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Rauch JI, Daniels J, Robillard A, Joseph RP. Breast Cancer Screening among African Immigrants in the United States: An Integrative Review of Barriers, Facilitators, and Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1004. [PMID: 39200613 PMCID: PMC11353535 DOI: 10.3390/ijerph21081004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 09/02/2024]
Abstract
The purpose of this review was to synthesize the available literature on breast cancer-screening barriers, facilitators, and interventions among U.S. African immigrants. Following the integrative review framework and PRISMA guidelines for reporting systemic reviews, five electronic databases were searched: PubMed, CINAHL, PsycINFO, Medline, and Google Scholar. Studies were included if they were published in English language journals after 1 January 2000 and reported data on breast cancer-screening barriers, facilitators, or interventions among U.S. African immigrants. Barriers and facilitators reported by studies were descriptively examined and synthesized by two authors and classified as aligning with one of the three levels of influences based on the social-ecological model (intrapersonal, interpersonal, and community). Interventions promoting breast cancer screening were narratively summarized. Search procedures retrieved 1011 articles, with 12 meeting the criteria for inclusion in the review (6 qualitative and 6 quantitative). Intrapersonal barriers included limited awareness, fear of pain, language barriers, health concerns, transportation issues, costs, and negative past experiences. Interpersonal barriers involved modesty, spiritual beliefs, and lack of support, while community-level barriers included provider and healthcare-system challenges. Regarding facilitators, past screening experiences and health insurance were the most commonly reported intrapersonal facilitators. The only interpersonal facilitator identified was observing other women experience a breast cancer diagnosis and undergo treatment. Community-level facilitators included appointment reminders, scheduling assistance, culturally congruent interpreters, transportation to screening facilities, and patient navigators. Three articles reported outcomes of breast cancer-screening interventions. All three were pilot studies and reported increased knowledge and attitudes regarding breast cancer screening following the respective interventions. One study examined the uptake of breast cancer screening following the intervention, with results indicating an increase in screening. Findings provide a comprehensive synthesis of factors influencing breast cancer screening among African immigrants and highlight the need for future research on the topic. This review was registered with Prospero (CRD42024502826) before the initiation of search procedures.
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Affiliation(s)
- Julian I. Rauch
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA (R.P.J.)
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Lu N, Zhang C, You H, Ma Z, Zhu P, Cheng F. Factors Affecting Breast Screening Behavior of First-Degree Relatives of Breast Cancer Patients in China: A Cross-sectional Study. Cancer Nurs 2024; 47:271-280. [PMID: 36480333 DOI: 10.1097/ncc.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear. OBJECTIVE The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs. METHODS A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior. RESULTS The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = -0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior. CONCLUSION Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior. IMPLICATIONS FOR PRACTICE Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.
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Affiliation(s)
- Ningning Lu
- Author Affiliations: School of Nursing, Nanjing Medical University (Mss Lu, Zhang, and Ma); Department of Nursing, Kangda College of Nanjing Medical University (Ms Lu); Department of Social Medicine and Health Education, School of Public Health, and Institute of Healthy Jiangsu Development, Nanjing Medical University (Dr You); and Jiangsu Cancer Hospital; The Affiliated Cancer Hospital of Nanjing Medical University; Jiangsu Institute of Cancer Research (Ms Zhu and Dr Cheng), Nanjing, China
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Waddell KJ, Goel K, Park SH, Linn KA, Navathe AS, Liao JM, McDonald C, Reitz C, Moore J, Hyland S, Mehta SJ. Association of Electronic Self-Scheduling and Screening Mammogram Completion. Am J Prev Med 2024; 66:399-407. [PMID: 38085196 PMCID: PMC10922640 DOI: 10.1016/j.amepre.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 01/29/2024]
Abstract
INTRODUCTION The purpose of this study was to evaluate if an electronic health record (EHR) self-scheduling function was associated with changes in mammogram completion for primary care patients who were eligible for a screening mammogram using U.S. Preventive Service Task Force recommendations. METHODS This was a retrospective cohort study (September 1, 2014-August 31, 2019, analyses completed in 2022) using a difference-in-differences design to examine mammogram completion before versus after the implementation of self-scheduling. The difference-in-differences estimate was the interaction between time (pre-versus post-implementation) and group (active EHR patient portal versus inactive EHR patient portal). The primary outcome was mammogram completion among all eligible patients, with completion defined as receiving a mammogram within 6 months post-visit. The secondary outcome was mammogram completion among patients who received a clinician order during their visit. RESULTS The primary analysis included 35,257 patient visits. The overall mammogram completion rate in the pre-period was 22.2% and 49.7% in the post-period. EHR self-scheduling was significantly associated with increased mammogram completion among those with an active EHR portal, relative to patients with an inactive portal (adjusted difference 13.2 percentage points [95% CI 10.6-15.8]). For patients who received a clinician mammogram order at their eligible visit, self-scheduling was significantly associated with increased mammogram completion among patients with an active EHR portal account (adjusted difference 14.7 percentage points, [95% CI 10.9-18.5]). CONCLUSIONS EHR-based self-scheduling was associated with a significant increase in mammogram completion among primary care patients. Self-scheduling can be a low-cost, scalable function for increasing preventive cancer screenings.
