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Yao L, Zhou K, Zhou Y, Kueh YC, Liu H, Liu Z, Pan M, Kuan G. Psychometric properties of the Chinese version of the Exercise Self-Efficacy Scale for the Transtheoretical Model: a confirmatory analysis among Chinese children and adolescents. BMC Public Health 2024; 24:151. [PMID: 38200518 PMCID: PMC10782543 DOI: 10.1186/s12889-023-17596-2] [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] [Received: 09/25/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Self-efficacy has been recognized as a critical component in people's participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA). METHODS A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA. RESULTS The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach's alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale. CONCLUSION The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.
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Affiliation(s)
- Liying Yao
- School of Physical Education, Shangrao Normal University, Shangrao, Jiangxi, 334000, China
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Ke Zhou
- Sports Reform and Development Research Center of Henan University, School of Physical Education, Henan University, Kaifeng, China.
| | - Yanli Zhou
- Sports Reform and Development Research Center of Henan University, School of Physical Education, Henan University, Kaifeng, China
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hongyou Liu
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Zhongbiao Liu
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Mingzhu Pan
- School of Physical Education, Shangrao Normal University, Shangrao, Jiangxi, 334000, China
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
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Baumeister A, Aldin A, Chakraverty D, Hübner C, Adams A, Monsef I, Skoetz N, Kalbe E, Woopen C. Interventions for improving health literacy in migrants. Cochrane Database Syst Rev 2023; 11:CD013303. [PMID: 37963101 PMCID: PMC10645402 DOI: 10.1002/14651858.cd013303.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Health literacy (HL) is a determinant of health and important for autonomous decision-making. Migrants are at high risk for limited HL. Improving HL is important for equitable promotion of migrants' health. OBJECTIVES To assess the effectiveness of interventions for improving HL in migrants. To assess whether female or male migrants respond differently to the identified interventions. SEARCH METHODS We ran electronic searches to 2 February 2022 in CENTRAL, MEDLINE, Embase, PsycInfo and CINAHL. We also searched trial registries. We used a study filter for randomised controlled trials (RCTs) (RCT classifier). SELECTION CRITERIA We included RCTs and cluster-RCTs addressing HL either as a concept or its components (access, understand, appraise, apply health information). DATA COLLECTION AND ANALYSIS We used the methodological procedures recommended by Cochrane and followed the PRISMA-E guidelines. Outcome categories were: a) HL, b) quality of life (QoL), c) knowledge, d) health outcomes, e) health behaviour, f) self-efficacy, g) health service use and h) adverse events. We conducted meta-analysis where possible, and reported the remaining results as a narrative synthesis. MAIN RESULTS We included 28 RCTs and six cluster-RCTs (8249 participants), all conducted in high-income countries. Participants were migrants with a wide range of conditions. All interventions were adapted to culture, language and literacy. We did not find evidence that HL interventions cause harm, but only two studies assessed adverse events (e.g. anxiety). Many studies reported results for short-term assessments (less than six weeks after total programme completion), reported here. For several comparisons, there were also findings at later time points, which are presented in the review text. Compared with no HL intervention (standard care/no intervention) or an unrelated HL intervention (similar intervention but different information topic) Self-management programmes (SMP) probably improve self-efficacy slightly (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.50; 2 studies, 333 participants; moderate