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Kemp D, Jacobs EA, Kvale E, Shokar NK, Sebastian K, Benzer JK, Woods Bennett JM. Evaluating the persuasiveness of messages promoting mobile mammography among uninsured women. HEALTH EDUCATION RESEARCH 2024; 39:331-338. [PMID: 38394465 DOI: 10.1093/her/cyae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/12/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Mobile mammography units (MMUs) can enhance access to breast cancer screening by providing convenient, cost-effective service, particularly for uninsured and underinsured women. However, prior studies indicate that acceptability concerns about quality and privacy, among other issues, may prevent women from utilizing MMUs. The current study employs a within-participant experimental design exposing participants to messages about different MMU characteristics to determine which characteristics are most effective in persuading them to use an MMU. The study also examined how messaging interacts with participants' ethnic identity to influence outcomes. Data were collected from a diverse sample of uninsured and underinsured women as part of a formative study to promote the utilization of a mobile mammography facility in Central Texas. Results of mixed-effect linear models show that messages about equity, appointment convenience, privacy and comfort, and quality of equipment and staff were rated as more persuasive than messages about convenience of location and language accessibility. However, Hispanic women rated language accessibility higher than other participants did. The results can guide MMU organizers and promotion managers as they determine the best approach to promote mobile mammography services in different communities.
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Affiliation(s)
- Deena Kemp
- Stan Richards School of Advertising & Public Relations, Moody College of Communication, The University of Texas at Austin, 300 W Dean Keeton St. (A1200), DMC 4.338, Austin, TX 78712, USA
| | - Elizabeth A Jacobs
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, 1601 Trinity St., BLDG B STOP Z0900, Austin, TX 78712, USA
| | - Elizabeth Kvale
- Geriatrics and Palliative Medicine, Baylor College of Medicine, 6501 Fannin St, Suite NC100, Houston, TX 77030, USA
| | - Navkiran K Shokar
- Department of Population Health, Dell Medical School, The University of Texas at Austin, 1601 Trinity St., BLDG B STOP Z0500, Austin, TX 78712, USA
| | - Katherine Sebastian
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, 1601 Trinity St., BLDG B STOP Z0900, Austin, TX 78712, USA
| | - Justin K Benzer
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, 1601 Trinity St., BLDG B STOP Z0600, Austin, TX 78712, USA
- VISN 17 Center of Excellence for Research on Returning War Veterans, Veterans Health Administration, 4800 Memorial Boulevard, Waco, TX 76711, USA
| | - Joy Melody Woods Bennett
- Department of Communication Studies, Moody College of Communication, The University of Texas at Austin, 2504A Whitis Ave. (A1105), Austin, TX 78712-0115, USA
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Jolidon V, De Prez V, Bracke P, Cullati S, Burton-Jeangros C. Lack of social support, gender and colorectal cancer screening participation across Europe: How do screening programmes mitigate the effect of social support for men and women? SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:1212-1237. [PMID: 38761366 DOI: 10.1111/1467-9566.13791] [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] [Received: 02/02/2023] [Accepted: 04/16/2024] [Indexed: 05/20/2024]
Abstract
This study investigates how a lack of social support differentially affects men and women's colorectal cancer (CRC) screening participation, considering different screening strategies implemented across European countries. Although health sociology has stressed gender differences in social support and its effects on health behaviours, this was overlooked by cancer screening research. Using a data set of 65,961 women and 55,602 men in 31 European countries, we analysed the effect of social support variables on CRC screening uptake. We found that living alone and lower perceived social support were associated with lower screening uptake for both men and women. These effects were, however, stronger among men. Population-based screening programmes mitigated these effects, particularly for women, but not for men living alone. In countries with opportunistic screening programmes, social support variables remained associated with screening uptake. We conclude that cancer screening interventions should pay attention to social support and its gender-differentiated effects.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
| | - Vincent De Prez
- Department of Sociology, Ghent University, Ghent, Belgium
- Health Services Research, Sciensano, Brussels, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Stéphane Cullati
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
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Nguyen DL, Grimm LJ, Nelson JS, Johnson KS, Ghate SV. Screening the Implant-Augmented Breast with Digital Breast Tomosynthesis: Is Tomosynthesis Necessary for Non-implant-Displaced Views? JOURNAL OF BREAST IMAGING 2024; 6:261-270. [PMID: 38703091 PMCID: PMC11129616 DOI: 10.1093/jbi/wbae021] [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: 10/31/2023] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To determine cancer visualization utility and radiation dose for non-implant-displaced (ID) views using standard protocol with digital breast tomosynthesis (DBT) vs alternative protocol with 2D only when screening women with implant augmentation. METHODS This retrospective cohort study identified women with implants who underwent screening DBT examinations that had abnormal findings from July 28, 2014, to December 31, 2021. Three fellowship-trained breast radiologists independently reviewed examinations retrospectively to determine if the initially identified abnormalities could be visualized on standard protocol (DBT with synthesized 2D (S2D) for ID and non-ID views) and alternate protocol (DBT with S2D for ID and only the S2D images for non-ID views). Estimated exam average glandular dose (AGD) and associations between cancer visualization with patient and implant characteristics for both protocols were evaluated. RESULTS The study included 195 patients (mean age 55 years ± 10) with 223 abnormal findings. Subsequent biopsy was performed for 86 abnormalities: 59 (69%) benign, 8 (9%) high risk, and 19 (22%) malignant. There was no significant difference in malignancy visualization rate between standard (19/223, 8.5%) and alternate (18/223, 8.1%) protocols (P = .92), but inclusion of the DBT for non-ID views found one additional malignancy. Total examination AGD using standard protocol (21.9 mGy ± 5.0) was significantly higher than it would be for estimated alternate protocol (12.6 mGy ± 5.0, P <.001). This remained true when stratified by breast thickness: 6.0-7.9 cm, 8.0-9.9 cm, >10.0 cm (all P <.001). CONCLUSION The inclusion of DBT for non-ID views did not significantly increase the cancer visualization rate but did significantly increase overall examination AGD.
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Affiliation(s)
- Derek L Nguyen
- Department of Radiology, Duke University School of Medicine, Durham, NCUSA
| | - Lars J Grimm
- Department of Radiology, Duke University School of Medicine, Durham, NCUSA
| | - Jeffrey S Nelson
- Department of Radiology, Duke University School of Medicine, Durham, NCUSA
| | - Karen S Johnson
- Department of Radiology, Duke University School of Medicine, Durham, NCUSA
| | - Sujata V Ghate
- Department of Radiology, Duke University School of Medicine, Durham, NCUSA
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Rossi J, Mullen LA, Oluyemi ET, Panigrahi B, Myers KS, DiCarlo P, Ambinder EB. Patient Utilization of Weekend and Evening Appointments for Screening Mammography: An 8-Year Observational Cohort Study. J Am Coll Radiol 2024:S1546-1440(24)00454-X. [PMID: 38797380 DOI: 10.1016/j.jacr.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To characterize the patient population using weekend and evening appointments for screening mammography versus standard appointment times across four outpatient facilities in our academic health system. METHODS In this institutional review board-approved retrospective cohort study, there were 203,101 screening mammograms from 67,323 patients who had a screening mammogram performed at outpatient centers at a multisite academic institution from January 1, 2015, to December 31, 2022. Screening appointments were defined as "standard appointment time" (between 8 am and 5 pm on Monday through Friday) or "weekend or evening appointment time" (scheduled after 5 pm on Monday through Friday or at any time on a Saturday or Sunday). Associations between appointment group and patient characteristics were analyzed using univariate and multivariate logistic regression. RESULTS Most screening mammograms (n = 185,436, 91.3%) were performed at standard times. The remainder (n = 17,665, 8.7%) were performed during weekends or evenings. As we created additional weekend and evening appointments after the coronavirus disease 2019 pandemic, the annual percentage of all screening mammograms performed on evenings and weekends increased. On multivariate analysis, when compared with standard appointment times, we found that patients who were younger than age 50 (P < .001), a race other than non-Hispanic White (P < .001), non-English speakers (P < .001), and from less advantaged zip codes (P < .03) were more likely to use weekend and evening appointment times compared with those aged 70 and above, non-Hispanic White patients, English speakers, and those from the most advantaged zip codes. CONCLUSIONS Weekend and evening appointment availability for screening mammograms might improve screening access for all patients, particularly for those younger than age 50, those of races other than non-Hispanic White, and those from less advantaged zip codes.
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Affiliation(s)
- Joanna Rossi
- Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Lisa A Mullen
- Breast Imaging Fellowship Director, Johns Hopkins University School of Medicine, Baltimore, Maryland; President, Maryland Radiological Society
| | - Eniola T Oluyemi
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Babita Panigrahi
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kelly S Myers
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Philip DiCarlo
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily B Ambinder
- Chief of Breast Imaging, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Hofvind S, Iqbal N, Thy JE, Mangerud G, Bhargava S, Zackrisson S, Berstad P. Effect of invitation letter in language of origin on screening attendance: randomised controlled trial in BreastScreen Norway. BMJ 2023; 382:e075465. [PMID: 37726122 PMCID: PMC10507477 DOI: 10.1136/bmj-2023-075465] [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] [Accepted: 08/24/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To explore attendance at organised mammographic screening among immigrant groups that received an invitation letter and information leaflet (invitation) in their language of origin and Norwegian compared with Norwegian only. DESIGN Randomised controlled trial. SETTING Population based screening programme for breast cancer in Norway (BreastScreen Norway), which invites women aged 50-69 to two-view mammographic screening biennially. PARTICIPANTS All women invited to BreastScreen Norway in the study period April 2021 to June 2022 whose language of origin was Arabic (women born in Algeria, Egypt, Lebanon, Iraq, Palestine, Sudan, Syria, Tunisia, or Morocco), English (women born in the Philippines), Polish (women born in Poland), Somali (women born in Somalia), or Urdu (women born in Pakistan) (n=11 347). INTERVENTION The study group received an invitation to screening in their language of origin and in Norwegian, whereas the control group received an invitation in Norwegian only during the study period. MAIN OUTCOME MEASURE Attendance at BreastScreen Norway during the study period. RESULTS Overall attendance was 46.5% (2642/5683) in the study group and 47.4% (2682/5664) in the control group. No statistical differences in attendance were observed after stratification by language of invitation, age at invitation, or years since immigration. CONCLUSIONS No difference in attendance was observed between immigrant women invited to BreastScreen Norway in their language of origin and in Norwegian compared with Norwegian only. Several barriers to cancer screening may exist among immigrants, and translating the invitation is probably only a part of a complex explanation. TRIAL REGISTRATION NCT04672265. CLINICALTRIALS gov NCT04672265.