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Affiliation(s)
- Kimberly J Waddell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Cresencz VA Medical Center, Philadelphia, PA.
| | - Keshav Goel
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sae-Hwan Park
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA
| | - Kristin A Linn
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania
| | - Amol S Navathe
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Cresencz VA Medical Center, Philadelphia, PA
| | - Joshua M Liao
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Medicine, University of Washington, Seattle, WA
| | - Caitlin McDonald
- Center for Health Care Transformation and Innovation, University of Pennsylvania, Philadelphia, PA
| | - Catherine Reitz
- Center for Health Care Transformation and Innovation, University of Pennsylvania, Philadelphia, PA
| | - Jake Moore
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Steve Hyland
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shivan J Mehta
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA; Center for Health Care Transformation and Innovation, University of Pennsylvania, Philadelphia, PA
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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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Ganguli I, Mulligan KL, Chant ED, Lipsitz S, Simmons L, Sepucha K, Rudin RS. Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2342464. [PMID: 37943557 PMCID: PMC10636635 DOI: 10.1001/jamanetworkopen.2023.42464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 11/10/2023] Open
Abstract
Importance Medical test overuse and resulting care cascades represent a costly, intractable problem associated with inadequate patient-clinician communication. One possible solution with potential for broader benefits is priming routine, high-quality medical test conversations. Objective To assess if a peer comparison and educational intervention for physicians and patients improved medical test conversations during annual visits. Design, Setting, and Participants Randomized clinical trial and qualitative evaluation at an academic medical center conducted May 2021 to October 2022. Twenty primary care physicians (PCPs) were matched-pair randomized. For each physician, at least 10 patients with scheduled visits were enrolled. Data were analyzed from December 2022 to September 2023. Interventions In the intervention group, physicians received previsit emails that compared their low-value testing rates with those of peer PCPs and included point-of-care-accessible guidance on medical testing; patients received previsit educational materials via email and text message. Control group physicians and patients received general previsit preparation tips. Main outcomes and measures The primary patient outcome was the Shared Decision-Making Process survey (SDMP) score. Secondary patient outcomes included medical test knowledge and presence of test conversation. Outcomes were compared using linear regression models adjusted for patient age, gender, race and ethnicity, and education. Poststudy interviews with intervention group physicians and patients were also conducted. Results There were 166 intervention group patients and 148 control group patients (mean [SD] patient age, 50.2 [15.3] years; 210 [66.9%] female; 246 [78.3%] non-Hispanic White). Most patients discussed at least 1 test with their physician (95.4% for intervention group; 98.3% for control group; difference, -2.9 percentage points; 95% CI, -7.0 to 1.2 percentage points). There were no statistically significant differences in SDMP scores (2.11 out of 4 for intervention group; 1.97 for control group; difference, 0.14; 95% CI, -0.25 to 0.54) and knowledge scores (2.74 vs 2.54 out of 4; difference, 0.19; 95% CI, -0.05 to 0.43). In poststudy interviews with 3 physicians and 16 patients, some physicians said the emails helped them reexamine their testing approach while others noted competing demands. Most patients said they trusted their physicians' advice even when inconsistent with educational materials. Conclusions and Relevance In this randomized clinical trial of a physician-facing and patient-facing peer comparison and educational intervention, there was no significant improvement in medical test conversation quality during annual visits. These results suggest that future interventions to improve conversations and reduce overuse and cascades should further address physician adoption barriers and leverage patient-clinician relationships. Trial Registration ClinicalTrials.gov Identifier: NCT04902664.