certainty). SMP may improve HIV-related HL (understanding (mean difference (MD) 4.25, 95% CI 1.32 to 7.18); recognition of HIV terms (MD 3.32, 95% CI 1.28 to 5.36)) (1 study, 69 participants). SMP may slightly improve health behaviours (3 studies, 514 participants), but may have little or no effect on knowledge (2 studies, 321 participants) or subjective health status (MD 0.38, 95% CI -0.13 to 0.89; 1 study, 69 participants) (low certainty). We are uncertain of the effects of SMP on QoL, health service use or adverse events due to a lack of evidence. HL skills building courses (HLSBC) may improve knowledge (MD 10.87, 95% CI 5.69 to 16.06; 2 studies, 111 participants) and any generic HL (SMD 0.48, 95% CI 0.20 to 0.75; 2 studies, 229 participants), but may have little or no effect on depression literacy (MD 0.17, 95% CI -1.28 to 1.62) or any health behaviour (2 studies, 229 participants) (low certainty). We are uncertain if HLSBC improve QoL, health outcomes, health service use, self-efficacy or adverse events, due to very low-certainty or a lack of evidence. Audio-/visual education without personal feedback (AVE) probably improves depression literacy (MD 8.62, 95% CI 7.51 to 9.73; 1 study, 202 participants) and health service use (MD -0.59, 95% CI -1.11 to -0.07; 1 study, 157 participants), but probably has little or no effect on health behaviour (risk ratio (RR) 1.07, 95% CI 0.91 to 1.25; 1 study, 135 participants) (moderate certainty). AVE may improve self-efficacy (MD 3.51, 95% CI 2.53 to 4.49; 1 study, 133 participants) and may slightly improve knowledge (MD 8.44, 95% CI -2.56 to 19.44; 2 studies, 293 participants) and intention to seek depression treatment (MD 1.8, 95% CI 0.43 to 3.17), with little or no effect on depression (SMD -0.15, 95% CI -0.40 to 0.10) (low certainty). No evidence was found for QoL and adverse events. Adapted medical instruction may improve understanding of health information (3 studies, 478 participants), with little or no effect on medication adherence (MD 0.5, 95% CI -0.1 to 1.1; 1 study, 200 participants) (low certainty). No evidence was found for QoL, health outcomes, knowledge, health service use, self-efficacy or adverse events. Compared with written information on the same topic SMP probably improves health numeracy slightly (MD 0.7, 95% CI 0.15 to 1.25) and probably improves print literacy (MD 9, 95% CI 2.9 to 15.1; 1 study, 209 participants) and self-efficacy (SMD 0.47, 95% CI 0.3 to 0.64; 4 studies, 552 participants) (moderate certainty). SMP may improve any disease-specific HL (SMD 0.67, 95% CI 0.27 to 1.07; 4 studies, 955 participants), knowledge (MD 11.45, 95% CI 4.75 to 18.15; 6 studies, 1101 participants) and some health behaviours (4 studies, 797 participants), with little or no effect on health information appraisal (MD 1.15, 95% CI -0.23 to 2.53; 1 study, 329 participants) (low certainty). We are uncertain whether SMP improves QoL, health outcomes, health service use or adverse events, due to a lack of evidence or low/very low-certainty evidence. AVE probably has little or no effect on diabetes HL (MD 2, 95% CI -0.15 to 4.15; 1 study, 240 participants), but probably improves information appraisal (MD -9.88, 95% CI -12.87 to -6.89) and application (RR 1.51, 95% CI 1.29 to 1.77) (1 study, 608 participants; moderate certainty). AVE may slightly improve knowledge (MD 8.35, 95% CI -0.32 to 17.02; low certainty). No short-term evidence was found for QoL, depression, health behaviour, self-efficacy, health service use or adverse events. AVE compared with another AVE We are uncertain whether narrative videos are superior to factual knowledge videos as the evidence is of very low certainty. Gender differences Female migrants' diabetes HL may improve slightly more than that of males, when receiving AVE (MD 5.00, 95% CI 0.62 to 9.38; 1 study, 118 participants), but we do not know whether female or male migrants benefit differently from other interventions due to very low-certainty or a lack of evidence. AUTHORS' CONCLUSIONS Adequately powered studies measuring long-term effects (more than six months) of HL interventions in female and male migrants are needed, using well-validated tools and representing various healthcare systems.
