screening. Multivariate models showed that higher education, lack of fatalism, older age, lower household income, and unmarried status were associated with cervical cancer screening adherence. CONCLUSIONS Among a Hispanic population in the state of Indiana, factors associated with cervical cancer screening adherence were similar to the general population, with the exceptions of income and marital status. Younger Hispanic individuals were more likely to be adherent with breast and colorectal cancer screening, and given the higher incidence of cancer among older individuals, these results should guide future research and targeted outreach.
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Affiliation(s)
- Manuel R. Espinoza‐Gutarra
- Division of Hematology and Oncology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Susan M. Rawl
- Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
- Indiana University School of NursingIndianapolisIndianaUSA
| | - Gerardo Maupome
- Indiana University Purdue University Indianapolis, Richard M. Fairbanks School of Public HealthIndianapolisIndianaUSA
| | | | | | - Caeli Malloy
- Indiana University School of NursingIndianapolisIndianaUSA
| | | | - Erik Parker
- School of Public HealthIndiana University BloomingtonBloomingtonIndianaUSA
| | - Laura Haunert
- Indiana University School of NursingIndianapolisIndianaUSA
- Indiana University School of MedicineIndianapolisIndianaUSA
| | - David A. Haggstrom
- Center for Health Services ResearchRegenstrief InstituteIndianapolisIndianaUSA
- VA HSR&D Center for Health Information and CommunicationRichard L. Roudebush Veterans Affairs Medical CenterIndianapolisIndianaUSA
- Division of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisIndianaUSA
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8
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Pinheiro LC, Soroka O, Razon DT, Antoine F, Rothman J, Kanis MJ, Khan U, Tamimi RM, Nanus D, Phillips E. Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents. J Behav Med 2022; 45:954-961. [PMID: 36083412 DOI: 10.1007/s10865-022-00358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Abstract
Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - Orysya Soroka
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA
| | - Dominic T Razon
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Francesse Antoine
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Julia Rothman
- College of Human Ecology, Cornell University - Martha Van Rensselaer Hall, Ithaca, NY, USA
| | - Margaux J Kanis
- Division of Gynecological Oncology, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Uqba Khan
- Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Rulla M Tamimi
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - David Nanus
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Weill Cornell Medicine, NY, New York, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA. .,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.
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9
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Glasgow TE, McGuire KP, Fuemmeler BF. Eat, sleep, play: health behaviors and their association with psychological health among cancer survivors in a nationally representative sample. BMC Cancer 2022; 22:648. [PMID: 35698055 PMCID: PMC9190125 DOI: 10.1186/s12885-022-09718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer survivors are able to live much longer today than in the past due to advances in treatment. The promotion of health behaviors is important to address among cancer survivors. Not only can health behaviors reduce the risk of comorbidities, but they may also be key to improving psychological health among cancer survivors, such as psychological distress, perceptions of one's general health, and distress of cancer mortality (i.e., cancer fatalism). Our overall goal is to 1) determine which individual health behaviors (e.g., fruit consumption, physical activity, and sleep) are associated with psychological health among cancer survivors and 2) determine if the number of health behaviors engaged in is associated with better psychological health among cancer survivors. METHODS Using data from the HINTS 5 Cycle III survey (N = 856 cancer survivors), we compared whether participants who met guidelines for seven health behaviors (e.g., fruit and vegetable consumption, moderate physical activity, sleep duration) had improved psychological health. Multiple ordinal regression models controlling for sociodemographic variables were used to determine if meeting more recommendations was related to psychological health and then specifically which behaviors were of greatest importance to psychological health. RESULTS Meeting guidelines for sleep quality and moderate physical activity was associated with higher general health and meeting guidelines for vegetable intake and better sleep quality was associated with less psychological distress. Although the associations were not significant, cancer survivors who met more of the health behavior guidelines reported higher general health, lower psychological distress, and less distress about what could be done to lower one's chances to get cancer. CONCLUSIONS Meeting the guidelines for individual and multiple health behaviors is associated with favorable psychological health among cancer survivors. The findings can contribute to the development of health behavior interventions that focus on multiple health behaviors to improve psychological health and quality of life among cancer survivors.