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Affiliation(s)
- Ishani Ganguli
- Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Kathleen L. Mulligan
- Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut
| | - Emma D. Chant
- Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Stuart Lipsitz
- Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Leigh Simmons
- Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Karen Sepucha
- Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert S. Rudin
- Health Care Division, RAND Corporation, Boston, Massachusetts
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Bouchard EG, Saad-Harfouche FG, Clark N, Colon J, LaValley SA, Reid M, Attwood K, Bansal-Travers M, Glaser K. Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:854-862. [PMID: 35840859 PMCID: PMC9286703 DOI: 10.1007/s13187-022-02197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/02/2023]
Abstract
Few eligible patients receive lung cancer screening. We developed the Lung AIR (awareness, information, and resources) intervention to increase community education regarding lung cancer screening. The intervention was designed as an in-person group intervention; however, the COVID-19 pandemic necessitated adapting the mode of delivery. In this study we examined intervention feasibility and efficacy overall and by mode of delivery (in-person group vs. one-on-one phone) to understand the impact of adapting community outreach and engagement strategies. Feasibility was examined through participant demographics. Efficacy was measured through pre/post knowledge, attitudes, and beliefs about lung cancer screening, and intention to complete screening. We reached N = 292 participants. Forty percent had a household income below $35,000, 58% had a high school degree or less, 40% were Hispanic, 57% were Black, and 84% reported current or past smoking. One-on-one phone sessions reached participants who were older, had lower incomes, more current smoking, smoked for more years, more cigarettes per day, lower pre-intervention lung cancer screening knowledge, and higher pre-intervention fear and worry. Overall pre/post test scores show significant increases in knowledge, salience, and coherence, and reduced fear and worry. Participants in the one-on-one phone sessions had significantly higher increases in salience and coherence and intention to complete screening compared to participants in the in-person group sessions. The Lung AIR intervention is a feasible and effective community-based educational intervention for lung cancer screening. Findings point to differences in reach and efficacy of the community-based intervention by mode of delivery.
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Affiliation(s)
- Elizabeth G Bouchard
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Frances G Saad-Harfouche
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Nikia Clark
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Jomary Colon
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Susan A LaValley
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Mary Reid
- Department of Medical Oncology, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Kristopher Attwood
- Department of Biostatistics, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Kathryn Glaser
- Department of Cancer Prevention and Control, Office of Community Outreach and Engagement, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263, USA
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Hall IJ, Rim SH, Dasari S. Preventive care use among Hispanic adults with limited comfort speaking English: An analysis of the Medical Expenditure Panel Survey data. Prev Med 2022; 159:107042. [PMID: 35398368 PMCID: PMC9617098 DOI: 10.1016/j.ypmed.2022.107042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/11/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
Language barriers have been associated with worse access to healthcare and poorer health outcomes. To assess differences in access to care and utilization of healthcare services between Hispanic adults and non-Hispanic white adults (NHW), we used the Medical Expenditure Panel Survey (2013-2016) to compare Hispanic adults who expressed limited comfort speaking in English (LCE) with Hispanic adults who were comfortable speaking in English (CE) and NHW adults. Hispanic adults with CE were less likely than NHW adults to have a usual source of care, use preventive services, including cervical cancer screening, and healthcare services. However, after adjustment breast and cervical cancer screening exceeded that of NHW adults. Hispanic adults with LCE fared substantially worse than their Hispanic counterparts with CE in having a usual source of care, use of preventive services, breast and colorectal cancer screening, and healthcare services. After adjustment, use of all cancer screening tests were similar. Eliminating disparities for Hispanic adults will require a multi-pronged approach to address access to healthcare and other social determinants of health, including poverty, employment discrimination, and educational inequities. The public health community can help improve health literacy, address barriers to care, and provide appropriate language assistance at point of care using culturally-competent means to promote greater utilization of preventive services, including demand for and delivery of cancer screenings.