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Affiliation(s)
- Annika Baumeister
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Angela Aldin
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Digo Chakraverty
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christiane Woopen
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
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Zhang L, Shi Y, Deng J, Yi D, Chen JA. The effect of health literacy, self-efficacy, social support and fear of disease progression on the health-related quality of life of patients with cancer in China: a structural equation model. Health Qual Life Outcomes 2023; 21:75. [PMID: 37461043 DOI: 10.1186/s12955-023-02159-1] [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] [Received: 11/24/2022] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Health literacy (HL), self-efficacy (SE), social support (SS) and fear of disease progression (FOP) are all important factors affecting health-related quality of life (HRQoL) in cancer patients. However, their synergistic effects and underlying mechanisms on HRQoL in cancer patients remain unclear. Therefore, the purpose of this study was to construct a structural equation model (SEM) to explore the underlying mechanism of factors affecting HRQoL. It is hoped that this study will provide a theoretical basis for future interventions. METHODS A cross-sectional design and convenience sampling method were used to investigate cancer inpatients in two general hospitals in Chongqing and Chengdu. Data were collected using structured scales, including HL, SE, SS, FOP and HRQoL. Finally, the SEM was constructed, and P ≤ 0.05 was considered significant. RESULTS There were 1749 participants included in this study. Correlation analysis showed that all variables were significantly correlated with one another except for symptoms, physical health (PD) and social family (SF) (p < 0.01). The SEM of the HRQoL had a good overall fit (GFI = 0.943, AGFI = 0.917, NFI = 0.950, RFI = 0.936, CFI = 0.955, IFI = 0.955, RMSEA = 0.072). The model indicated that HL had the strongest correlation with HRQoL (β = 0.398, p < 0.01), followed by FOP (β = -0.364, p < 0.01), SE (β = 0.347, p < 0.01) and SS (β = 0.184, p < 0.01). CONCLUSIONS The HRQoL of cancer patients is correlated with HL, SS, SE and FOP. HL can directly affect HRQoL and mediate HRQoL through SS and SE. Future programs should consider HL promotion, SE improvement and SS expansion as the breakthrough point when designing targeted intervention strategies. At the same time, the importance of the impact of FOP on the HRQoL of patients with cancer should not be ignored.
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Affiliation(s)
- Ling Zhang
- Department of Health Education, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038, China
| | - Yumei Shi
- Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Jing Deng
- Gastric Cancer Center, West China Hospital, Sichuan University, Sichuang, 610041, China
| | - Dali Yi
- Department of Health Education, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038, China
| | - Ji-An Chen
- Department of Health Education, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038, China.
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Han H, Mendez KJW, Perrin N, Cudjoe J, Taylor G, Baker D, Murphy‐Stone J, Sharps P. Community-based health literacy focused intervention for cervical cancer control among Black women living with human immunodeficiency virus: A randomized pilot trial. Health Expect 2022; 26:172-182. [PMID: 36444391 PMCID: PMC9854322 DOI: 10.1111/hex.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/05/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Health literacy plays an essential role in how individuals process health information to make decisions about health behaviours including cancer screening. Research is scarce to address health literacy as a strategy to improve cancer screening participation among women living with human immunodeficiency virus (HIV), particularly Black women who, despite the heavy burden of cervical cancer, report consistently low screening rates. AIM To assess the feasibility, acceptability and preliminary efficacy of a health literacy-focused intervention called CHECC-uP-Community-based, HEalth literacy focused intervention for Cervical Cancer control-among women living with HIV. METHODS We conducted a community-based, single-blinded randomized pilot trial. A total of 123 eligible women were enrolled and randomized to one of two conditions, control (i.e., cervical cancer brochure) or intervention (cervical cancer brochure plus 30-60 min health literacy-focused education followed by monthly phone counselling and navigation assistance for 6 months). Study assessments were done at baseline, 3 and 6 months. The final analysis sample included 58 women who completed all data points and whose Papanicolaou (Pap) test status was confirmed by medical records. RESULTS All intervention participants who completed the programme would recommend the CHECC-uP to other women living with HIV. However, adherence in the experimental conditions was low (49.6% attrition rate including 20 women who dropped out before the intervention began) due, in large part, to phone disconnection. Those who had received the intervention had a significantly higher Pap test rate compared to women in the control group at 6 months (50% vs. 21.9%, p = .025). Participation in the intervention programme was associated with improved health literacy and other psychosocial outcomes at 3 months but the trend was attenuated at 6 months. CONCLUSIONS The CHECC-uP was highly acceptable and led to improved Pap testing rates among Black women living with HIV. Future research should consider addressing social determinants of health such as phone connectivity as part of designing a retention plan targeting low-income Black women living with HIV. IMPLICATIONS The findings should be incorporated into a future intervention framework to fulfil the unmet needs of Black women living with HIV to facilitate their decision-making about Pap test screening. PATIENT OR PUBLIC CONTRIBUTION Nineteen community members including women living with HIV along with HIV advocates and care providers participated in four focus groups to develop cervical cancer screening decision-relevant information and the health literacy intervention. Additionally, a community advisory board was involved to provide guidance in the general design and conduct of the study.