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Affiliation(s)
- Solveig Hofvind
- The Cancer Registry of Norway, Oslo, Norway
- Department of Health and Care Sciences, The Arctic University of Norway - the University of Tromsø, Tromsø, Norway
| | - Nadia Iqbal
- The Cancer Registry of Norway, Oslo, Norway
- Cancer Registry of Norway and Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Sameer Bhargava
- The Cancer Registry of Norway, Oslo, Norway
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Sophia Zackrisson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine, Lund University, Malmö, Sweden
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Ganguly AP, Baker KK, Redman MW, McClintock AH, Yung RL. Racial disparities in the screening mammography continuum within a heterogeneous health care system. Cancer 2023; 129:3171-3181. [PMID: 37691529 DOI: 10.1002/cncr.34632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/13/2022] [Accepted: 12/01/2022] [Indexed: 09/12/2023]
Abstract
BACKGROUND Decreased mammography drives breast cancer disparities. Black women have lower rates of mammography completion than White women, and this contributes to disparities in outcomes. Points of disparity along the continuum for screening mammography remain underresearched. METHODS The authors compared mammography referrals for Black and White women aged 40-74 years at a heterogeneous academic medical center. Completion of steps of the screening mammography continuum was compared between Black and White women within two age cohorts: 40-49 and 50-74 years. Multivariable logistic regression was used to evaluate the association between race and mammogram completion. RESULTS Among 26,476 women, 3090 (12%) were Black, and 23,386 (88%) were White. Among Black women aged 50-74 years who were due for mammography, 40% had referrals, 39% were scheduled, and 21% completed mammography; the corresponding values for White women were 42%, 41%, and 27%, respectively. Similar differences in referral outcomes were noted for women aged 40-49 years, although Black women had lower rates of provider-initiated referrals (9% vs. 13%). Adjusted analyses for those aged 40-49 and 50-74 years demonstrated an association between Black race and lower rates of mammography completion (odds ratio [OR] for 40-49 years, 0.74; 95% CI, 0.57-0.95; p = .02; OR for 50-74 years, 0.85; 95% CI, 0.74-0.98; p = .02). In multivariable analyses, noncommercial insurance and higher comorbidity were associated with lower rates of mammography. Provider-initiated referral was positively correlated to mammogram completion. CONCLUSIONS Black race was associated with 15%-26% lower mammography completion (adjusted). Both groups experienced the highest attrition after scheduling mammograms, although attrition was more precipitous for Black women. These findings have implications for future interventions, including increasing provider-initiated referrals and decreasing barriers to attending scheduled mammograms.
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Affiliation(s)
- Anisha P Ganguly
- Center for Innovation and Value, Parkland Health and Hospital System, Dallas, Texas, USA
- Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kelsey K Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mary W Redman
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Adelaide H McClintock
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Rachel L Yung
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, Washington, USA
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Mahmood A, Kedia S, Dillon PJ, Kim H, Arshad H, Ray M. Food security status and breast cancer screening among women in the United States: Evidence from the Health and Retirement Study and Health Care and Nutrition Study. Cancer Causes Control 2023; 34:321-335. [PMID: 36695824 DOI: 10.1007/s10552-023-01667-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/03/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE To assess the impact of food insecurity on biennial breast cancer screenings (i.e., mammography or breast X-ray) among older women in the United States (US). METHODS Data from the 2014 and 2016 waves of the Health and Retirement Study and the 2013 Health Care and Nutrition Study were used. The analyses were limited to a nationally representative sample of 2,861 women between 50 and 74 years of age, residing in the US. We employed a propensity score weighting method to balance observed confounders between food-secure and food-insecure women and fit a binary logistic regression to investigate population-level estimates for the association between food security and breast cancer screening. RESULTS Food insecurity was significantly associated with failure to obtain a mammogram or breast X-ray within the past two years. Food-insecure women had 54% lower odds of reporting breast cancer screening in the past 2 years (adjusted OR = 0.46; 95% CI 0.30-0.70, p-value < 0.001) as compared to food-secure women. Additional factors associated with a higher likelihood of receiving breast cancer screenings included greater educational attainment, higher household income, regular access to health care/advice, not smoking, and not being physically disabled or experiencing depressive symptoms. CONCLUSION Results demonstrate a socioeconomic gradient existing in regard to the utilization of regular breast cancer screenings among women. Those who tend to have lower education, lower income, and lack of reliable healthcare access are more likely to be food insecure. Thus, more likely to face the financial, logistical, or environmental barriers in obtaining screening services that accompany food insecurity.
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Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, 956 Court Avenue, Coleman A218A, Memphis, TN, 38163, USA. .,Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Hyunmin Kim
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hassan Arshad
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Meredith Ray
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN, USA
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The Potential of Adding Mammography to Handheld Ultrasound or Automated Breast Ultrasound to Reduce Unnecessary Biopsies in BI-RADS Ultrasound Category 4a: A Multicenter Hospital-Based Study in China. Curr Oncol 2023; 30:3301-3314. [PMID: 36975464 PMCID: PMC10047589 DOI: 10.3390/curroncol30030251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
The appropriate management strategies for BI-RADS category 4a lesions among handheld ultrasound (HHUS) remain a matter of debate. We aimed to explore the role of automated breast ultrasound (ABUS) or the second-look mammography (MAM) adjunct to ultrasound (US) of 4a masses to reduce unnecessary biopsies. Women aged 30 to 69 underwent HHUS and ABUS from 2016 to 2017 at five high-level hospitals in China, with those aged 40 or older also accepting MAM. Logistic regression analysis assessed image variables correlated with false-positive lesions in US category 4a. Unnecessary biopsies, invasive cancer (IC) yields, and diagnostic performance among different biopsy thresholds were compared. A total of 1946 women (44.9 ± 9.8 years) were eligible for analysis. The false-positive rate of category 4a in ABUS was almost 65.81% (77/117), which was similar to HHUS (67.55%; 127/188). Orientation, architectural distortion, and duct change were independent factors associated with the false-positive lesions in 4a of HHUS, whereas postmenopausal, calcification, and architectural distortion were significant features of ABUS (all p < 0.05). For HHUS, both unnecessary biopsy rate and IC yields were significantly reduced when changing biopsy thresholds by adding MAM for US 4a in the total population (scenario #1:BI-RADS 3, 4, and 5; scenario #2: BI-RADS 4 and 5) compared with the current scenario (all p < 0.05). Notably, scenario #1 reduced false-positive biopsies without affecting IC yields when compared to the current scenario for ABUS (p < 0.001; p = 0.125). The higher unnecessary biopsy rate of category 4a by ABUS was similar to HHUS. However, the second-look MAM adjunct to ABUS has the potential to safely reduce false-positive biopsies compared with HHUS.
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Chandra M, Yu R, Shete S. Association between employer-based health promotion programs and adherence to breast cancer screening in Texas. Prev Med Rep 2023; 32:102128. [PMID: 36846467 PMCID: PMC9945785 DOI: 10.1016/j.pmedr.2023.102128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
Breast cancer is the most common cancer diagnosed among women in Texas. Although adherence to recommended screening mammogram guidelines enables early detection and reduces breast cancer risks, screening mammogram adherence is low in Texas. With the rising percentage of women in the workforce, employer-based health promotion programs could be an effective measure in increasing mammogram adherence, thereby reducing breast cancer risk in Texas. Although employer-based health programs are common in the state, little is known about their effectiveness in increasing screening mammogram adherence among age-eligible employed females. The study survey was administered using Qualtrics and the study participants were representative of the Texas population. The study population included 318 females from Texas who were 50-74 years old. Among those who had access to employer-based health promotion programs, 65.4 % were adherent and 34.6 % were non-adherent to the guidelines. Population-weighted survey logistic regression analysis showed no significant association between access to employer-based health promotion programs and mammogram adherence for employed women (AOR: 0.85 [0.15-4.79], p-value = 0.86). However, access to healthcare coverage (AOR: 7.58 [2.89-19.88], p-value < 0.001), those who disagree with the fatalistic belief that everything causes cancer (AOR: 2.99 [1.45-6.19], p-value < 0.001), and those who perceive cancer screening important (AOR: 12.36 [2.26-67.47], p < 0.05) were found as significant determinants of mammogram adherence among females in Texas. The study concluded that access to employer-based health promotion programs alone was insufficient to improve breast cancer screening. The employers and the insurance companies, with support from the government, should develop a comprehensive program that addresses all structural and psychosocial barriers to employee breast cancer screening adherence.
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Affiliation(s)
- Monalisa Chandra
- Department of Epidemiology, UT MD Anderson Cancer Center, Houston TX, USA
| | - Robert Yu
- Department of Biostatistics, UT MD Anderson Cancer Center, Houston TX, USA
| | - Sanjay Shete
- Department of Epidemiology, UT MD Anderson Cancer Center, Houston TX, USA,Department of Biostatistics, UT MD Anderson Cancer Center, Houston TX, USA,Division of Cancer Prevention and Population Sciences, UT MD Anderson Cancer Center, Houston TX, USA,Corresponding author at: Department of Cancer Prevention and Population Sciences, UT MD Anderson Cancer Center, 1155 Pressler St, CPB8.3080, Houston TX 77030, USA.