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Affiliation(s)
- Ingrid J Hall
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sun Hee Rim
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Performance in Iranian Women: a Randomized Controlled Trial Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M. The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010263. [PMID: 33396424 PMCID: PMC7795851 DOI: 10.3390/ijerph18010263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 12/31/2022]
Abstract
There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
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Affiliation(s)
- Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
- Malaysian Research Institute of Ageing (MyAgeing), Serdang 43400, Malaysia
- Correspondence:
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Musheer Abdulwahid Al-Jaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Meram Azzani
- Community Medicine Department, Faculty of Medicine, MAHSA University, Saujana Putra Campus, Jenjarom 42610, Malaysia;
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10
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McElfish PA, Rowland B, Riklon S, Aitaoto N, Sinclair KA, Ima S, Kadlubar SA, Goulden PA, Hudson JS, Mamis S, Long CR. Development and Evaluation of a Blood Glucose Monitoring YouTube Video for Marshallese Patients Using a Community-Based Participatory Research Approach. Policy Polit Nurs Pract 2019; 20:205-215. [PMID: 31537196 PMCID: PMC9524581 DOI: 10.1177/1527154419872834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to (a) describe the development of a culturally appropriate glucose monitoring video using a community-based participatory research approach and (b) assess the cultural appropriateness and effectiveness of the video. The topic of the video-using a glucometer and the importance of performing blood glucose checks-was chosen by Marshallese community stakeholders. The video was produced in Marshallese with English subtitles and disseminated through YouTube. Participants were recruited from August 16, 2016 to September 12, 2016 in a diabetes clinic that serves Marshallese patients in northwest Arkansas. Fifty participants completed a survey at pre- and postintervention, with questions capturing demographic information and questions on glucose monitoring self-efficacy using an adapted version of the Stanford Patient Education Research Center's Diabetes Self-Efficacy Scale. Twenty of those participants who completed the survey also completed semistructured interviews that assessed cultural appropriateness and effectiveness of the video. Participants reported significant increases in self-efficacy related to glucometer use and the importance of performing blood glucose checks (p < .001) and a 1.45% reduction in A1C between preintervention and 12 weeks postintervention (p = .006). Qualitative results indicated the video was both culturally appropriate and effective. The findings of this study were consistent with evidence in the literature, which shows health education videos can be effective at improving health behaviors. Using a community-based participatory research approach to prioritize video topics, and including members of the community in the creation and dissemination of the videos, could aid in ensuring the videos are effective and culturally appropriate.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sheldon Riklon
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Nia Aitaoto
- Nutrition & Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | | | - Shumona Ima
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Susan A Kadlubar
- Division of Medical Genetics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Peter A Goulden
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jonell S Hudson
- College of Pharmacy, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sammie Mamis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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11
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Bashirian S, Mohammadi Y, Barati M, Moaddabshoar L, Dogonchi M. Effectiveness of the Theory-Based Educational Interventions on Screening of Breast Cancer in Women: A Systematic Review and Meta-Analysis. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:219-236. [PMID: 31488039 DOI: 10.1177/0272684x19862148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Screening plays an essential role in the reduction of mortality and morbidity of breast cancer, which is one of the most common cancers in women worldwide. The aim of this study was to find out whether the use of health education model and theory-based behavioral interventions is effective in women’s breast cancer screening behavior. Applying different search strategies, we searched electronic databases including PubMed, ScienceDirect, Web of Science, and Scopus without time limit from January 12 to March 11, 2017. Keywords included “Breast neoplasm,” Screening,” “Women,” and “Health Education.” First, screening was conducted based on title, abstract, and full text. Then, the studies were screened according to the selection criteria of our study. The relevant and eligible studies were critically appraised by Delphi checklist. In addition, a meta-analysis of eligible studies was conducted with the random-effect approach. Twenty-six of 8,620 initial studies (with sample size of 10,681 in the intervention group and 8,854 in the control group) were included in the final analysis. The results of the meta-analysis showed that the probability of screening behavior in the intervention group is 1.4 times of that in the control group. Furthermore, subgroup analysis by the type of screening behavior indicates that the probabilities of conducting breast self-examination and mammography in the intervention group are 1.9 and 1.4 times of those in the control group. The health education program has a significant impact on breast cancer screening behaviors, particularly breast self-examination. Thus, given the positive effects of the educational screening programs in women, it is suggested that these programs must be continuously pursued with long-term follow-up and increasing rates of screening behaviors should be monitored.