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Affiliation(s)
- Hae‐Ra Han
- The Johns Hopkins University School of NursingBaltimoreMarylandUSA,The Johns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA,Center for Community ProgramsInnovation, and ScholarshipBaltimoreMarylandUSA
| | | | - Nancy Perrin
- The Johns Hopkins University School of NursingBaltimoreMarylandUSA
| | - Joycelyn Cudjoe
- United States Government Accountability OfficeDistrict of ColumbiaWashingtonUSA
| | - Gregory Taylor
- University of Maryland School of MedicineBaltimoreMarylandUSA
| | - Dorcas Baker
- Older Women Embracing Life (OWEL)BaltimoreMarylandUSA
| | | | - Phyllis Sharps
- The Johns Hopkins University School of NursingBaltimoreMarylandUSA
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Urrutia MT, Padilla O. Validity of a questionnaire on self-efficacy for Pap test adherence screening. Front Oncol 2022; 12:979799. [DOI: 10.3389/fonc.2022.979799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionSelf-efficacy has been related to different health preventive behaviors, included adherence to the Papanicolaou test—also called Pap smear or Pap test. The aim of this study is to test construct and criterion validity and reliability of a questionnaire on self-efficacy and the Pap test in Chilean women.MethodThis study was carried out on a sample of 969 women of ages from 25 to 64, who are users of the public health care system in Santiago, Chile. The validity of the Self-Efficacy Scale for the Pap Smear Screening Participation (SES-PSSP) questionnaire was done by confirmatory factor analysis, external criteria by t-test, and reliability by Cronbach’s alpha.ResultsThree models were tested, obtaining a questionnaire with 20 items and 2 dimensions. The criteria validity was confirmed by adherence to the Pap test. The final questionnaire has a reliability of 0.95, measured by Cronbach´s alpha.ConclusionA valid and reliable questionnaire to measure self-efficacy in relation to the Pap test is a relevant contribution in cervical cancer prevention, especially related to interventions focused on increasing adherence.
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Juwitasari, Harini R, Rosyad AA. Husband Support Mediates the Association between Self-Efficacy and Cervical Cancer Screening among Women in the Rural Area of Indonesia. Asia Pac J Oncol Nurs 2021; 8:560-564. [PMID: 34527786 PMCID: PMC8420921 DOI: 10.4103/apjon.apjon-2085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/01/2020] [Indexed: 12/31/2022] Open
Abstract
Objective: Standard cervical cancer screening is seen as the most efficient way of preventing cases of cervical cancer. This study aimed to test indirect husband support pathways and the use of self-efficacy and Visual Inspection with Acetic Acid (VIA) testing among women in Indonesian rural areas. Methods: The research implemented a cross-sectional design carried out in East Java, Indonesia, a remote county. The inclusion criteria were women between the ages of 30 and 50 years, married or women having experienced of having sexual intercourse, have been utilized VIA test at least 3 years ago. The Self-Efficacy Scale and the Husband Help Survey were used to test the interest variable. A structural equation modeling was used to assess the relationship between husband help and VIA test self-efficacy. Results: The study was followed by a total of 219 respondents. Women's mean age was 33.03 years (standard deviation [SD]: 6.44), and the mean age for the husband was 37.51 (SD: 7.45). Just 7.31% had a year ago VIA test, and most (65.75%) had a VIA test within 4 years. A husband's help had the greatest direct impact on the use of Papanicolaou tests, with a 0.312 direction coefficient (P < 0.001). The mediator between the husband's help and the use of VIA tests was self-efficacy (standardized coefficients of the path: 0.123, P < 0.001). Conclusions: Our analysis revealed a route through which husband help influences the use of VIA tests among women in Indonesian rural areas. Providers must consider the effect of husband support on VIA testing in promoting the use of VIA tests among females in Indonesia. One potential communication approach is that providers make improvements to improve the use of VIA tests in supporting self-efficacy.