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10
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Design and Psychometric Evaluation of Mammography Behavior Predicting Scale (MBPS). INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-123884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Breast cancer disease is an important public health trouble in the world. Over the past 2 decades, incidences of breast cancer among Iranian women have shown an alarmingly rapid increase. Mammography screening can lead to early detection and management of breast cancer and it also plays an important preventive role in decreasing breast cancer, especially among women over 40 years old. Objectives: This paper aims at reporting the psychometric properties of a questionnaire on mammography behavior based on health action process approach (HAPA) model. Methods: This cross-sectional study was performed between May and September 2017, and was attended by 400 women aged 40 years and older, in comprehensive health service centers in Iran. The research subjects were selected by multi-stage cluster sampling. The instrument was designed basis on the constructs of HAPA and current literature. The scale’s psychometric properties were examined by exploratory factor analysis (EFA), infraclass correlation coefficient (ICC), and Cronbach’s alpha. Results: The results showed 45 items of the questionnaire, 41 items had important item-to-total correlations (P < 0.05), and they were placed in 8 factors that contributed 60.88% of the scale variance. Conclusions: The research findings contribute to the reliability and validity of the HAPA model for predictively evaluating mammography goals.
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11
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Nichol BAB, Hurlbert AC, Read JCA. Predicting attitudes towards screening for neurodegenerative diseases using OCT and artificial intelligence: Findings from a literature review. J Public Health Res 2022; 11:22799036221127627. [PMID: 36310821 PMCID: PMC9597051 DOI: 10.1177/22799036221127627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Recent developments in artificial intelligence (AI) and machine learning raise the possibility of screening and early diagnosis for neurodegenerative diseases, using 3D scans of the retina. The eventual value of such screening will depend not only on scientific metrics such as specificity and sensitivity but, critically, also on public attitudes and uptake. Differential screening rates for various screening programmes in England indicate that multiple factors influence uptake. In this narrative literature review, some of these potential factors are explored in relation to predicting uptake of an early screening tool for neurodegenerative diseases using AI. These include: awareness of the disease, perceived risk, social influence, the use of AI, previous screening experience, socioeconomic status, health literacy, uncontrollable mortality risk, and demographic factors. The review finds the strongest and most consistent predictors to be ethnicity, social influence, the use of AI, and previous screening experience. Furthermore, it is likely that factors also interact to predict the uptake of such a tool. However, further experimental work is needed both to validate these predictions and explore interactions between the significant predictors.
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Affiliation(s)
- Beth AB Nichol
- Department of Social Work, Education,
and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK,Beth AB Nichol, Department of Social Work,
Education, and Community Wellbeing, Northumbria University, Coach Lane,
Newcastle upon Tyne NE7 7XA, UK.
| | - Anya C Hurlbert
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
| | - Jenny CA Read
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
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12
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Mert T. Evaluation of knowledge and practice regarding mammography among a group of Turkish women attending a tertiary hospital. Turk J Surg 2022; 38:230-236. [PMID: 36846069 PMCID: PMC9948670 DOI: 10.47717/turkjsurg.2022.5672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/17/2022] [Indexed: 03/01/2023]
Abstract
Objectives Early detection is the most important cornerstone of breast cancer in determining treatment outcome and survival. In this study, it was aimed to investigate the level of knowledge, attitude, and practice of mammography in the early diagnosis of breast cancer in a group of women. Material and Methods Data of this descriptive study were collected under observation with the help of a questionnaire. Female patients over 40 years of age or over 30 years of age with a family history of breast cancer admitted to our general surgery outpatient clinic for a health problem other than breast were included. Results A total of 300 female patients with a mean age of 48.7 ± 10.9 years (min-max, 33-83 years) were included. Median frequency of correct answers among the women participating in the study was 83.7% (76.0-92.0). Mean score obtained by the participants from the questionnaire was 75.7 ± 15.8 (the median score 80; 25th-75th centiles, 73.3-86.7). Slightly more than half of the patients (159 patients, 53%) had at least one mammography scan before. The level of mammography knowledge was negatively correlated with age and the number of previous mammographies, and positively correlated with education level (r= -0.700, p <0.001; r= -0.419, p <0.001 and r= 0.643, p <0.001, respectively). Conclusion Although the level of knowledge about breast cancer and early diagnosis methods in women was at a satisfactory level, it is obvious that mammography screening practice of women without any breast symptoms is very low. Therefore, it should be aimed to increase women's awareness of cancer prevention and compliance with early diagnosis methods and to promote participation in mammography screening.
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Affiliation(s)
- Tuba Mert
- Department of General Surgery, Pendik Medipol University Faculty of Medicine, İstanbul, Türkiye
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13
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Shirzadi S, Asghari-Jafarabadi M, Harrison MM, Allahverdipour H. Development and validation of the psychometric properties of the perceived barriers of mammography scale. Health Care Women Int 2022; 45:621-641. [PMID: 35587356 DOI: 10.1080/07399332.2021.1971671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 10/18/2022]
Abstract
We aimed to develop and test the psychometric properties of the Perceived Barriers of Mammography Scale (PBMS-23). Based on a mixed method design researchers generated item pool through qualitative data and literature review and next, 500 women ages 40 to 69 years completed the questionnaire. Based on exploratory and confirmatory Factor Analysis, 23 items, researchers revealed eight domains of fate and destiny, breast conflict, defense avoidance, inconveniences/difficulties of mammography screening, contrasting/competing priorities, fear, distrust of mammography, and lack of knowledge with appropriate fitness for the data. PBMS-23 is valid and reliable instrument for assessing perceived barriers of mammography.
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Affiliation(s)
- Shayesteh Shirzadi
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | | | | | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Jolidon V. Gender inequality and mammography screening: Does living with a partner improve women's mammography uptake? Soc Sci Med 2022; 298:114875. [PMID: 35276623 DOI: 10.1016/j.socscimed.2022.114875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/29/2022] [Accepted: 02/27/2022] [Indexed: 11/19/2022]
Abstract
Macrolevel gender inequality is defined as the unequal distribution of power and resources between men and women shaped by macrolevel social structures and institutions. An emerging line of health research is emphasising its negative consequences on women's health and healthcare access. The present study examines how gender inequality contexts affect women's mammography screening uptake. It adopts a macrosociological and institutionalist approach on preventive healthcare use and compares women who live with a partner with those who do not. This is the first study to test the effect of macrolevel gender inequality on mammography uptake across the 26 Swiss cantons (i.e. regions). The Swiss cantons' autonomy to manage their political and healthcare systems, as provided by the federal system, offers an ideal setting for the comparative analysis of macrolevel factors. Data on 9724 women aged 50-70 from the Swiss Health Interview Survey (waves 2007, 2012 and 2017) is analysed. Multilevel logistic models estimate two canton-level indicators of gender inequality, the gender gaps in time use and full-time employment, and their association with mammography uptake, controlling for women's socioeconomic and demographic characteristics, health status and healthcare use. Cross-level interactions assess how these indicators moderate the mammography uptake of women living with and without a partner. Results show that in cantons with higher gender inequality, women have a lower probability of mammography uptake. Women who live with a partner have a higher mammography uptake than those who do not. However, this advantage is moderated by canton-level gender inequality, namely, women who live with a partner in more gender unequal cantons have a lower mammography uptake than their counterparts who reside in more gender equal cantons. Results support the hypothesis that macrolevel gender inequality moderates women's preventive healthcare uptake, from an institutionalist approach.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, 40 Bd du Pont-d'Arve, 1205, Genève, Switzerland.
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15
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Ding L, Wang J, Greuter MJW, Goossens M, Van Hal G, de Bock GH. Determinants of Non-Participation in Population-Based Breast Cancer Screening: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:817222. [PMID: 35311110 PMCID: PMC8924365 DOI: 10.3389/fonc.2022.817222] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer (BC) screening can be performed in a screening program (BCSP) or in opportunistic screening. The existing reviews on the determinants of non-participation depend on self-reported data which may be biased. Furthermore, no distinction was made between the probably different determinants of both screening strategies. Objective To find the determinants of non-participation in BCSP by means of a meta-analysis. Methods PubMed, Embase, and Web of Science were searched for observational studies which quantified factors associated with non-participation in BCSP in a general population. Studies on opportunistic screening and studies using self-reported data were excluded. A random-effect model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by stratification of the results. Results Twenty-nine studies with in a total of 20,361,756 women were included. Low income (OR: 1.20, 95% CI: 1.10–1.30), low education (OR: 1.18, 95% CI: 1.05–1.32), living far from an assigned screening unit (OR: 1.15, 95% CI: 1.07–1.24), being immigrant (OR: 2.64, 95% CI: 2.48–2.82), and having a male family doctor (OR: 1.43, 95% CI: 1.20–1.61) was associated with higher non-participation in screening. Reminders sent to non-attenders and estimations of ORs (adjusted or not) partly explained substantial heterogeneity. Conclusion In this meta-analysis excluding studies on the non-participation in opportunistic screening, or with self-reported data on non-participation, the well-known determinants for non-participation are still significant, but less strong. This analysis only supports the relevance of meta-analysis of studies with registered non-participation in a BCSP. Systematic Review Registration PROSPERO, CRD42020154016.