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Affiliation(s)
- Trevin E Glasgow
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main St, Richmond, VA, 23219, USA.
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA, 23284, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main St, Richmond, VA, 23219, USA
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10
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Racial and Ethnic Disparities in Colorectal Cancer Screening and Outcomes. Hematol Oncol Clin North Am 2022; 36:415-428. [DOI: 10.1016/j.hoc.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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San Diego ERN, Merz EL. Diabetes knowledge, fatalism and type 2 diabetes-preventive behavior in an ethnically diverse sample of college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:385-394. [PMID: 32369714 DOI: 10.1080/07448481.2020.1751175] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/29/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
Objective This study examined diabetes knowledge, health fatalism (the belief that health outcomes are outside one's control), and their interaction, as predictors of Type 2 Diabetes preventive behavior. Participants: Ethnically diverse college students (N = 345) without prior diagnosis of diabetes. Methods: Cross-sectional design using validated self-report measures. Results: Respondents answered approximately half of the diabetes knowledge items correctly. Physical activity and sedentary behavior were not predicted by diabetes knowledge, fatalism, or their interaction. Higher diabetes knowledge was associated with a healthier diet among individuals with low fatalism. Greater fatalism was associated with a poorer diet among individuals with moderate or high diabetes knowledge. Conclusions: Diabetes knowledge was moderate in this college student sample. Greater knowledge was linked with a healthier diet among those with sense of personal control over their health. College health educators may consider emphasizing modifiability of health behaviors in conjunction with Type 2 diabetes education efforts.
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Affiliation(s)
- Emily Rose N San Diego
- Department of Psychology, California State University, Carson, California, USA
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee, USA
| | - Erin L Merz
- Department of Psychology, California State University, Carson, California, USA
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Guo Y, Szurek SM, Bian J, Braithwaite D, Licht JD, Shenkman EA. The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida. Cancer Med 2021; 10:6048-6057. [PMID: 34254469 PMCID: PMC8419763 DOI: 10.1002/cam4.4122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND People's fatalistic beliefs about cancer can influence their cancer prevention behaviors. We examined the association between fatalistic beliefs and breast and colorectal cancer screening among residents of north-central Florida and tested whether there exists any sex or rural-non-rural disparities in the association. METHODS We conducted a cross-sectional, random digit dialing telephone survey of 895 adults residing in north-central Florida in 2017. Using weighted logistic models, we examined the association between (1) respondents' sociodemographic characteristics and cancer fatalistic beliefs and (2) cancer fatalistic beliefs and cancer screening utilization among screening eligible populations. We tested a series of sex and rurality by fatalistic belief interactions. RESULTS Controlling for sociodemographics, we found the agreement with "It seems like everything causes cancer" was associated with a higher likelihood of having a mammogram (odds ratio [OR]: 3.34; 95% confidence interval [CI]: 1.17-9.51), while the agreement with "Cancer is most often caused by a person's behavior or lifestyle" was associated with a higher likelihood of having a blood stool test (OR: 1.85; 95% CI: 1.12-3.05) or a sigmoidoscopy or colonoscopy among women (OR: 2.65; 95% CI: 1.09-6.44). We did not observe any rural-non-rural disparity in the association between fatalistic beliefs and cancer screening utilization. CONCLUSIONS Some, but not all, cancer fatalistic beliefs are associated with getting breast and colorectal cancer screening in north-central Florida. Our study highlights the need for more research to better understand the social and cultural factors associated with cancer screening utilization.