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Affiliation(s)
- Juwitasari
- Department of Maternity Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Jawa Timur, Indonesia
| | - Ririn Harini
- Department of Maternity Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Jawa Timur, Indonesia
| | - Achmad Ainur Rosyad
- Department of Maternity Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Jawa Timur, Indonesia
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A Vax4HPV Mobile Application for Parents of Human Papillomavirus Vaccine–Eligible Children. Comput Inform Nurs 2021; 40:455-465. [DOI: 10.1097/cin.0000000000000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abdi HI, Hoover E, Fagan SE, Adsul P. Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research. J Immigr Minor Health 2021; 22:1304-1319. [PMID: 32350683 DOI: 10.1007/s10903-020-01014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.
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Affiliation(s)
- Hamdi I Abdi
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | | | | | - Prajakta Adsul
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, 1 University of New Mexico, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
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Drokow EK, Effah CY, Agboyibor C, Sasu E, Amponsem-Boateng C, Akpabla GS, Ahmed HAW, Sun K. The Impact of Video-Based Educational Interventions on Cervical Cancer, Pap Smear and HPV Vaccines. Front Public Health 2021; 9:681319. [PMID: 34307280 PMCID: PMC8294697 DOI: 10.3389/fpubh.2021.681319] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/08/2021] [Indexed: 01/24/2023] Open
Abstract
Background: Video-based interventions have the potential to contribute to long-lasting improvements in health-seeking behaviours. Ghana's upsurge rate of information and communication technology usage presents an opportunity to improve the awareness of HPV vaccination and screening rates of cervical cancer among women in Ghana. This research aimed to assess the impact of video-based educational intervention centred on the Health Belief and Transtheoretical Models of behavioural changes in promoting HPV vaccination, cervical carcinoma awareness and willingness to have Pap smear test (PST) among women in Ghana. Methods: To achieve the intended sample size, convenient, purposive and stratified random sampling techniques were used. SPSS v. 23.0 was used in the data analysis. Percentages and frequencies were used to represent participants' demographic characteristics, knowledge of (1) cervical carcinoma, (2) human papillomavirus vaccine, and (3) Pap smear test. The chi-square test by McNemar was employed to evaluate variations in the post- and pre-intervention responses. A p-value < 0.05 was considered statistically significant. The level of significance was adjusted owing to multiple comparisons by using the Bonferroni's correction. Results: Before the intervention, 84.2% of the participant had some knowledge or information about cervical cancer, but after the intervention, 100% of the participant became aware of cervical cancer which represents 15.8% increment at a P < .001. The willingness to have a pap smear test increased from 35.8% to 94.2% (df = 58.4%, P < .001) after the educational intervention. The willingness to be vaccinated increased from 47.5% to 81.7% (df = 34.2%, P < .001) after the educational intervention. Six months after the intervention, participants were followed-up. 253 (42.2%) participants had gone for cervical cancer screening (Pap smear test) while 347 (57.8%) participants had not been screened. In terms of HPV vaccination, 192 participants (32.0%) had begun their HPV vaccination cycle. Conclusion: The study results show that health education, using videos, may be influential in perception changing, self-efficacy improvement and the understanding of cervical carcinoma screening and HPV vaccination.