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Affiliation(s)
- Lilu Ding
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - J Wang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - M J W Greuter
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Robotics and Mechatronics, University of Twente, Enschede, Netherlands
| | - M Goossens
- Center for Cancer Detection, Flanders, Belgium
| | - Guido Van Hal
- Center for Cancer Detection, Flanders, Belgium.,Department of Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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16
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Núñez ER, Caverly TJ, Zhang S, Glickman ME, Qian SX, Boudreau JH, Slatore CG, Miller DR, Wiener RS. Adherence to Follow-up Testing Recommendations in US Veterans Screened for Lung Cancer, 2015-2019. JAMA Netw Open 2021; 4:e2116233. [PMID: 34236409 PMCID: PMC8267608 DOI: 10.1001/jamanetworkopen.2021.16233] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Lung cancer screening (LCS) can reduce lung cancer mortality with close follow-up and adherence to management recommendations. Little is known about factors associated with adherence to LCS in real-world practice, with data limited to case series from selected LCS programs. OBJECTIVE To analyze adherence to follow-up based on standardized follow-up recommendations in a national cohort and to identify factors associated with delayed or absent follow-up. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study was conducted in Veterans Health Administration (VHA) facilities across the US. Veterans were screened for lung cancer between 2015 to 2019 with sufficient follow-up time to receive recommended evaluation. Patient- and facility-level logistic regression analyses were performed. Data were analyzed from November 26, 2019, to December 16, 2020. MAIN OUTCOMES AND MEASURES Receipt of the recommended next step after initial LCS according to Lung CT Screening Reporting & Data System (Lung-RADS) category, as captured in VHA or Medicare claims. RESULTS Of 28 294 veterans (26 835 [94.8%] men; 21 969 individuals [77.6%] were White; mean [SD] age, 65.2 [5.5] years) who had an initial LCS examination, 17 863 veterans (63.1%) underwent recommended follow-up within the expected timeframe, whereas 3696 veterans (13.1%) underwent late evaluation, and 4439 veterans (15.7%) had no apparent evaluation. Facility-level differences were associated with 9.2% of the observed variation in rates of late or absent evaluation. In multivariable-adjusted models, Black veterans (odds ratio [OR], 1.19 [95% CI, 1.10-1.29]), veterans with posttraumatic stress disorder (OR, 1.13 [95% CI, 1.03-1.23]), veterans with substance use disorders (OR, 1.11 [95% CI, 1.01-1.22]), veterans with lower income (OR, 0.88 [95% CI, 0.79-0.98]), and those living at a greater distance from a VHA facility (OR, 1.06 [95% CI, 1.02-1.10]) were more likely to experience delayed or no follow-up; veterans with higher risk findings (Lung-RADS category 4 vs Lung-RADS category 1: OR, 0.35 [95% CI, 0.28-0.43]) and those screened in high LCS volume facilities (OR, 0.38 [95% CI, 0.21-0.67]) or academic facilities (OR, 0.86 [95% CI, 0.80-0.92]) were less likely to experience delayed or no follow-up. In sensitivity analyses, varying how stringently adherence was defined, expected evaluation ranged from 14 486 veterans (49.7%) under stringent definitions to 20 578 veterans (78.8%) under liberal definitions. CONCLUSIONS AND RELEVANCE In this cohort study that captured follow-up care from the integrated VHA health care system and Medicare, less than two-thirds of patients received timely recommended follow-up after initial LCS, with higher risk of delayed or absent follow-up among marginalized populations, such as Black individuals, individuals with mental health disorders, and individuals with low income, that have long experienced disparities in lung cancer outcomes. Future work should focus on identifying facilities that promote high adherence and disseminating successful strategies to promote equity in LCS among marginalized populations.
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Affiliation(s)
- Eduardo R. Núñez
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - Tanner J. Caverly
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- University of Michigan School of Medicine, Ann Arbor
| | - Sanqian Zhang
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
- Department of Statistics, Harvard University, Cambridge, Massachusetts
| | - Mark E. Glickman
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
- Department of Statistics, Harvard University, Cambridge, Massachusetts
| | - Shirley X. Qian
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - Jacqueline H. Boudreau
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - Christopher G. Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland
| | - Donald R. Miller
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - Renda Soylemez Wiener
- Center for Healthcare Organization & Implementation Research, Bedford VA Healthcare System, Bedford, Massachusetts
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
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17
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Jolidon V, Bracke P, Burton-Jeangros C. Macro-contextual determinants of cancer screening participation and inequalities: A multilevel analysis of 29 European countries. SSM Popul Health 2021; 15:100830. [PMID: 34141853 PMCID: PMC8184663 DOI: 10.1016/j.ssmph.2021.100830] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 11/05/2022] Open
Abstract
Background Little attention has been devoted to the role of macro-level determinants in preventive health inequalities, particularly in cancer screening participation. Research has evidenced inequalities in cancer screening uptake yet has mainly focused on the screening programmes’ moderating role at the macro-level. To address this gap, this study examines how welfare provision and healthcare system features modify cancer screening uptake and inequalities across European countries. Methods Data from 99 715 (Pap smear) and 54 557 (mammography) women in 29 countries from the European Health Interview Survey (EHIS) 2014 wave and Swiss Health Interview Survey (SHIS) 2012 wave was analysed. We estimated multilevel logistic regression models, including cross-level interactions, to examine whether social protection expenditure in particular policy areas and healthcare system characteristics explained cross-country differences in Pap smear and mammography uptake and inequalities. Results Main findings revealed that GP gatekeeping systems were associated with reduced screening uptake likelihood in both Pap smear and mammography, and so were stronger primary care systems in Pap smear, while higher expenditures on old age and survivors were associated with increased mammography uptake. Cross-level interactions showed that in countries with higher expenditures on sickness/healthcare, disability, social exclusion and public health, and a higher number of GPs, educational inequalities in both Pap smear and mammography uptake were smaller, while higher out-of-pocket payments had the opposite effect of increasing inequalities. Conclusions Overall, our results show that social protection policies and healthcare system features affect cancer screening participation. We conclude that institutional and policy arrangements interact with individuals’ (educational) resources and, through the (re)distribution of valued goods and resources at the macro level, these arrangements may contribute to enhancing preventive healthcare use and mitigating screening uptake inequalities. Welfare provision and healthcare system features affect Pap smear and mammography uptake. Social spending and healthcare features moderate inequalities in cancer screening uptake. Policymakers should consider macro-level factors for cancer screening strategies and programmes. Policies and institutions shape social determinants of preventive healthcare use.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, 40 Bd Du Pont-d'Arve, 1205, Genève, Switzerland
| | - Piet Bracke
- Department of Sociology, Ghent University, Korte Meer 5, 9000, Ghent, Belgium
| | - Claudine Burton-Jeangros
- Institute of Sociological Research, University of Geneva, 40 Bd Du Pont-d'Arve, 1205, Genève, Switzerland
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18
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A lay health worker intervention to improve breast and cervical cancer screening among Latinas in El Paso, Texas: A randomized control trial. Prev Med 2021; 145:106446. [PMID: 33548363 DOI: 10.1016/j.ypmed.2021.106446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION We examined the effectiveness of a lay health worker (promotora)-delivered intervention on increasing breast and cervical cancer screening among low-income, primarily uninsured Latinas living in El Paso, Texas. METHODS In 2015, Breast and Cervical Cancer Screening (BCCS) program promotoras recruited Latinas overdue for breast and/or cervical cancer screening in community settings. Promotoras consented eligible women and conducted baseline surveys before individually randomizing women into control (n = 313) or intervention (n = 314) groups. Control participants received printed material providing basic information about breast and cervical cancer screening.Intervention participants received promotora-delivered one-on-one breast and cervical cancer screening education followed by navigation calls, providing assistance to address personal and logistic barriers to accessing clinical services. We assessed breast and cervical cancer screening outcomes using a 6-month follow-up survey. Per protocol (PP) and intent to treat (ITT) analyses are reported. RESULTS At follow-up, among women in need of breast cancer screening, those in the intervention group were significantly more likely to complete a mammogram than those in the control group (PP: 53.4% vs. 40.1%, p = .013; ITT: 47.9% vs. 35.2%, p = .011). Among women in need of Pap screening, only intervention group women 50 years and older were more likely to complete a Pap screening compared with control group women (PP: 64.5% vs. 43.5%, p = .019). CONCLUSIONS A promotora-delivered behavioral intervention, embedded in a community-based organization, increased mammography uptake in all women and Pap uptake among women 50 years and older in a sample of low-income Latinas. NCT04397744.
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19
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Meadows RJ, Padamsee TJ. Financial constraints on genetic counseling and further risk-management decisions among U.S. women at elevated breast cancer risk. J Genet Couns 2021; 30:1452-1467. [PMID: 33749063 DOI: 10.1002/jgc4.1413] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 12/30/2022]
Abstract
Clinical guidelines recommend that women at high risk of breast cancer should consider various risk-management options, which remain widely underutilized. We conducted semi-structured, qualitative interviews with 50 high-risk women to understand how financial constraints affect use of genetic counseling, genetic testing, and further risk-management decisions. Inductive analyses revealed three categories of health-related financial constraint: (a) lack of insurance, (b) underinsurance, and (c) other financial constraints (e.g., medical debt, raising children, managing comorbidities). Various breast cancer risk-management actions were limited by these financial constraints, including genetic counseling, genetic testing, enhanced screening, and prophylactic surgeries. Women's narratives also identified complex relationships between financial constraint and perceptions of healthcare providers and insurance companies, particularly as related to bias, price transparency, and potential genetic discrimination. Results from this study have implications for further research and expansion of genetic counseling services delivery to more economically and racially diverse women.
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Affiliation(s)
- Rachel J Meadows
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.,Center for Outcomes Research, JPS Health Network, Fort Worth, TX, USA
| | - Tasleem J Padamsee
- Division of Health Services Management and Policy, College of Public Health and Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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20
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Emami L, Ghahramanian A, Rahmani A, Mirza Aghazadeh A, Onyeka TC, Nabighadim A. Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices. Nurs Open 2021; 8:890-899. [PMID: 33570277 PMCID: PMC7877223 DOI: 10.1002/nop2.696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/28/2020] [Accepted: 10/29/2020] [Indexed: 12/26/2022] Open
Abstract
AIM This study sought to investigate the beliefs, fear and awareness about breast cancer and mammography screening practices of women in Iran. METHODS This descriptive-correlational study was conducted at Tabriz, East Azerbaijan Province, northwest of Iran from February-July 2017. One hundred and fifty-two women aged 40 years and older, who were referred to 12 health centres for health services were selected via clustering sampling. Associations between variables and mammography screening practices were examined using bivariate and multivariate logistic regression analyses. Participants who had a mammogram within the last 24 months were compared with those who had none. Sociodemographic questionnaire, Champion's Breast Cancer Fear Scale, Champion's Health Belief Model Scale for Mammography Screening, Breast Cancer Awareness Scale and Powe Fatalism Inventory were the tools used for data gathering. RESULTS Just 38.2% of women reported having a mammogram within the last 24 months. Self-efficacy (OR = 5.36, B = 1.68, p < .001), susceptibility (OR = 2.83, B = 1.04, p < .001), motivation (OR = 2.11, B = 0.75, p = .024) and lower perceived barriers (OR = 0.25, B = -1.37, p < .001) were associated with being screened. Neither fatalistic belief nor awareness towards breast cancer was significant.