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Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Sarah M. Szurek
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Dejana Braithwaite
- University of Florida Health Cancer CenterGainesvilleFLUSA
- Department of Aging and Geriatric ResearchCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- Department of EpidemiologyCollege of Public Health and Health Professions and College of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Jonathan D. Licht
- University of Florida Health Cancer CenterGainesvilleFLUSA
- Division of Hematology and OncologyDepartment of MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
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Lee MH, Hong S, Merighi JR. The Association Between Fatalism and Mammography Use in Korean American Immigrant Women. HEALTH EDUCATION & BEHAVIOR 2021; 49:740-749. [PMID: 34396786 DOI: 10.1177/10901981211029253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.
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Affiliation(s)
- Mi Hwa Lee
- East Carolina University, Greenville, NC, USA
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14
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Zhang X, Zhang Y, Chen J, Zhang M, Gong N. Psychological distance: a qualitative study of screening barriers among first-degree relatives of colorectal cancer patients. BMC Public Health 2021; 21:716. [PMID: 33849506 PMCID: PMC8045384 DOI: 10.1186/s12889-021-10786-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 04/07/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Colorectal cancer screening can reduce the incidence and mortality through early detection. First-degree relatives (FDRs) of patients with colorectal cancer are at high risk for colorectal cancer and therefore require colonoscopy. However, despite the high risk, screening adherence among FDRs remains low and the barriers to undergoing screening among FDRs in China are not clear. We explored the reasons why FDRs refused screening. METHODS In this qualitative study, 28 semistructured, in-depth interviews were conducted face-to-face. Participants were recruited at two hospitals (an urban tertiary hospital and a community health center) in Guangzhou, South China. We used qualitative content analysis to analyze transcripts based on audio recordings and identify major themes and subthemes. RESULTS Three major themes emerged related to FDRs' low screening participation. First, the emotional distance between FDRs and medicine was pulled away by uncomfortable feelings approaching hospitals and misunderstanding of cancer. Second, they confirmed their health state and minimized cancer risk if they had no signs in routine health examination, no symptoms and maintained a healthy, happy life. Third, they considered screening far from their daily life from the perspective of spatial distance and priority. Therefore, screening was not necessary in their view. CONCLUSIONS Healthcare professionals should narrow psychological distance between people and screening when promoting screening technology.
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Affiliation(s)
- Xueying Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Jingyu Chen
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.
| | - Ni Gong
- School of Nursing, Jinan University, No.601 West Huangpu Avenue, Guangzhou, 510632, Guangdong, China.
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15
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Maurer LR, Rahman S, Perez N, Allar BG, Witt E, Moya J, Pichardo MS, Romero Arenas MA, Uribe-Leitz T, Dey T, Bergmark RW, Peck G, Ortega G. Differences in outcomes after emergency general surgery between Hispanic subgroups in the New Jersey State Inpatient Database (2009-2014): The Hispanic population is not monolithic. Am J Surg 2021; 222:492-498. [PMID: 33840445 DOI: 10.1016/j.amjsurg.2021.03.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Our aim was to examine differences in clinical outcomes between Hispanic subgroups who underwent emergency general surgery (EGS). METHODS Retrospective cohort study of the HCUP State Inpatient Database from New Jersey (2009-2014), including Hispanic and non-Hispanic White (NHW) adult patients who underwent EGS. Multivariable analyses were performed on outcomes including 7-day readmission and length of stay (LOS). RESULTS 125,874 patients underwent EGS operations. 22,971 were Hispanic (15,488 with subgroup defined: 7,331 - Central/South American; 4,254 - Puerto Rican; 3,170 - Mexican; 733 - Cuban). On multivariable analysis, patients in the Central/South American subgroup were more likely to be readmitted compared to the Mexican subgroup (OR 2.02; p < 0.001, respectively). Puerto Rican and Central/South American subgroups had significantly shorter LOS than Mexican patients (Puerto Rico -0.58 days; p < 0.001; Central/South American -0.30 days; p = 0.016). CONCLUSIONS There are significant differences in EGS outcomes between Hispanic subgroups. These differences could be missed when data are aggregated at Hispanic ethnicity.