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Iran
| | - Majid Barati
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Leila Moaddabshoar
- Department of Radiation Oncology, School of Medicine, Hamadan University of Medical Sciences, Iran
| | - Mitra Dogonchi
- Department of public health, School of Public Health, Hamadan University of Medical Sciences, Iran
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12
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Saei Ghare Naz M, Simbar M, Rashidi Fakari F, Ghasemi V. Effects of Model-Based Interventions on Breast Cancer Screening Behavior of Women: a Systematic Review. Asian Pac J Cancer Prev 2018; 19:2031-2041. [PMID: 30139040 PMCID: PMC6171373 DOI: 10.22034/apjcp.2018.19.8.2031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/23/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Breast cancer is a great concern for women’s health; early detection can play a key role in reducing associated morbidity and mortality. The objective of this study was to systematically assess the effectiveness of model-based interventions for breast cancer screening behavior of women. Methods: We searched Scopus, PubMed, Web of Science, Science Direct, Cochrane library and Google scholar search engines for systematic reviews, clinical trials, pre- and post-test or quasi-experimental studies (with limits to publication dates from 2000-2017), Keywords were: breast cancer, screening, systematic review, trials, and health model. In this review, qualitative analysis was used to assess the heterogeneity of data. Results: Thirty six articles with 17,770 female participants were included in this review. The Health belief model was used in twenty three articles as the basis for intervention. Two articles used both the Health belief model and the Health Promotion Model, 5 articles used Health belief model and The Trans theoretical Model, 2 used Hthe ealth belief model and Theory planned behavior, 2 used the Health belief model and the Trans theoretical Model, 2 used the Trans theoretical Model, 1 used social cognitive theory, and 1 used Systematic Comprehensive Health Education and Promotion Model. The results showed that model-based educational interventions are more effective for BSE and CBE and mammography screening behavior of women compare to no model based intervention. The Health belief model was the most popular model for promoting breast cancer screening behavior. Conclusions: Educational model-based interventions promote self-care and create a foundation for improving breast cancer screening behavior of women and increase policy makers’ awareness and efforts towards its enhancement breast cancer screening behavior.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Student Research committee, School of Nursing and Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
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13
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Safizadeh H, Hafezpour S, Mangolian Shahrbabaki P. Health Damaged Context: Barriers to Breast Cancer Screening from Viewpoint of Iranian Health Volunteers. Asian Pac J Cancer Prev 2018; 19:1941-1949. [PMID: 30051677 PMCID: PMC6165652 DOI: 10.22034/apjcp.2018.19.7.1941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Breast cancer is common among cancer diseases and the second leading cause of death among women worldwide. The breast cancer-caused death is directly associated with diagnosis time of the disease. Screening is one of the major methods for health promotion in human societies. However, many women still refuse to do the periodic screening. The present study is aimed to analyze the experiences of health volunteers in order to understand the barriers to breast cancer screening among women at southeast of Iran. Methods Data collection was performed through focus groups. Using the purposive sampling method, 24 participants were selected and then were allocated to 6-member groups. The data were analysed using Lundman and Graneheim qualitative content analysis. Results The main theme of “Health Damage Context” was extracted with four main categories, including: family barriers, cultural and social barriers, personal barriers and organizational barriers. Conclusion Based on the results of the present study, there are numerous barriers to regular breast cancer screening, and for the same reasons, the willingness to screening is sometimes not satisfactory. Therefore, in case of the women’s referral to health centers, nurses and other health-care professionals should inform them about the role of different screening methods in early diagnosis and rapid treatment of breast cancer.