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Affiliation(s)
- Emmanuel Kwateng Drokow
- Department of Radiation Oncology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | | | - Clement Agboyibor
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Evans Sasu
- Department of Radiotherapy, National Centre for Radiotherapy and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | | | - Hafiz Abdul Waqas Ahmed
- Department of Haematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | - Kai Sun
- Department of Haematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
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Fuzzell LN, Perkins RB, Christy SM, Lake PW, Vadaparampil ST. Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Prev Med 2021; 144:106400. [PMID: 33388330 DOI: 10.1016/j.ypmed.2020.106400] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/09/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
Cervical cancer screening rates in the United States are generally high, yet certain groups demonstrate disparities in screening and surveillance. Individuals at greatest risk for cervical cancer are often from marginalized or underserved groups who do not participate in regular screening for a variety of reasons. Using the Population-based Research to Optimize the Screening Process (PROSPR) Trans-Organ Conceptual Model, including concepts of individual-, provider-, facility-, system-, or policy-level factors, we provide a commentary to highlight reasons for low screening participation among subgroups in the U.S. These include racial and ethnic minorities, rural residents, sexual and gender minorities, those with limited English proficiency, those with particular religious beliefs, and various health conditions. We describe barriers and offer potential solutions for each group. In addition, we discuss cross-cutting barriers to screening including difficulty interacting with the healthcare system (limited knowledge and health literacy, lack of provider recommendation/contact), financial (cost, lack of insurance), and logistical barriers (e.g., lack of usual source of care, competing demands, scheduling issues). Solutions to address these barriers are needed to improve screening rates across all underscreened groups. Changes at state and national policy levels are needed to address health insurance coverage. Mobile screening, ensuring that interpreters are available for all visits, and targeted in reach at non-gynecological visits can further overcome barriers. Employing community outreach workers can increase community demand for screening, and patient navigators can improve adherence to both screening and follow-up diagnostic evaluation. HPV self-sampling can address multiple barriers to cervical cancer screening.
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Affiliation(s)
- Lindsay N Fuzzell
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America.
| | - Rebecca B Perkins
- Boston University School of Medicine, 85 E. Concord St., Boston, MA 02118, United States of America
| | - Shannon M Christy
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; University of South Florida, College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States of America
| | - Paige W Lake
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America
| | - Susan T Vadaparampil
- Moffitt Cancer Center, Department of Health Outcomes & Behavior, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, 12902 Magnolia Dr. Tampa, FL 33612, United States of America; University of South Florida, College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, United States of America.
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11
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The association between health literacy and theory of planned behavior with performance of cancer screening tests among rural patients: Cross- sectional study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Knowledge, attitude, practice, and self-efficacy of women regarding cervical cancer screening. Obstet Gynecol Sci 2020; 64:216-225. [PMID: 33355856 PMCID: PMC7991003 DOI: 10.5468/ogs.20236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Objective Iran has a low incidence of cervical cancer (CC). The country is introducing an organized screening system, including human papillomavirus screening. Studies show a high dropout rate among eligible women in continuing testing. Methods This descriptive-analytic study was part of the first phase of a clinical trial conducted on a random sample of 400 women aged 18–49 in Andimeshk City, Khuzestan Province, in 2020. The data collection tool consisted of a man-made questionnaire that included domains of demographic characteristics, knowledge, attitude, practice, and self-efficacy in the Pap smear test. The data were analyzed with Stata-16 using linear and logistic regression models. Results The mean knowledge, attitude, and self-efficacy scores were 6.80±2.33, 34.99±4.32, and 28.67±7.34, respectively. In the multiple models, every unit increase in the knowledge or attitude scores raised the mean self-efficacy score by 1.04 and 0.48, respectively (P<0.001). Every unit increase in the knowledge and self-efficacy scores increased the chance of performing Pap smear 1.61 and 1.41 times, respectively (P<0.001). Conclusion Given the association of women’s knowledge and self-efficacy with practice in performing the Pap smear, it seems that an effective program promoting women’s health behavior regarding CC screening would include applied education to raise community awareness and improve women’s attitudes, self-efficacy, and practice.