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Affiliation(s)
- Lida Emami
- Medical Surgical Department, Nursing and Midwifery FacultyIslamic Azad UniversityBonab BranchBonabIran
| | - Akram Ghahramanian
- Medical and Surgical Department, Nursing and Midwifery Faculty, Hematology and Oncology Research CenterTabriz University of Medical SciencesTabrizIran
| | - Azad Rahmani
- Medical Surgical Department, Nursing and Midwifery FacultyTabriz University of Medical SciencesTabrizIran
| | - Ahmad Mirza Aghazadeh
- Department of Basic sciencesParamedical FacultyTabriz University of Medical SciencesTabrizIran
| | - Tonia C. Onyeka
- Department of Anaesthesia/Pain & Palliative Care UnitMultidisciplinary Oncology CentreCollege of MedicineUniversity of NigeriaItuku‐Ozalla CampusEnuguNigeria
| | - Amirreza Nabighadim
- Department of UrologyUro‐Oncology Research CenterTehran University of Medical SciencesTehranIran
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21
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Patel MM, Parikh JR. Patient Diversity in Breast Imaging: Barriers and Potential Solutions. JOURNAL OF BREAST IMAGING 2021; 3:98-105. [PMID: 38424834 DOI: 10.1093/jbi/wbaa092] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Indexed: 03/02/2024]
Abstract
Recent reports have highlighted disparities in breast cancer care related to patient diversity. Breast radiologists represent the face of breast imaging and are key players in advocating for patients to reduce these disparities. Diversity-related barriers for breast imaging patients, as they journey from screening to survivorship, include impediments to access and quality of care, gaps in communication, and lack of knowledge in both providers and patients. Potential strategies for overcoming these specific barriers include "culturally tailored" nurse navigators, mobile mammography, improved communication, patient and provider education, and breast radiologist involvement in advocacy efforts promoting diversity. As current trends in recommendations and guidelines for breast imaging include more numerous and advanced imaging modalities, it is important to acknowledge and address diversity-related disparities.
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Affiliation(s)
- Miral M Patel
- The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
| | - Jay R Parikh
- The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
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22
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Moreira CB, Dahinten VS, Howard AF, Fernandes AFC. The Revised Champion's Health Belief Model Scale: Predictive Validity Among Brazilian Women. SAGE Open Nurs 2021; 6:2377960820940551. [PMID: 33415294 PMCID: PMC7774489 DOI: 10.1177/2377960820940551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/26/2020] [Accepted: 06/13/2020] [Indexed: 11/25/2022] Open
Abstract
Mammography screening is provided free of charge for the recommended target
population in Brazil but participation rates have remained low, and breast
cancer mortality has continued to increase. Thus, it is important to
identify factors that are associated with poor participation in mammography
screening so that service providers can target health promotion messages and
screening programs more effectively. Objective: To evaluate the
predictive validity of the Revised Champion’s Health Belief Model scale
(RCHBMS) for identifying women at high risk of not adhering to national
guidelines for mammography screening in Brazil. Methods: We
used a longitudinal survey design with a 1-year follow-up data from 194
women living in northeastern Brazil, in the city of Fortaleza, Ceará,
participants completed the RCHBMS at baseline, and mammography uptake was
measured 1 year later. Hierarchical logistic regression was used to
determine the predictive validity of the RCHBMS for identifying women who
had not adhered to recommendations for mammography screening, after
accounting for the women’s sociodemographic and clinical characteristics.
The sensitivity and specificity of various cut-off points were calculated to
determine the optimal cut-off point for identifying women at high risk of
not adhering to mammography screening guidelines. Results: Two
subscales of the RCHBMS uniquely predicted nonadherence: susceptibility and
barriers, along with race and family history of cancer. The total scale
score (with barriers reverse coded) was also highly predictive. For our
sample, using only the RCHBMS with a cutoff of ≤ 3.67 (out of a total
possible range of 1–5) yielded a high sensitivity and specificity for
predicting nonadherence. Conclusion: Study findings support the
validity and clinical utility of the RCHBM for identifying women at risk of
not adhering to national guidelines for mammography screening in Brazil.
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23
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Ding L, Jidkova S, Greuter MJW, Van Herck K, Goossens M, Martens P, de Bock GH, Van Hal G. Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade. Int J Equity Health 2020; 19:212. [PMID: 33246477 PMCID: PMC7694412 DOI: 10.1186/s12939-020-01323-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown. Objective To assess the determinants of BC screening coverage in Flanders. Methods Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type. Results Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P < 0.001) associated with more crowded households (OR: 3.797, 95% CI: 3.199–4.508), younger age, higher population densities (OR: 2.528, 95% CI: 2.455–2.606), a lower proportion of unemployed job seekers (OR: 0.641, 95% CI: 0.624–0.658) and lower use of dental care (OR: 0.969, 95% CI: 0.967–0.972). Conclusion Coverage rate of BC screening is not optimal in Flanders. Women with low SES that are characterized by younger age, living in a high population density area, living in crowded households, or having low dental care are less likely to be screened for BC in Flanders. If screened, they are more likely to be screened outside the BCSP.
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Affiliation(s)
- L Ding
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - S Jidkova
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Center for Cancer Detection, Flanders, Belgium
| | - M J W Greuter
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
| | - K Van Herck
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Center for Cancer Detection, Flanders, Belgium
| | - M Goossens
- Center for Cancer Detection, Flanders, Belgium
| | - P Martens
- Center for Cancer Detection, Flanders, Belgium
| | - G H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - G Van Hal
- Department of Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium.,Center for Cancer Detection, Flanders, Belgium
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24
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Moreira CB, Dahinten VS, Howard AF, Fernandes AFC, Schirmer J. Factors related to mammography adherence among women in Brazil: A scoping review. Nurs Open 2020; 8:2035-2049. [PMID: 34388860 PMCID: PMC8363398 DOI: 10.1002/nop2.706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/30/2020] [Accepted: 11/04/2020] [Indexed: 01/24/2023] Open
Abstract
AIM To explore and synthesize the literature on factors related to mammography screening adherence among women in Brazil. DESIGN A scoping review. METHODS We searched 11 databases for studies published between 2006-January 2020. All identified articles were screened, and data were extracted from eligible studies. We used the UK Government Social Research Service weight of evidence appraisal tool to appraise the quality of the included study. RESULTS From a total of 1,384 identified articles, 22 were retained. All included studies used quantitative, non-experimental methods and all but two studies used cross-sectional data. Quality of evidence varied across studies. We identified 41 factors that were investigated across the set of studies. Demographic and socio-economic factors were the most commonly investigated, with older age, urban residence, living in the southeast of Brazil, higher level of education, higher income and private health insurance most consistently associated with mammography adherence.
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Affiliation(s)
- Camila Brasil Moreira
- School of Nursing, Federal University of São Paulo, São Paulo, Brazil.,School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - V Susan Dahinten
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - A Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Janine Schirmer
- School of Nursing, Federal University of São Paulo, São Paulo, Brazil
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Al-Mousa DS, Alakhras M, Hossain SZ, Al-Sa'di AG, Al Hasan M, Al-Hayek Y, Brennan PC. Knowledge, Attitude and Practice Around Breast Cancer and Mammography Screening Among Jordanian Women. BREAST CANCER (DOVE MEDICAL PRESS) 2020; 12:231-242. [PMID: 33204150 PMCID: PMC7666976 DOI: 10.2147/bctt.s275445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/07/2020] [Indexed: 01/28/2023]
Abstract
Background Breast cancer is the most common occurring cancer in women worldwide. To guide current breast cancer screening program, the level of knowledge about breast cancer should be evaluated. This study aims to ascertain the level of breast cancer knowledge including risk factors, signs and symptoms, and early detection methods, especially mammography screening. Methods The study was conducted among 1353 Jordanian women from the public using a self-administered questionnaire. Responses to the knowledge test were summed for an overall knowledge score. Comparisons between socio-demographics and knowledge, attitude and practice were also measured using a Chi-square test. Results About 76% of participants were aware that breast cancer is the most common cancer among women in Jordan. About 53.7% of our participants were rated as having an intermediate level of knowledge regarding risk factors, and 44% were rated as having a good to an excellent level of knowledge about breast cancer signs and symptoms. The participants' level of education was the main factor identified as influencing the participants' knowledge of the risk factors, signs and symptoms, and knowledge of early detection methods of breast cancer. The study sample was rated as having an intermediate level of knowledge regarding mammography screening; however, their participation in this screening method was low. Conclusion Although Jordanian women had an acceptable level of knowledge of breast cancer, the screening rates for mammography were low. These findings suggest that there is a need to provide extra awareness programs for Jordanian women to improve their breast cancer knowledge and practice.