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Affiliation(s)
- Hossein Safizadeh
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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14
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Salinas JJ, Byrd T, Martin C, Dwivedi AK, Alomari A, Salaiz R, Shokar NK. Change in Breast Cancer Screening Knowledge is Associated With Change in Mammogram Intention in Mexican-Origin Women After an Educational Intervention. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2018; 12:1178223418782904. [PMID: 29977113 PMCID: PMC6024335 DOI: 10.1177/1178223418782904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Purpose: To determine the relationship between breast cancer screening knowledge and intent to receive a mammogram within 6 months in a sample of Mexican-origin women living in El Paso, Texas. Methods: A total of 489 uninsured Mexican-origin women were assigned to treatment or control and completed surveys at pre- and postintervention. Pre-post associations between breast cancer screening knowledge and intent were tested. Results: Participants were on average were 56.7 years of age and spoke primarily Spanish (92.6%). Most of the samples had not had a mammogram in 3 or more years (51.6%) and 14.6% had never had a mammogram. At baseline, the majority intended to be screened for breast cancer within the next 6 months (93.4%). At postintervention, half of the intervention group changed their 6-month intent to be screened for breast cancer from likely to unlikely. Change in intent was associated with a change in knowledge of risk of having a first child by the age of 30 and breast cancer being rare after the age of 70. Discussion: Intent to be screened for breast cancer in Mexican-origin women may be influenced by the type of knowledge. Conclusions: Change in screening knowledge may influence perceived risk that influences intention to be screened.
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Affiliation(s)
- Jennifer J Salinas
- Center of Emphasis in Cancer, Department of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.,Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Theresa Byrd
- Department of Public Health, Texas Tech Health University Sciences Center El Paso, El Paso, TX, USA
| | - Charmaine Martin
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Alok K Dwivedi
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Adam Alomari
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Rebekah Salaiz
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Navkiran K Shokar
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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15
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Winters S, Martin C, Murphy D, Shokar NK. Breast Cancer Epidemiology, Prevention, and Screening. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 151:1-32. [PMID: 29096890 DOI: 10.1016/bs.pmbts.2017.07.002] [Citation(s) in RCA: 285] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Globally, breast cancer is both the most commonly occurring cancer and the commonest cause of cancer death among women. Available data suggest that incidence and mortality in high-resource countries has been declining whereas incidence and mortality in low-resource countries has been increasing. This pattern is likely to be due to changing risk factor profiles and differences in access to breast cancer early detection and treatment. Risk factors for breast cancer include increasing age, race, menarche history, breast characteristics, reproductive patterns, hormone use, alcohol use, tobacco use, diet, physical activity, and body habitus. Mutations in the BRCA 1 and BRCA 2 tumor suppressor genes are significantly associated with the development of breast and ovarian cancer by the age of 70. Survival depends on both stage and molecular subtype. As there are few signs and symptoms early on, early detection is an important strategy to improve outcomes. Major professional organizations in the United States and elsewhere recommend screening with mammography with appropriate follow up for an abnormal screening test, although they differ somewhat by recommended ages and frequency of screening. Studies suggest a 15%-40% mortality reduction secondary to screening, however, there are also concerns about harms, such as overdiagnosis (5%-54%) and overtreatment leading to long term complications, and false negatives (6%-46%). Identification of women at risk for BRCA1 and BRCA 2 mutations is also recommended with referral for genetic testing. Preventive interventions, such as lifestyle, medical, and surgical options are available for women testing positive for BRCA mutations.
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Affiliation(s)
- Stella Winters
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Charmaine Martin
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Daniel Murphy
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Navkiran K Shokar
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States.
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16
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Hazavehei SMM, Ezzati Rastegar K, Dogonchi M, Salimi N, Gheisvandi E. The Impact of Educational Intervention Programs to Promoting Mammography Screening: A Systematic Review. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2017. [DOI: 10.21859/jech-03018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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