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Cartwright K, Kanda D, Kosich M, Sheche J, Leekity S, Edwardson N, Pankratz VS, Mishra SI. Breast cancer screening attitudes, beliefs, and behaviors of Zuni Pueblo women: identifying cornerstones for building effective mammogram screening intervention programs. Cancer Causes Control 2024; 35:583-595. [PMID: 37940784 PMCID: PMC10960741 DOI: 10.1007/s10552-023-01814-8] [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: 02/02/2023] [Accepted: 10/07/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE Breast cancer is the leading form of cancer and has the second highest mortality rate of cancers for American Indian/Alaska Native (AI/AN) women. Early screening is critical. This study examines the breast cancer-related knowledge, beliefs, and behaviors of Zuni women in the Southwest United States (U.S.). METHODS In 2020 and 2021, a survey was administered to better understand cancer screening patterns in Zuni Pueblo; 110 women from 50 to 75 years of age were recruited to respond to the breast cancer screening portion. Inclusion criteria included self-identifying as AI, a member of the Zuni tribe, or married to a Zuni tribal member, and meeting the age and gender requirements. Descriptive statistics and bivariate analyses were conducted examining the associations between measures of breast cancer knowledge, beliefs, and behaviors and breast cancer screening status (never, ever/non-compliant, and ever/compliant). RESULTS Of survey participants, 47.3% have had a breast cancer screening and are up-to-date, 39.1% have had a screening in the past but are not up-to-date, and 13.6% have never been screened. Age was the only statistically significant socioeconomic predictor of breast cancer screening; the median (interquartile range) ages of each group are 62 (54, 68) ever/compliant, 56 (54, 68) ever/non-compliant, and 53 (51, 55) never (p-value < 0.001). Significant differences by health status and access to medical care include having a regular health care provider and going to see a provider for routine check-ups. The survey also shows differences in knowledge about breast cancer risk factors, beliefs, and behaviors. Women across all three screening statuses reported that they would get screened if encouraged by a health care provider. CONCLUSION While survey respondents report a relatively high rate of ever having had a breast cancer screening, less than half are compliant with screening guidelines, which shows there is an opportunity to improve breast cancer screening rates. With culturally tailored interventions, providers have the potential to improve breast cancer screening for Zuni women.
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Affiliation(s)
- Kate Cartwright
- School of Public Administration, University of New Mexico, Albuquerque, NM, USA.
| | - Deborah Kanda
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Mikaela Kosich
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Judith Sheche
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Samantha Leekity
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Nicholas Edwardson
- School of Public Administration, University of New Mexico, Albuquerque, NM, USA
| | - V Shane Pankratz
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Shiraz I Mishra
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
- Departments of Pediatric and Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA
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Cartwright K, Kosich M, Gonya M, Kanda D, Leekity S, Sheche J, Edwardson N, Pankratz VS, Mishra SI. Cervical Cancer Knowledge and Screening Patterns in Zuni Pueblo Women in the Southwest United States. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1531-1538. [PMID: 37046142 PMCID: PMC10097513 DOI: 10.1007/s13187-023-02295-8] [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: 03/26/2023] [Indexed: 05/27/2023]
Abstract
American Indian women experience cervical cancer disparities, including later-stage diagnosis and a higher cervical cancer mortality rate. These disparities are interconnected and linked to cervical cancer screening disparities. Cervical cancer when identified early is highly treatable. Individual- and health system-level factors often contribute to gaps in cervical cancer screening. To better understand the source of these inequities experienced by American Indian women, specifically Zuni women, this paper examines how knowledge about cervical cancer and related risk factors is linked to cervical cancer screening for Zuni women using primary data gathered by the Zuni Health Initiative in 2020 and 2021. We find that of the women who completed the survey (n = 171), women with greater cervical cancer knowledge are statistically significantly more likely to have received cervical cancer screening. Closer examination of knowledge on the specific risk factors for cervical cancer provides evidence upon which to develop a cervical cancer education intervention.