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Affiliation(s)
- Dana S Al-Mousa
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Maram Alakhras
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Syeda Z Hossain
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Amani G Al-Sa'di
- Technical Coordination and Consumer Education Section of the Jordanian Food and Drug Administration, Irbid 22110, Jordan
| | - Marwa Al Hasan
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Yazan Al-Hayek
- Medical Radiation Science, School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.,Faculty of Applied Health Sciences, The Hashemite University, Zarqa 13133, Jordan
| | - Patrick C Brennan
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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26
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Cadet T, Burke SL, Bakk L, Nedjat-Haiem FR, Schroepfer T. Attending to the Psychosocial Needs of Older Hispanic, Black and Non-Hispanic White Women and Their Breast Cancer Screening Behaviors. J Natl Med Assoc 2020; 113:342-350. [PMID: 34278988 DOI: 10.1016/j.jnma.2020.09.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer risk increases with age. Despite breast cancer screening guidelines, older minorities are less likely to obtain screenings. Many factors influence cancer screening participation, though the literature rarely examines factors influencing cancer screening in older adult minority populations. METHODS Using 2008 and 2012 waves of data from the Health and Retirement study, we examined and compared the relationships between psychosocial factors and breast screening participation among older African American, Hispanic and non-Hispanic White women. We utilized logistic regression to determine the influence of psychosocial factors (satisfaction with aging, religiosity, perceived control, emotions, purpose in life) in 2008 predicting breast cancer screening participation in 2012, given the increasing importance of understanding health behaviors as predicted by prior circumstances. While controlling for other variables, the major findings demonstrated that the odds of having a mammogram among Hispanics decreased as feelings that 'things were getting worse' with age intensified; and screening was more likely among Hispanic religious women. The odds of obtaining a mammogram increased with increasing purpose in life for Hispanics. CONCLUSIONS AND IMPLICATIONS These findings suggest the need for comprehensive geriatric assessments to understand the perspectives of older minority women, and provides formative data to inform shared decision-making interventions.
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Affiliation(s)
- Tamara Cadet
- Simmons University School of Social Work, Boston, MA, USA; Lecturer on Oral Health Policy and Epidemiology Harvard School of Dental Medicine, Oral Health Policy and Epidemiology.
| | - Shanna L Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, Miami, FL, USA
| | - Louanne Bakk
- School of Social Work, The University at Buffalo, Buffalo, NY, USA
| | | | - Tracy Schroepfer
- Hartford Geriatric Social Work Faculty Scholar, School of Social Work, University of Wisconsin-Madison, Madison, WI, USA
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Duong LT, Chen HM, Liu CY, Chiou PY. Factors affecting mammography screening behaviour among rural Vietnamese women. Eur J Cancer Care (Engl) 2020; 29:e13300. [PMID: 32851751 DOI: 10.1111/ecc.13300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/19/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To identify factors associated with mammography screening behaviour and its predictors among rural Vietnamese women. METHOD A predictive correlational study involving 120 women aged ≥ 40 years was conducted in the suburbs of Hanoi, Vietnam, in July 2018 by using Breast Cancer Awareness Measurement and the Champion Health Beliefs Model Scale. Mammography screening behaviour was assessed by asking participants about their previous mammography experience. RESULTS Only 16.7% of participants had undergone mammography screening. High education levels, high monthly family income, having family members or friends with breast cancer, and receiving physicians' recommendations increased the likelihood of participants screening for breast cancer. Mean scores on perceived susceptibility and perceived barriers differed significantly between participants who had and those who had not undergone screening (t = 4.31; p < .001; t = -5.05; p < .001, respectively). Perceived susceptibility and perceived barriers significantly increased the predictive power of the hierarchical logistic model (critical value = 6.16; [df = 2]; p = .046). Perceived barriers were the most significant predictors of screening behaviour (odds ratio 0.84; 95% CI, 0.71-0.99; p = .039). CONCLUSION Efforts are necessary to increase mammography awareness in the community and promote screening rates in Vietnam.
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Affiliation(s)
- Linh Thuy Duong
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
| | - Hui-Mei Chen
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Piao-Yi Chiou
- School of Nursing, Medical College, National Taiwan University, Taipei City, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei City, Taiwan
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Miller BC, Sarma EA, Sun Y, Messina CR, Moyer A. Psychosocial predictors of mammography history among Chinese American women without a recent mammogram. ETHNICITY & HEALTH 2020; 25:862-873. [PMID: 29506393 DOI: 10.1080/13557858.2018.1447653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/26/2018] [Indexed: 06/08/2023]
Abstract
Chinese American women have lower rates of mammography screening compared with non-Hispanic White women. Although the extent of perceived barriers, as conceptualized by the Health Belief Model, have been shown to distinguish between currently non-adherent Chinese American women who have ever and never had a mammogram, it is less clear which types of perceived barriers differentiate them. One hundred twenty-eight Chinese American women in the New York metropolitan area who had not had a mammogram in the past year completed baseline assessments for a mammography framing intervention study. Demographics, medical access variables, and perceived barriers to mammography (lack of access, lack of need for screening, and modesty) were used to predict mammography history (ever versus never screened). Fifty-five women (43%) reported having been screened at least once. A sequential logistic regression showed that English speaking ability and having health insurance significantly predicted mammography history. However, these control variables became non-significant when the three barrier factors were included in the final model. Women who reported a greater lack of access (OR = 0.36, p < .05) and greater lack of need (OR = 0.27, p < .01) were less likely to be ever screeners. Unexpectedly, women who reported greater modesty were more likely to be ever screeners (OR = 4.78, p < .001). The results suggest that interventions for Chinese American women should identify and target specific perceived barriers with consideration of previous adherence.
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Affiliation(s)
| | | | - Yiyuan Sun
- Stony Brook University, Stony Brook, NY, USA
| | | | - Anne Moyer
- Stony Brook University, Stony Brook, NY, USA
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Implementation and Utilization of a "Pink Card" Walk-In Screening Mammography Program Integrated With Physician Visits. J Am Coll Radiol 2020; 17:1602-1608. [PMID: 32739416 DOI: 10.1016/j.jacr.2020.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE The aim of this study was to evaluate the implementation and utilization of the Pink Card program, which links a physician-delivered reminder that a woman is due for screening mammography (SM) during an office visit with the opportunity to undergo walk-in screening. METHODS In 2016, the authors' community-based breast imaging center provided physicians from three primary care and obstetrics and gynecology practices located in the same outpatient facility business card-sized Pink Cards to offer women due for SM during office visits. The card includes a reminder that screening is due and can be used to obtain SM on a walk-in basis. The primary outcome measure was the proportion of women who used Pink Cards among all screened women over 2 years. Independent predictors of Pink Card utilization were evaluated using multivariate logistic regression analyses. RESULTS Among 3,688 women who underwent SM, Pink Cards were used by 19.9% (733 of 3,688). Compared with women with prescheduled screening visits, Pink Card users were more likely to be Asian (odds ratio [OR], 1.37; P =.032), Black (OR, 2.05; P = .002), and Medicaid insured (OR, 1.71; P = .013) and less likely to use English as their primary language (OR, 2.75; P = .003). Additionally, Pink Card users were less likely to be up to date for biennial SM compared with women with prescheduled visits (31.9% [234 of 733] versus 66.6% [1,968 of 2,955], P < .001). CONCLUSIONS The Pink Card walk-in SM program can improve screening access, particularly for racial/ethnic minorities and Medicaid-insured patients. Expansion of this program may help reduce disparities and increase engagement in breast cancer screening.
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Reduced Mammography Screening for Breast Cancer among Women with Visual Impairment. Ophthalmology 2020; 128:317-323. [PMID: 32682837 DOI: 10.1016/j.ophtha.2020.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/07/2020] [Accepted: 07/08/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Timely mammography to screen for breast cancer in accordance with the United States Preventive Services Task Force (USPSTF) recommendations can reduce morbidity and mortality substantially. This study assessed whether the odds of undergoing screening mammography are similar for women with and without visual impairment (VI). DESIGN Retrospective, longitudinal cohort study. PARTICIPANTS Women aged 65 to 72 years enrolled in fee-for-service Medicare from January 1, 2008, through December 31, 2015. METHODS Patients with no vision loss (NVL), partial vision loss (PVL), and severe vision loss (SVL) were matched 1:1:1 based on age, race, time in Medicare, urbanicity of residence, and overall health. Women with pre-existing breast cancer were excluded. Multivariable conditional logistic regression modeling compared the odds of undergoing screening mammography within a 2-year follow-up period among the 3 groups. MAIN OUTCOMES MEASURES Proportion of participants undergoing mammography and adjusted odds ratios (ORs) of undergoing mammography within 2 years of follow-up. RESULTS A total of 1044 patients were matched (348 in each group). The mean ± standard deviation age at the index date was 69.0 ± 1.5 years for all 3 groups. The proportion of women undergoing 1 mammography screening or more within the 2-year follow-up was 69.0% (n = 240), 56.9% (n = 198), and 56.0% (n = 195) for the NVL, PVL, and SVL groups, respectively (P = 0.0005). The mean ± standard deviation number of mammography screenings undergone per patient during the 5-year period (3-year look-back plus 2-year follow-up) was 3.1 ± 2.0, 2.5 ± 2.0, and 2.3 ± 2.1 for the NVL, PVL, and SVL groups, respectively (P < 0.0001). Women with SVL had 42% decreased odds (OR, 0.58; 95% CI, 0.37-0.90; P = 0.01), and those with PVL had 44% decreased odds (OR, 0.56; CI, 0.36-0.87; P = 0.009) of undergoing mammography during follow-up compared with those with NVL. CONCLUSIONS Women with VI were significantly less likely to undergo mammography screening for breast cancer than women without VI. Clinicians should look for ways to help ensure that patients with VI undergo mammography and other preventive screenings as recommended by the USPSTF.
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Cox DAL, Heiney SP, Baliko B. Use of a Paper Checklist to Increase Clinician Adherence to Mammography Screening Guidelines. Nurs Womens Health 2020; 24:277-282. [PMID: 32663442 DOI: 10.1016/j.nwh.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 04/08/2020] [Accepted: 05/01/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To increase clinician adherence to mammography screening guidelines. DESIGN Quality improvement initiative. SETTING/LOCAL PROBLEM At a nurse practitioner-led primary care practice, a chart audit of adherence to American Cancer Society mammography screening guidelines indicated a 12% adherence rate for clinicians writing mammography orders. PARTICIPANTS Nurse practitioners providing care to women ages 40 years and older. INTERVENTION/MEASUREMENTS The intervention was a screening checklist that was completed by the woman at registration and given to the clinician during the examination. The pre- and postintervention measurement was the percentage of mammogram orders. A Fisher exact test was used to examine changes from pre- to postintervention rates of adherence. RESULTS After the intervention, the percentage of women for whom a mammogram was recommended and ordered was 69.6%, compared to 12% from the original chart audit. This change was statistically significant (p = .01). CONCLUSION Clinicians must find efficient approaches to improve processes within their practice settings to ensure that preventive care recommendations are made during visits. Although the screening checklist was deemed useful, improvement in adherence rates is still needed, and a paperless system should be initiated.