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Kim K, Zhang Y, Lee J, Meehan TP, Gans K. Age at Human Papillomavirus Vaccine Initiation Among Adolescents and Young Adults From 22 Pediatric Practices in the Northeastern United States. J Nurs Scholarsh 2020; 53:46-54. [PMID: 33306868 DOI: 10.1111/jnu.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To examine trends in human papillomavirus (HPV) vaccine initiation and its determinants. DESIGN This retrospective correlational study involved 12,260 individuals born between 1996 and 2000 receiving care from one of 22 pediatric practices in the northeastern region of the United States between 2016 and 2017. METHODS We extracted data about HPV vaccination status and date, birth year, race, ethnicity, language, and geographic regions. Mean age at initiation was estimated using descriptive statistics. Multiple linear regression with weighted least squares was used to examine its correlates. FINDINGS Of 12,260 individuals, about 76% initiated the HPV vaccination series at 9 to 17 years of age. While the initiation age decreased overall for both females and males (e.g., 14.3 vs. 16.2 years and 13.8 vs. 14.4 years in the 1996 vs. 2000 birth cohorts, respectively), a greater reduction was noted for males. Individuals tended to delay initiation if they were non-Hispanic or Asian and resided in urban areas. CONCLUSIONS Most adolescents in our sample started HPV vaccination later than the recommended age, with variations in different demographic groups. Rapid improvement in on-time HPV vaccination is occurring, especially for males. CLINICAL RELEVANCE The findings of this analysis emphasize continuous efforts to increase on-time HPV vaccination rates for all groups, including non-Hispanic whites and female adolescents, to eliminate current and possible disparities.
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Affiliation(s)
- Kyounghae Kim
- Assistant Professor, Korea University College of Nursing, Seoul, South Korea; and University of Connecticut School of Nursing, Storrs, CT, USA
| | - Yiming Zhang
- Ph.D. Candidate, University of Connecticut Department of Statistics, Storrs, CT, USA
| | - Joochul Lee
- Ph.D. Candidate, University of Connecticut Department of Statistics, Storrs, CT, USA
| | - Thomas P Meehan
- Vice President, Research and Medical Education, Connecticut Center for Primary Care, Farmington, CT; ProHealth Physicians, Inc., Farmington, CT; and Frank H. Netter MD School of Medicine, North Haven, CT, USA
| | - Kim Gans
- Professor, University of Connecticut Human Development and Family Studies, Storrs, CT, USA
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14
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Eshah NF, Mosleh SM, Al-Smadi A. The Decisional Balance Toward Health Behaviors Among Patients With Hypertension. Clin Nurs Res 2020; 30:977-984. [PMID: 33131320 DOI: 10.1177/1054773820967548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The decisional balance is related to the transtheoretical model, and involves weighting the pros and cons of performing a behavior. The study aimed to assess hypertensive patients' decisional balances about smoking, weight control, and physical exercise. A cross-section descriptive correlation design was used, and 110 patients were recruited using convenience sampling in outpatient clinics. The decisional balance was measured using "Decisional Balance Scales," which assess an individual's decisional balance related to smoking, weight control, and physical exercise behaviors. The results predicted that Jordanian hypertensive patients with higher physical exercise decisional balance and higher weight decisional balance had lower smoking decisional behaviors. Nurses can foster health promotion and behavioral change by employing interventions that improve decisional balances. Improving the decisional balance of one behavior would have a positive impact on other behaviors. Thus, designing multidimensional interventions might be effective for modifying different types of health behaviors, and fostering health promotion practices.