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Affiliation(s)
- Kate Cartwright
- School of Public Administration, University of New Mexico, Albuquerque, NM USA
| | - Mikaela Kosich
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
| | - Madison Gonya
- School of Public Administration, University of New Mexico, Albuquerque, NM USA
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM USA
| | - Deborah Kanda
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
| | - Samantha Leekity
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
| | - Judith Sheche
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
| | - Nicholas Edwardson
- School of Public Administration, University of New Mexico, Albuquerque, NM USA
| | - V. Shane Pankratz
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM USA
| | - Shiraz I. Mishra
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM USA
- Departments of Pediatric and Family and Community Medicine, University of New Mexico, Albuquerque, NM USA
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Roh S, Lee YS, Kenyon DB, Elliott AJ, Petereit DG, Gaba A, Lee HY. Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study. JMIR Form Res 2023; 7:e47851. [PMID: 37471115 PMCID: PMC10401399 DOI: 10.2196/47851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains. OBJECTIVE This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure. METHODS Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention. RESULTS A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences. CONCLUSIONS This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations. TRIAL REGISTRATION ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.
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Affiliation(s)
- Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, SD, United States
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, United States
| | - DenYelle B Kenyon
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States
| | - Amy J Elliott
- Avera Research Institute, Avera Health, Sioux Falls, SD, United States
| | - Daniel G Petereit
- Monument Health Cancer Care Institute, Rapid City, SD, United States
| | - Anu Gaba
- Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND, United States
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, United States
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Afaya A, Japiong M, Konlan KD, Salia SM. Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: a national population-based cross-sectional survey. BMC Public Health 2023; 23:621. [PMID: 37004021 PMCID: PMC10067163 DOI: 10.1186/s12889-023-15443-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Breast cancer is a leading cause of cancer mortality and a major public health problem. The growing number of breast cancer-related deaths has been largely attributed to a lack of awareness of the disease among women. Whilst there have been frequent campaigns promoting breast cancer awareness, evidence suggests that women still lack awareness. Therefore, this study assessed the prevalence and factors associated with the awareness of breast cancer among women of reproductive age in Lesotho. METHODS We used population-based cross-sectional data from the 2014 Lesotho Demographic and Health survey. A total of 6,620 women of reproductive age were included in the analysis. The outcome variable was awareness of breast cancer. Women who heard about breast cancer were considered to be aware of the disease. Multilevel binary logistic regression models were fitted to determine the factors associated with breast cancer awareness among women. RESULTS The level of awareness of breast cancer was 86.8% (95% CI: 85.5, 87.9). Women aged 45-49 years [adjusted odds ratio (AOR) = 2.87, 95% confidence interval (CI): 1.83, 4.48], married women [AOR = 1.51 (95% CI: 1.19, 1.93)], and women with higher educational level [AOR = 12.56, (95% CI: 4.35, 36.28)] were more likely to be aware of breast cancer. Additionally, women who listened to the radio at least once a week [AOR = 1.96, (95% CI: 1.63, 2.37)], those who read newspapers or magazines [AOR = 1.91 (95% CI: 1.48, 2.46)] and women in the wealthiest group [AOR = 2.55, (95% CI: 1.67, 3.89)] had higher odds of breast cancer awareness. However, women who were in rural areas were less likely [AOR = 0.63, (95% CI: 0.47, 0.84)] to be aware of breast cancer than those in urban areas. CONCLUSION The level of awareness of breast cancer among women of reproductive age in Lesotho was extremely low. We recommend that policymakers, clinicians, and public health practitioners should consider the factors identified in this study when designing and developing intervention programs to improve the awareness of breast cancer among women in Lesotho.
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Affiliation(s)
- Agani Afaya
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Milipaak Japiong
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- School of Nursing, Faculty of Graduate Studies, York University, York, Canada
| | - Kennedy Diema Konlan
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
- Department of Public Health, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Solomon Mohammed Salia
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
- Graduate School of Medical Sciences, Research Institute SHARE, University of Groningen, Groningen, Netherlands.