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Valent F, Sammartano F, Degano S, Dellach C, Franzo A, Gerin D, Gnesutta D, Mentil S, Stel S, Pattitoni C, Gongolo F. Reasons for non-participation in public oncological screening programs in the Italian region Friuli Venezia Giulia. Public Health 2020; 181:80-85. [PMID: 31958673 DOI: 10.1016/j.puhe.2019.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 11/14/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES In the Italian region Friuli Venezia Giulia, public screening is offered for cervical cancer, breast cancer, and colorectal cancer. Participation of the target population is lower than 70%. Our aim was to investigate reasons for non-participation. STUDY DESIGN This is a qualitative survey. METHODS A telephone survey was conducted in 2018 on a random sample of persons not adhering in 2017. Only one question about the reason for non-participation was asked. The answers were transcribed verbatim with no personal identifiers and no additional information. The transcribed anonymous answers were then read and classified into mutually exclusive macrocategories and subcategories. RESULTS A total of 4456 non-adhering persons were surveyed. Personal practical issues were the most common type of barrier reported in all three screening programs, followed by personal beliefs. Program-related issues were more common in cervical cancer screening than in the others. Almost half of the women not participating in the public breast cancer screening and 40% of those not adhering to the public cervical cancer screening had mammography or Pap test out of the public program. CONCLUSIONS In this region, practitioners should work to overcome practical barriers and discuss personal beliefs. Surveys of non-participants in other geographic areas would be important to adequately inform local policymaking.
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Affiliation(s)
- F Valent
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - F Sammartano
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - S Degano
- Azienda Regionale di Coordinamento per la Salute, Udine, Italy
| | - C Dellach
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - A Franzo
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy; Azienda per l'Assistenza Sanitaria N. 5, "Friuli Occidentale", Pordenone, Italy
| | - D Gerin
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - D Gnesutta
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - S Mentil
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy; Azienda per l'Assistenza Sanitaria N. 3, "Altro Friuli Collinare Medio Friuli", Gemona del Friuli, Italy
| | - S Stel
- Azienda per l'Assistenza Sanitaria N. 2, "Bassa Friulana Isontina", Palmanova, Italy
| | | | - F Gongolo
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy
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Miles RC, Lehman CD, Mercaldo SF, Tamimi RM, Dontchos BN, Narayan AK. Obesity and breast cancer screening: Cross-sectional survey results from the behavioral risk factor surveillance system. Cancer 2019; 125:4158-4163. [PMID: 31393609 DOI: 10.1002/cncr.32430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 07/07/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Postmenopausal obese women demonstrate an elevated breast cancer risk and experience increased breast cancer morbidity and mortality compared with women with a normal body mass index (BMI). However, to the authors' knowledge, prior studies have yielded inconclusive results regarding the effects of obesity on mammography screening adherence. Using national cross-sectional survey data, the objective of the current study was to assess the current association between increasing BMI and use of mammography screening. METHODS Cross-sectional survey data from the 2016 Behavioral Risk Factor Surveillance System, a state-based national telephone survey of noninstitutionalized adults in the United States, was used to identify the association between mammography screening use and increasing incremental BMI categories, including normal (18.5-24.9 kg/m2 ), overweight (25-29.9 kg/m2 ), obese class I (30-34.9 kg/m2 ), obese class II (35-39.9 kg/m2 ), and obese class III (>40 kg/m2 ), with adjustments for potential confounders. A multivariable logistic regression model was used to evaluate the effect of each BMI category on self-reported mammography use, using unadjusted and adjusted odds ratios. Effect modification by race/ethnicity was determined by testing interaction terms using Wald tests. RESULTS Of 116,343 survey respondents, 33.5% (38,984 respondents) had a normal BMI, 32.6% (37,969 respondents) were overweight, 19.3% (22,416 respondents) were classified as obese class I, 8.4% (9791 respondents) were classified as obese class II, and 6.2% (7183 respondents) were classified as obese class III. There was no statistically significant difference (P < .05) observed with regard to mammography use between women with a normal BMI and obese women from each obese class (classes I-III) when compared individually. There also was no evidence of effect modification by race (P = .53). CONCLUSIONS In contrast to prior reports, the results of the current study demonstrated no association between obesity and adherence to screening mammography. These findings may relate to the increasing social acceptance of obesity among women from all racial/ethnic groups and the removal of weight-related facility-level barriers over time.
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Affiliation(s)
- Randy C Miles
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Constance D Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sarah F Mercaldo
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Rulla M Tamimi
- Channing Institute, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brian N Dontchos
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Anand K Narayan
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
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Wu Z, Liu Y, Li X, Song B, Ni C, Lin F. Factors associated with breast cancer screening participation among women in mainland China: a systematic review. BMJ Open 2019; 9:e028705. [PMID: 31455705 PMCID: PMC6720337 DOI: 10.1136/bmjopen-2018-028705] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Although detecting breast cancer at an early stage through screening has been clearly shown to be an effective strategy, the screening participation rate in China remains low. This systematic review sought to synthesise the current evidence to identify factors associated with breast cancer screening participation among women in mainland China. DESIGN This study was a systematic review. DATA SOURCES Studies were collected from PubMed, PsycINFO, CINAHL, EMBASE and three major Chinese databases, specially China National Knowledge Infrastructure, Chongqing VIP and Wanfang Data. ELIGIBILITY CRITERIA All included papers were original research studies with a longitudinal or cross-sectional study design that considered associated factors of breast cancer screening participation among women in mainland China. DATA EXTRACTION AND SYNTHESIS Study selection, data extraction and quality assessment were conducted independently by two reviewers, involving a third to help reach a consensus when necessary. Primary outcomes of interest included factors associated with breast cancer screening participation. RESULTS A total of 19 studies were included in this review. Based on these studies, geographical region, a personal history of breast disease, past screening behaviours for breast disease, physical examination and the availability of medical specialists/equipment for breast examination were consistently associated with participation in breast cancer screening, while residential area, ethnicity and attitude towards breast cancer screening appeared to be associated with participation in breast cancer screening. There were additionally some factors with even more limited evidence with which to ascertain their association with screening participation. CONCLUSIONS There exists a wide range of factors that influence breast cancer screening participation in mainland China. These findings could help to inform future research and policy efforts.
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Affiliation(s)
- Zijing Wu
- School of Nursing, China Medical University, Shenyang, China
| | - Yu Liu
- School of Nursing, China Medical University, Shenyang, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, China
| | - Bing Song
- School of Nursing, China Medical University, Shenyang, China
| | - Cuiping Ni
- School of Nursing, China Medical University, Shenyang, China
| | - Frances Lin
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Pourhaji F, Ghofranipour F. Inconsistent Mammography Perceptions and Practice among Women of Over 40 Years in Iran. Asian Pac J Cancer Prev 2019; 20:1481-1485. [PMID: 31127912 PMCID: PMC6857896 DOI: 10.31557/apjcp.2019.20.5.1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: This paper aims to report the relationship between perceptions of mammography and screening practices. Methods: This cross-sectional study was conducted between May and September 2017, involving 400 women of over 40 years old, who was referred to as urban health centers in Tehran, Iran. The subjects were selected by multi-stage cluster sampling. Women with inconsistent mammography perceptions and practices were identified the Pros and Cons of mammography behavior for perceptions and Transtheoretical model (TTM) stage of adoption for prior and intended screening practices. The research instrument included a self-administered questionnaire and data were analyzed using descriptive statistics and measures of central tendency, and the chi-square, T-tests, and correlation regression analysis. Results: The average age participant was 45.6±5.4. Consistent with the TTM and pros and cons of mammography, women in action tended to have more positive perceptions of mammography than women in pre-contemplation or contemplation (mean decisional balance: action= 16.8; SD, 1.4; contemplation=1.8; SD, 0.48; precontemplation= SD, 1.4;0.56; p<0.001). Conclusion: results of the current study indicate there are inconsistent mammography perceptions and practice among women in Iran, then we recommend that future intervention, consider setting factors in addition to standard perceptions focused counseling.
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Affiliation(s)
- Fatemeh Pourhaji
- Health Education and Health Promotion Department, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
| | - Fazlollah Ghofranipour
- Health Education and Health Promotion Department, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
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Testing the decoy effect to increase interest in colorectal cancer screening. PLoS One 2019; 14:e0213668. [PMID: 30913209 PMCID: PMC6435152 DOI: 10.1371/journal.pone.0213668] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/26/2019] [Indexed: 12/01/2022] Open
Abstract
Literature on consumer choice has demonstrated that the inclusion of an inferior alternative choice (decoy) can increase interest in a target product or action. In two online studies, we tested the impact of decoys on the probability of previous non-intenders to have a screening test which could significantly lower their chances of dying of colorectal cancer. We find that the presence of a decoy increased the probability to choose screening at the target hospital (over no screening) from 39% to 54% and 37% to 59% depending on how many hospital attributes were communicated and how strongly the decoy was dominated by the target. We also show that the presence of the decoy was associated with lower levels of reported decisional complexity while not undermining information seeking and knowledge acquisition. These findings offer a ‘proof of principle’ that decoys have the potential to increase screening uptake without negatively influencing informed choice.