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Affiliation(s)
| | - Sultan M Mosleh
- Faculty of Nursing, Mutah University, Jordan, UAE.,Higher colleges of Technology, Fujairah, UAE
| | - Ahmed Al-Smadi
- Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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15
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Bunkarn O, Kusol K, Eksirinimit T. The Outcome of a Self-Efficacy Enhancement Program for Cervical Cancer Screening among Women in Phrasaeng District, Suratthani Province, Thailand. Asian Pac J Cancer Prev 2020; 21:2075-2081. [PMID: 32711435 PMCID: PMC7573414 DOI: 10.31557/apjcp.2020.21.7.2075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Indexed: 12/20/2022] Open
Abstract
Objective: The purpose of this research was to examine the effect of a self-efficacy enhancement program on perceived self-efficacy and cervical cancer screening among women. Methods: This research was quasi-experimental research, using the subjects consisted of 130 samples; each of the experimental and control group consisted of 65 samples. The experimental group received a self-efficacy enhancement program. The control group received knowledge and usual care by health personnel in the health promoting hospital. The duration of the research was 8 weeks. The self-efficacy was testing the reliability equal to 0.90. Data were analyzed using descriptive statistics, Chi-square, and t-test. Results: The mean scores of perceived self-efficacy between the experimental and control group before using the program (M=2.18, S.D.=0.40; M=2.22, S.D.=0.39), there was no significantly different (p> 0.05). The mean scores of perceived self-efficacy between the experimental and control group after using the program (M=4.11, S.D.=0.44; M=2.28, S.D.=0.42), there was a significantly different (p< 0.001). The mean scores of perceived self-efficacy of the experimental group before and after using the program were higher, (M=2.18, S.D.=0.40; M=4.11, S.D.=0.44), there was a significantly different (p< 0.001). The experimental group came to screening 64 people (98.5 %), and the control group came to screening eight people (12.3 %), calculated ratio as 8:1 and compared the cervical cancer screening in the experimental and control group had differences significantly (p< 0.001). Conclusion: The self-efficacy enhancement program, resulting in increased screening rates and screened after the first week by having most screening tests in the community. Therefore, the program should be applied, and proactive services should be provided for women to have access in community and a health service place.
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Affiliation(s)
- Ornuma Bunkarn
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Kiatkamjorn Kusol
- School of Nursing, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
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Ebu NI, Amissah-Essel S, Asiedu C, Akaba S, Pereko KA. Impact of health education intervention on knowledge and perception of cervical cancer and screening for women in Ghana. BMC Public Health 2019; 19:1505. [PMID: 31711469 PMCID: PMC6849238 DOI: 10.1186/s12889-019-7867-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 10/29/2019] [Indexed: 11/20/2022] Open
Abstract
Background The burden of cervical cancer continues to rise in developing economies. Women in the sub-Saharan African region have higher chances of developing cervical cancer due to a greater prevalence of related risk factors. The purpose of this study was to determine the effect of health education intervention on cervical cancer and screening perceptions of women in the Komenda, Edina, Eguafo, and Abirem (K.E.E.A) District in the Central Region of Ghana. Methods A non-equivalent control-group design was used to select church women; 396 in the intervention group and 386 in the control group, aged 11 to 70 years in the K.E.E.A District in the Central Region of Ghana. Data was collected via a validated structured interview schedule and analysed using the paired - and independent-samples t-tests, Kruskal-Wallis test, and Mann-Whitney U test. Results A comparison of the mean differences between the pre-post-test scores for the intervention and control groups showed a statistically significant difference for knowledge of cervical cancer (t = 6.22, df = 780, p = 0.001), knowledge of cervical cancer screening (t = 5.96, df = 780, p = 0.001), perceived seriousness (t = 3.36, df = 780, p = 0.001), perceived benefits (t = 9.19, df = 780, p = 0.001), and perceived barriers (t = 3.19, df = 780, p = 0.001). However, perceived susceptibility for the intervention group reduced, evidenced by a decrease in the mean (mean = − 0.12) compared to the control group (mean = 0.93) and this was statistically significant (t = 2.72, df = 780, p = 0.007). Conclusions Health education interventions are critical in improving knowledge and perceptions, and increasing self-efficacy of women about cervical cancer and screening.
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Affiliation(s)
- Nancy Innocentia Ebu
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, Faculty of Science and Technology Education, University of Cape Coast, Cape Coast, Ghana
| | - Christiana Asiedu
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Selorm Akaba
- Department of Agricultural Economics and Extension, School of Agriculture, University of Cape Coast, Cape Coast, Ghana
| | - Kingsley Asare Pereko
- Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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The Association Between Health Literacy and Breast and Cervical Cancer Screening Behaviors. Nurs Res 2019; 68:177-188. [DOI: 10.1097/nnr.0000000000000346] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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