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Roh S, Lee YS. Developing Culturally Tailored Mobile Web App Education to Promote Breast Cancer Screening: Knowledge, Barriers, and Needs Among American Indian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023:10.1007/s13187-022-02252-x. [PMID: 36631714 PMCID: PMC10366295 DOI: 10.1007/s13187-022-02252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
American Indian (AI) women face disproportionate rates of breast cancer mortality and cancer disparities. This study conducted qualitative research to assess perspectives of AI women towards breast cancer screening, knowledge, barriers, and needs about mobile web app-based education to promote breast cancer screening. This study, in collaboration with the Yankton Sioux Tribe (YST), followed a community-based participatory research approach and conducted two focus groups with a total of 22 YST women aged 40-70 years living on reservation in rural South Dakota. Each group consisted of 11 local professionals working in healthcare and social services and community members. A grounded theory was used for the qualitative analysis. A large portion of participants reported having prior knowledge about breast cancer and screening methods, yet lacked awareness of the detailed procedure and recommended guidelines. Competing priorities and cost of mammograms were noted as major barriers to screening. Participants wanted to learn-in a convenient and easy-to-understand manner-more about breast cancer and prevention from a credible source. Both groups were favorable toward novel educational tools, such as the mobile web app education, and cited potential health benefits, particularly for women aged 40s to 60s. Our findings highlighted the importance of creating effective, culturally tailored educational interventions built into programs specific to AIs to increase understanding about breast cancer screening and promote screening behaviors among AI women. Particular attention to how AIs' culture, beliefs, and barriers are implicated in screening behaviors could help with developing culturally tailored health education tools for this population.
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Affiliation(s)
- Soonhee Roh
- Department of Social Work, University of South Dakota-Sioux Falls, 4801 North Career Ave, 145C, Sioux Falls, SD, 57107, USA.
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, 1600 Holloway Avenue, HSS 216, San Francisco, CA, 94132, USA
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Kayan S, Cinar IO. An examination of variables associated with breast cancer early detection behaviors of women. Afr Health Sci 2022; 22:133-144. [PMID: 36910411 PMCID: PMC9993324 DOI: 10.4314/ahs.v22i3.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Breast cancer is a worldwide common public health problem, and it is quite important to know the factors preventing the early detection behaviors to fight against it. Objective The aim of the study was to examine the effect of some sociodemographic variables associated with women's breast cancer detection behaviors and their breast cancer knowledge and fear levels. Methods The cross-sectional study was conducted with 363 women aged 40-69 who had presented to Cancer Early Diagnosis and Education Centers (CEDEC). Results The average age of women is 54.8±7.1. The mean score of breast cancer knowledge (CBCKT) was found as 10.72±2.34, and the breast cancer fear score was found as 27.6±6.5. The percentage of women who regularly breast self-examination (BSE) was 17.4%, clinical breast examination (CBE) was 13.5% and mammography was 42.7%. BSE and having a higher education correlated 6.25-fold. A 6.5-fold correlation was found between BSE and having a family history of breast cancer, and a 6.24-fold correlation between BSE and having information about breast cancer. In CBE, the related variables that affected women receiving information 4.42 times and going to CEDEC 5.3 times. It was found that employment (4.58) of women affected the mammography detection behavior mostly. While women's CBCKT score affected BSE behavior 1.16 times, fear of breast cancer was a variable that affected mammography behavior 2.1 times. It was determined that high CBCKT scores of women increased BSE behaviors 1.16 times, and high breast cancer fear scores increased mammography behavior 2.1 times. Conclusions Early detection practices of women are not sufficient in our study. An increase in the knowledge level of women and consideration of the variables determined to be effective in early detection behaviors will allow increasing detection behavior.
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Affiliation(s)
- Sultan Kayan
- Faculty of Health Science, Public Health Nursing Department, Bilecik Seyh Edebali University, Bilecik, Turkey
| | - Ilgun Ozen Cinar
- Faculty of Health Science, Public Health Nursing Department, Pamukkale University, Denizli, Turkey
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Comparison of Study Quality as Determined by Standard Research and Community Engagement Metrics: A Pilot Study on Breast Cancer Research in Urban, Rural, and Remote Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095008. [PMID: 35564401 PMCID: PMC9102080 DOI: 10.3390/ijerph19095008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
The purpose of this review is to compare research evaluation tools to determine whether the tools typically used for assessing the quality of research adequately address issues of Indigenous health and culture, particularly when the studies are intended to benefit Indigenous peoples in urban, regional, rural, and remote settings. Our previously published systematic review evaluated studies about breast cancer using a modified Indigenous community engagement tool (CET). In this study, we evaluated the same studies using two commonly used tools: the Critical Appraisal Skills Programme (CASP) for qualitative research; and the Effective Public Health Practice Project (EPHPP) for quantitative research. The results were then compared to ascertain whether there was alignment between performances in terms of engagement and the CASP/EPHPP metrics. Of the 15 papers, 3 papers scored weakly on both metrics, and are therefore the least likely to offer reliable findings, while 2 papers scored strongly on both metrics, and are therefore the most likely to offer reliable findings. Beyond this summation, it was clear that the results did not align and, therefore, could not be used interchangeably when applied to research findings intended to benefit Indigenous peoples. There does not appear to be a pattern in the relationship between the reliability of the studies and the study settings. In order to address disparities in health outcomes, we must assess research through a typical research quality and cultural engagement and settings lens, ensuring that there is rigour in all aspects of the studies.