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Affiliation(s)
- Lydia R Maurer
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sarah Rahman
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Numa Perez
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Healthcare Transformation Lab, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin G Allar
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily Witt
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jackelyn Moya
- David Geffen School of Medicine, Los Angeles, CA, USA
| | - Margaret S Pichardo
- Howard University College of Medicine, Washington, DC, USA; Yale School of Public Health, New Haven, CT, USA
| | | | - Tarsicio Uribe-Leitz
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Tanujit Dey
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Regan W Bergmark
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory Peck
- Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA; Rutgers School of Public Health, Piscataway, NJ, USA
| | - Gezzer Ortega
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Ortiz AP, Soto-Salgado M, Calo WA, Hull P, Fernández ME, Colon-López V, Tortolero-Luna G. Elimination of cervical cancer in U.S. Hispanic populations: Puerto Rico as a case study. Prev Med 2021; 144:106336. [PMID: 33678233 DOI: 10.1016/j.ypmed.2020.106336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/10/2020] [Accepted: 11/15/2020] [Indexed: 12/15/2022]
Abstract
Cervical cancer remains a major burden for women around the world. In 2018, the World Health Organization called for the elimination of cervical cancer worldwide (<4 cases per 100,000 women-years), within the 21st century. In the U.S., despite great progress toward this goal, existing disparities among racial/ethnic groups in cervical cancer raise concerns about whether elimination can be achieved for all women. We describe: 1) disparities in cervical cancer among Hispanics in the U.S. and factors that contribute to their increased risk, 2) prevention and control efforts to increase equity in the elimination of cervical cancer in this population, and 3) cervical cancer control efforts in Puerto Rico (PR), a U.S. territory, as a case study for cervical cancer elimination among a minority and underserved Hispanic population. Hispanics have the highest incidence rates of cervical cancer among all racial/ethnic groups in the U.S. Despite being more likely to complete HPV vaccination series, lower cervical cancer screening and access to treatment may lead to a higher cervical cancer mortality in Hispanics compared to non-Hispanic White women. These disparities are influenced by multiple individual-, sociocultural-, and system-level factors. To achieve the goal of cervical cancer elimination in the U.S., systematic elimination plans that consider the needs of Hispanic populations should be included within the Comprehensive Cancer Control Plans of each state. Because PR has implemented coordinated efforts for the prevention and control of cervical cancer, it represents a notable case study for examining strategies that can lead to cervical cancer elimination among Hispanics.
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Affiliation(s)
- Ana Patricia Ortiz
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico, United States of America; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, United States of America.
| | - Marievelisse Soto-Salgado
- Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, United States of America; Department of Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, United States of America
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Pamela Hull
- University of Kentucky Markey Cancer Center, United States of America; Department of Behavioral Science, University of Kentucky College of Medicine, United States of America
| | - María E Fernández
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, Houston, TX, United States of America
| | - Vivian Colon-López
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico, United States of America; Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, United States of America
| | - Guillermo Tortolero-Luna
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico, United States of America
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17
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Cognitive coping strategies of South African women in breast cancer care. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1177/0081246320961761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this qualitative study, we explored the cognitive strategies used by South African women with breast cancer to cope with their cancer experience. The themes that emerged were reappraisal, acceptance, relinquishing control, and benefit finding. Reappraisal involved downward comparison, normalising experiences, and positive self-talk. Acceptance included accepting unpleasantness, preparing for future challenges, acceptance for healing, and spirituality. Relinquishing control included giving up, trust in God, and trust in doctors. Benefit finding included spiritual growth, personal growth, altruism, and appreciation of life. To our knowledge, these were the first data to document South African women’s experiences of coping with breast cancer.
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18
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Özkan İ, Taylan S. Barriers to women’s breast cancer screening behaviors in several countries: A meta-synthesis study. Health Care Women Int 2020; 42:1013-1043. [DOI: 10.1080/07399332.2020.1814777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- İlknur Özkan
- Kumluca Faculty of Health Sciences, İnternal Medicine Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
| | - Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
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