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Christie V, Green D, Amin J, Pyke C, Littlejohn K, Skinner J, McCowen D, Gwynne K. What Is the Evidence Globally for Culturally Safe Strategies to Improve Breast Cancer Outcomes for Indigenous Women in High Income Countries? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116073. [PMID: 34199955 PMCID: PMC8200222 DOI: 10.3390/ijerph18116073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/13/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022]
Abstract
The aim was to systematically assess the evidence on whether cultural safety affects breast cancer outcomes with regards to care for Indigenous women in high income countries. We conducted a systematic review in accordance with PRISMA guidelines of peer-reviewed articles in Medline, EMBASE, CINAHL, Scopus, Web of Science, Proquest Sociology and Informit Rural health database and Indigenous collection databases. Key inclusion criteria were: adult female patients with breast cancer; high income country setting; outcome measure, including screening, diagnosis, treatment and follow up care. A total of 15 were selected. We developed a Community Engagement assessment tool in consultation with aboriginal researchers, based on the National Health and Medical Research Councils' community engagement guidelines, against which studies were appraised. This novel element allowed us to evaluate the literature from a new and highly relevant perspective. Thematic analysis of all 15 studies was also undertaken. Despite limited literature there are evidence-based strategies that are likely to improve outcomes for Indigenous women with breast cancer in high income countries and indicate that culture makes a positive difference. It is also clear that strong Indigenous community leadership and governance at all stages of the research including design is an imperative for feasibility.
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Affiliation(s)
- Vita Christie
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
- Poche Centre for Indigenous Health, The University of Sydney, Sydney 2006, Australia;
- Correspondence:
| | - Debbie Green
- Armajun Aboriginal Health Service, Armidale 2350, Australia; (D.G.); (D.M.)
| | - Janaki Amin
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
| | - Christopher Pyke
- Foundation for Breast Cancer Care, South Brisbane 4101, Australia; (C.P.); (K.L.)
| | - Karen Littlejohn
- Foundation for Breast Cancer Care, South Brisbane 4101, Australia; (C.P.); (K.L.)
| | - John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Sydney 2006, Australia;
| | - Deb McCowen
- Armajun Aboriginal Health Service, Armidale 2350, Australia; (D.G.); (D.M.)
| | - Kylie Gwynne
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (J.A.); (K.G.)
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McKinley CE, Roh S, Lee YS. American Indian Alcohol Use from a Sex-Specific Wellness Approach: Exploring Its Associated Physical, Behavioral, and Mental Risk and Protective Factors. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:32-48. [PMID: 32780658 PMCID: PMC7790549 DOI: 10.1080/26408066.2020.1799648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The top causes of death for American Indians (AIs), including heart and liver disease, are associated with alcohol use. Using the culturally based Framework of Historical Oppression, Resilience, and Transcendence (FHORT), the purpose of this article was to examine AI alcohol use from a sex-specific wellness approach, exploring its associated physical, behavioral, and mental risk and protective factors. METHOD Data were drawn from a cross-sectional survey with 479 AI adults in South Dakota. We employed a series of multiple hierarchical regression analyses to assess the associations of demographic (sex, age, marital status, income, and educational attainment), physical (Body Mass Index and cardiovascular risk), behavioral (smoking and health self-efficacy) and mental (depressive symptoms) factors with alcohol use. RESULTS Results indicated that surveyed males tended to drink three times that of females, and depressive symptoms were associated with higher levels of alcohol use. DISCUSSION This study highlights the need to examine AI alcohol use with sex in mind.
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Affiliation(s)
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, 365 Health Science Center, Sioux Falls, SD, USA
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, USA
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Sbaity E, Bejjany R, Kreidieh M, Temraz S, Shamseddine A. Overview in Breast Cancer Screening in Lebanon. Cancer Control 2021; 28:10732748211039443. [PMID: 34538124 PMCID: PMC8450617 DOI: 10.1177/10732748211039443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.
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Affiliation(s)
- Eman Sbaity
- Division of General Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rachelle Bejjany
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Malek Kreidieh
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sally Temraz
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Panahi R, Namdar P, Siboni FS, Fallah S, Anbari M, Dehghankar L, Yekefallah L, Shafaei M. Association between health literacy and adopting preventive behaviors of breast cancer in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:241. [PMID: 33209933 PMCID: PMC7652072 DOI: 10.4103/jehp.jehp_313_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Health literacy plays an important role in adopting preventive behaviors. Considering the relatively high prevalence of breast cancer in women, this study aimed to assess the association between health literacy and adopting the preventive behavior of breast cancer in Iran. METHODS This was a descriptive, cross-sectional study, in which 375 female students at Imam Khomeini International University in Qazvin in the academic year of 2018-2019 were selected through a stratified random sampling method. Demographic and background questionnaire, the standard questionnaire of Health Literacy for Iranian Adults in addition to another questionnaire for measuring breast cancer preventive behaviors, were used for collecting data. Data were analyzed using SPSS 22 using descriptive statistics and logistic regression. RESULTS The mean of the breast cancer preventive behaviors and health literacy were 8.92 ± 1.82 out of 16 and 70.80 ± 12.49 out of 100. Regression results showed that there was a statistically significant association between the adoption of breast cancer preventive behaviors and physical activity (P < 0.001) and health literacy (P < 0.018). Accordingly, the chance for adopting the preventive behaviors in good level among students with rare and without physical activity was 0.105 and 0.100 times, respectively, more than students who had been doing physical activity on a daily basis. Moreover, the same chance among students with adequate and very adequate health literacy was 1.802 and 2.169 times more than students with inadequate health literacy. CONCLUSION The results indicated that students with lower levels of health literacy and less physical activity had shown less tendency to adopt preventive behaviors of breast cancer. Therefore, special attention should be paid to health literacy (HL), particularly physical activity, application of health information, and assessment in students when designing educational programs to prevent breast cancer.
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Affiliation(s)
- Rahman Panahi
- Department of Health Education and Health Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Peyman Namdar
- Department of Emergency Medicine, Emergency Medicine Specialist, Metabolic Disease Research Center, Qazvin University of Medical Science, Qazvin, Iran
| | - Fatemeh Samiei Siboni
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Somayeh Fallah
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Anbari
- Department of Occupational Health, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Dehghankar
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Leili Yekefallah
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahya Shafaei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
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12
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Liu N, Li P, Wang J, Guo PP, Zhang XH, Yang S, Yu L, Zhang XM, Zhang W. Factors influencing breast cancer awareness: a cross-sectional study in China. J Comp Eff Res 2020; 9:679-689. [PMID: 32648473 DOI: 10.2217/cer-2020-0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: This study aimed to explore the factors that influence breast cancer awareness. Materials & methods: A community-based cross-sectional study was conducted between January and April 2019 in Changchun, Jilin Province, China. Results: A total of 274 women were recruited for this cross-sectional study. Participants had a moderate level of breast cancer awareness (median = 76.50 [68.75, 84.00]). Women in the action/maintenance stages reported higher breast cancer awareness (p = 0.044). Women's breast cancer awareness was positively associated with high health information literacy level, husbands' higher educational degrees, seeing doctors after detecting abnormal breast changes and living within a short distance from the nearest hospital. Conclusion: History of screening and higher health information literacy levels are important positive factors linked to higher breast cancer awareness.
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Affiliation(s)
- Na Liu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xiu-Min Zhang
- School of Public Health of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
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13
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Tarı Selçuk K, Avcı D, Yılmaz Dündar G, Mercan Y. Breast Cancer Screening Behaviors in Women Aged 40 Years and Over in a Semi-Urban Region in Turkey: Relationships with Health Beliefs. Healthcare (Basel) 2020; 8:healthcare8020171. [PMID: 32545805 PMCID: PMC7349266 DOI: 10.3390/healthcare8020171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/29/2022] Open
Abstract
In this study, we aimed to determine the breast cancer screening behavior of women and to investigate the relationship between health beliefs and screening behaviors. The study was cross-sectional. It was conducted between April 2017 and June 2017 with 416 women aged ≥40. The Sociodemographic Information Form and the Champion's Health Belief Model Scale were used to collect data. In the statistical analysis, the number, percentage, mean, standard deviation, Pearson chi-square test, and multivariate binary logistic regression analysis were used. The rates for participating women performing breast self-examination, having clinical breast examination, and undergoing mammography were 11.8%, 8.9%, and 11.3%, respectively. Perceived susceptibility, seriousness, self-efficacy, benefits, health motivation, and perceived barriers were found to have strong associations with screening behaviors (p < 0.05). In this study, we found that few women performed breast self-examination, had clinical breast examination and mammography. In the present study, women perceived barriers related to both performing breast self-examination and undergoing mammography.
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Affiliation(s)
- Kevser Tarı Selçuk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, 10200 Balıkesir, Turkey
- Correspondence:
| | - Dilek Avcı
- Nursing Department, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, 10200 Balıkesir, Turkey; (D.A.); (G.Y.D.)
| | - Gönül Yılmaz Dündar
- Nursing Department, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, 10200 Balıkesir, Turkey; (D.A.); (G.Y.D.)
| | - Yeliz Mercan
- Department of Health Management, Kırklareli University School of Health, 39000 Kırklareli, Turkey;
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14
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Abstract
American Indians and Alaska Natives (AIANs) have been documented as a population with high rates of cancer mortality in comparison to other racial and ethnic groups in the United States. During a time when other populations in the United States are experiencing improvements in cancer outcomes, cancer disparities in AIANs persist. The disparities in cancer outcomes in this diverse population can be attributed to a complex constellation of factors, which include access-to-care, economic, medical, and individual barriers, and mistrust and disenfranchisement.
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15
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Lee YS, Roh S, Moon H, Lee KH, McKinley C, LaPlante K. Andersen's Behavioral Model to Identify Correlates of Breast Cancer Screening Behaviors among Indigenous Women. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:117-135. [PMID: 32211512 PMCID: PMC7092411 DOI: 10.1080/26408066.2019.1650316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
This study examined predictive models of utilization of mammograms among Indigenous women adapting Andersen's behavioral model. Using a sample of 285 Indigenous women residing in South Dakota, nested logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. The results provide important implications for intervention strategies aimed at improving breast cancer screening and service use among Indigenous women.
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Affiliation(s)
- Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, California, USA
| | - Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, South Dakota, USA
| | - Heehyul Moon
- Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Kyoung Hag Lee
- School of Social Work, Wichita State University, Wichita, Kansas, USA
| | | | - Kathy LaPlante
- Department of Social Work, University of South Dakota, Sioux Falls, South Dakota, USA
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16
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Liu N, Wang J, Chen DD, Sun WJ, Zhang W. Tools for the assessment of breast cancer screening beliefs in women: a literature review. J Comp Eff Res 2019; 8:645-655. [PMID: 31298055 DOI: 10.2217/cer-2018-0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: This review aims to compare the development, characteristics and validity of three widely used breast cancer screening belief tools (the Champion's Health Belief Model Scale [CHBMS], the Breast Module of a Cancer Awareness Measures [BCAM] and the Breast Cancer Screening Beliefs Questionnaire [BCSBQ]). Materials & methods: Literature reports were retrieved from electronic databases, including PubMed, EMBASE, Web of Science and the Cochrane Library, and other references. All three tools had good reliability and validity. Certain significant differences between these tools should be noted. Results: CHBMS, BCAM and BCSBQ are valid and reliable instruments within certain populations. Due to the high heterogeneity among the targeted population, their characteristics and those of the instruments should be fully considered for clinical decision-making. Conclusion: The conclusion of this review contributes to the development of a more comprehensive and objective instruments based on the deficiencies of the existing studies.
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Affiliation(s)
- Na Liu
- Nursing School, Jilin University, Changchun, Jilin Province 130021, PR China
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin Province 130021, PR China
| | - Dan-Dan Chen
- Nursing School, Jilin University, Changchun, Jilin Province 130021, PR China
| | - Wei-Jia Sun
- Nursing School, Jilin University, Changchun, Jilin Province 130021, PR China
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin Province 130021, PR China
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17
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Easton SD, Roh S, Kong J, Lee YS. Childhood Sexual Abuse and Depression among American Indians in Adulthood. HEALTH & SOCIAL WORK 2019; 44:95-103. [PMID: 30809642 DOI: 10.1093/hsw/hlz005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
The present study investigated distal and proximal factors associated with depression among a sample of 479 American Indian (AI) adults in the Midwest. Distal factors included histories of childhood sexual abuse (CSA) and other childhood adversities. Proximal factors included levels of health self-efficacy and treatment for alcohol problems. The study also examined the moderating effect of treatment for alcohol problems on the relationship between CSA and depression. In model 1, results indicate that CSA was positively related to depression after controlling for demographic and background variables. In model 2, childhood adversities and treatment for alcohol problems were associated with increased depression in AI adults; CSA became nonsignificant. As a protective factor, level of health self-efficacy was negatively associated with depression. In model 3, treatment for alcohol problems magnified the effect of CSA on depression. These findings suggest that early traumatic experiences may have persistent, harmful effects on depression among AIs; one mechanism exacerbating the impact of CSA on depression is treatment for alcohol problems. Targeted interventions are needed to mitigate the long-term negative health effects of childhood trauma in this population and to strengthen proximal protective factors, such as health self-efficacy.
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Affiliation(s)
- Scott D Easton
- Scott D. Easton, PhD, ACSW, LMSW, is associate professor, School of Social Work, Boston College, Chestnut Hill, MA. Soonhee Roh, PhD, LMSW, is associate professor, Department of Social Work, University of South Dakota, Sioux Falls. Jooyoung Kong, PhD, MSW, is assistant professor, School of Social Work, University of Wisconsin, Madison. Yeon-Shim Lee, PhD, ACSW, is associate professor, School of Social Work, San Francisco State University. Data were collected with support from the University of South Dakota School of Health Sciences Seed Grants for the research of Dr. Soonhee Roh
| | - Soonhee Roh
- Scott D. Easton, PhD, ACSW, LMSW, is associate professor, School of Social Work, Boston College, Chestnut Hill, MA. Soonhee Roh, PhD, LMSW, is associate professor, Department of Social Work, University of South Dakota, Sioux Falls. Jooyoung Kong, PhD, MSW, is assistant professor, School of Social Work, University of Wisconsin, Madison. Yeon-Shim Lee, PhD, ACSW, is associate professor, School of Social Work, San Francisco State University. Data were collected with support from the University of South Dakota School of Health Sciences Seed Grants for the research of Dr. Soonhee Roh
| | - Jooyoung Kong
- Scott D. Easton, PhD, ACSW, LMSW, is associate professor, School of Social Work, Boston College, Chestnut Hill, MA. Soonhee Roh, PhD, LMSW, is associate professor, Department of Social Work, University of South Dakota, Sioux Falls. Jooyoung Kong, PhD, MSW, is assistant professor, School of Social Work, University of Wisconsin, Madison. Yeon-Shim Lee, PhD, ACSW, is associate professor, School of Social Work, San Francisco State University. Data were collected with support from the University of South Dakota School of Health Sciences Seed Grants for the research of Dr. Soonhee Roh
| | - Yeon-Shim Lee
- Scott D. Easton, PhD, ACSW, LMSW, is associate professor, School of Social Work, Boston College, Chestnut Hill, MA. Soonhee Roh, PhD, LMSW, is associate professor, Department of Social Work, University of South Dakota, Sioux Falls. Jooyoung Kong, PhD, MSW, is assistant professor, School of Social Work, University of Wisconsin, Madison. Yeon-Shim Lee, PhD, ACSW, is associate professor, School of Social Work, San Francisco State University. Data were collected with support from the University of South Dakota School of Health Sciences Seed Grants for the research of Dr. Soonhee Roh
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