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Characterization of radiographers' mammography practice in five European countries: a pilot study. Insights Imaging 2019; 10:31. [PMID: 30868292 PMCID: PMC6419669 DOI: 10.1186/s13244-019-0711-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 01/23/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives This pilot study aimed to characterize and compare radiographers’ mammography practice, including quality control and continuous professional development in five European countries. Methods Online survey was performed to collect data regarding participants’ profile, institution’s profile, mammography practice, quality control and continuous professional development. The questionnaire was sent to clinical radiographers working in Estonia, Finland, Norway, Portugal and Switzerland. Descriptive statistical and subgroup analyzes were performed. Results The amount of returned questionnaires was 140. Most respondents were female (92%), having radiography bachelor. The majority (89%) of radiographers was working with full-field digital mammography. The majority (97%) of mammography images were acquired using AEC, and half of the radiographers were using dose saving programmes suggested by the manufacturers. The most typical (50%) compression force ranged from 8 to 11 kg. Part of the radiographers (44%) did not know if their practice followed specific guidelines. The most challenging tasks in mammography identified by radiographers were patient positioning (86%), coping with pain (88%), managing anxiety (83%) and imaging breast implants (71%). The majority (88%) of the respondents undertook continuous professional development activities. Conclusions The mammography practice varies across the five countries. We found country-specific traits related to mammography image acquisition, patient-centered care and quality management procedures. The lack of evidence-based knowledge suggests the importance of well-designed studies on these topics. The variability found in this pilot study encourages radiographers to question their own practice and teachers to review and revise the training programmes. Validation in larger studies including more countries is needed.
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Shirzadi S, Allahverdipour H, Sharma M, Hasankhani H. Perceived Barriers to Mammography Adoption among Women in Iran: A Qualitative Study. Korean J Fam Med 2019; 41:20-27. [PMID: 30803223 PMCID: PMC6987031 DOI: 10.4082/kjfm.18.0054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/19/2018] [Indexed: 01/14/2023] Open
Abstract
Background Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women. Methods This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews. Results Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support. Conclusion Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women’s decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.
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Affiliation(s)
- Shayesteh Shirzadi
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manoj Sharma
- Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Hadi Hasankhani
- Department of Nursing, Qualitative Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Double Discourse: Qualitative Perspectives on Breast Screening Participation among Obese Women and Their Health Care Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040534. [PMID: 30781792 PMCID: PMC6407106 DOI: 10.3390/ijerph16040534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 01/10/2023]
Abstract
Obesity in Australia is rising rapidly, and is a major public health concern. Obesity increases the risk of breast cancer and worsens associated outcomes, yet breast screening participation rates in Australia are suboptimal and can be lower in higher risk, obese women. This study qualitatively explored barriers to breast screening participation in obese women in Australia. In-depth interviews (n = 29), were conducted with obese women (body mass index ≥ 30) and key health providers. A disconnect between providers’ and women’s perceptions was found. For women, low knowledge around a heightened need to screen existed, they also reported limited desire to prioritize personal health needs, reluctance to screen due to poor body image and prior negative mammographic experiences due to issues with weight. Providers perceived few issues in screening obese women beyond equipment limitations, and health and safety issues. Overall, weight was a taboo topic among our interviewees, indicating that a lack of discourse around this issue may be putting obese women at increased risk of breast cancer morbidity and mortality. Consideration of breast screening policy in obese women is warranted. Targeted health promotion on increased breast cancer risk in obese women is required as is a need to address body image issues and encourage screening participation.
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Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081677. [PMID: 30087259 PMCID: PMC6121647 DOI: 10.3390/ijerph15081677] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/18/2018] [Accepted: 08/05/2018] [Indexed: 01/29/2023]
Abstract
This study explored the association between health literacy, barriers to breast cancer screening, and breast screening participation for women from culturally and linguistically diverse (CALD) backgrounds. English-, Arabic- and Italian-speaking women (n = 317) between the ages of 50 to 74 in North West Melbourne, Australia were recruited to complete a survey exploring health literacy, barriers to breast cancer screening, and self-reported screening participation. A total of 219 women (69%) reported having a breast screen within the past two years. Results revealed that health literacy was not associated with screening participation. Instead, emotional barriers were a significant factor in the self-reported uptake of screening. Three health literacy domains were related to lower emotional breast screening barriers, feeling understood and supported by healthcare providers, social support for health and understanding health information well enough to know what to do. Compared with English- and Italian-speaking women, Arabic-speaking women reported more emotional barriers to screening and greater challenges in understanding health information well enough to know what to do. Interventions that can improve breast screening participation rates should aim to reduce emotional barriers to breast screening, particularly for Arabic-speaking women.
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Shirzadi S, Asghari-Jafarabadi M, Kouzekanani K, Hasankhani H, Allahverdipour H. Assessing the mediating role of breast conflict on cognitive factors associated with adopting mammography. Women Health 2018; 59:510-523. [PMID: 30040607 DOI: 10.1080/03630242.2018.1500414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Breast conflict may represent a woman's unpleasant feelings toward her breasts, which may adversely affect her decision to undertake the procedures for an early detection of breast cancer. The purpose of the present study was to examine the mediating role of breast conflict in cognitive factors, as suggested by the Health Belief Model (HBM), for adopting mammography. In this explanatory cross-sectional study, multistage cluster sampling was employed to recruit 738 women in the age range of 40 to 69 years in Iran. Champion's revised HBM Scale for mammography adoption and the Women's Breast Conflict Scale were used to measure the variables of interest. Generalized structural equation modeling and hierarchical logistic regression were used for data analysis. Breast conflict was negatively associated with perceived barriers of mammography. Perceived barriers were inversely related to self-efficacy, which was positively related to mammography, suggesting the mediating role of perceived barriers and self-efficacy, connecting breast conflict to mammography indirectly. The mediating role of breast conflict in perceived barriers and self-efficacy suggests an indirect link between breast conflict and mammography. Clinicians and public health-care providers must pay attention to women's feelings in formulating and delivering appropriate interventions and consultations.
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Affiliation(s)
- Shayesteh Shirzadi
- a Department of Health Education & Promotion , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari-Jafarabadi
- b Road Traffic Injury Research Center, Department of Statistics and Epidemiology , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Kamiar Kouzekanani
- c Department of Educational Leadership , College of Education & Human Development, TAMUCC , Corpus Christi , Texas , USA
| | - Hadi Hasankhani
- d Qualitative Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Allahverdipour
- e Department of Health Education & Promotion, Clinical Psychiatry Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
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Tavasoli SM, Kane E, Chiarelli AM, Kupets R. Women's Behaviors Toward Mammogram and Pap Test: Opportunities to Increase Cervical Cancer Screening Participation Rates among Older Women. Womens Health Issues 2018; 28:42-50. [DOI: 10.1016/j.whi.2017.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/13/2017] [Accepted: 10/19/2017] [Indexed: 12/18/2022]
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Shirzadi S, Nadrian H, Asghari Jafarabadi M, Allahverdipour H, Hassankhani H. Determinants of mammography adoption among iranian women: What are the differences in the cognitive factors by the stages of test adoption? Health Care Women Int 2017; 38:956-970. [PMID: 28586294 DOI: 10.1080/07399332.2017.1338705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our aim in this cross-sectional study was to investigate the predictors of the stages of change in mammography adoption (MA) based on Health Belief Model among Iranian women. Through multistage cluster sampling, we recruited and interviewed 1131 women older than 40. After statistical adjustment for other risk factors, perceived barriers (OR D 0.84, 95% CI D .81-.87) and benefits (OR D 1.17, 95% CI D 1.11-1.24) were significant predictors for MA. Majority of the women were in the pre-contemplation and contemplation stages of change for MA. Our findings are informative for the development of targeted interventions to foster MA among women.
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Affiliation(s)
- Shayesteh Shirzadi
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Haidar Nadrian
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari Jafarabadi
- b Road Traffic Injury Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,c Department of Biostatistics and Epidemiology , Faculty of Health, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Allahverdipour
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hadi Hassankhani
- d Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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Whelehan P, Evans A, Ozakinci G. Client and practitioner perspectives on the screening mammography experience. Eur J Cancer Care (Engl) 2017; 26:e12580. [PMID: 27739138 PMCID: PMC5484333 DOI: 10.1111/ecc.12580] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 12/30/2022]
Abstract
Mammography can be painful and unpleasant, but effective interventions to improve the experience remain scarce. As a first step towards more effective interventions, we aimed to achieve a thorough, contemporary understanding of thoughts, feelings and behaviours which affect and arise from mammography experiences. Research and professional experience suggest that the interaction between client and practitioner may be paramount in determining the quality of a client's experience. Therefore, this study aimed to capture the perspectives of clients and mammography staff from UK breast screening programmes. Thematic analysis of semi-structured qualitative in-depth interviews with 22 clients and 18 staff revealed that clients had positive attitudes to breast screening and mostly low knowledge about potential harms. Staff data indicated that some women attend for breast screening under pressure from others. Pain and coping with it were prominent themes, with wide variations in pain experiences. Clients recognised differences in mammographers' abilities to put them at ease. Staff difficulties included empowering clients within the confines of a taxing technique, and maintaining compassionate care when under strain. Future intervention development should focus on the information and support needs of women prior to the appointment and on effectively training and supporting mammographers to deal with challenging encounters.
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Affiliation(s)
- P. Whelehan
- School of MedicineUniversity of DundeeMailbox 4Ninewells Hospital & Medical SchoolDundeeUK
- School of MedicineUniversity of St AndrewsSt AndrewsUK
| | - A. Evans
- School of MedicineUniversity of DundeeMailbox 4Ninewells Hospital & Medical SchoolDundeeUK
| | - G. Ozakinci
- School of MedicineUniversity of St AndrewsSt AndrewsUK
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Brandzel SD, Bowles EJA, Wieneke A, Bradford SC, Kimbel K, Gao H, Buist DS. Cancer Screening Reminders: Addressing the Spectrum of Patient Preferences. Perm J 2017; 21:17-051. [PMID: 29035189 PMCID: PMC5638633 DOI: 10.7812/tpp/17-051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
CONTEXT Health care systems continue to seek evidence about how to optimize the efficiency and effectiveness of cancer screening reminders. Annual reminders to receive preventive services can be an efficient strategy. OBJECTIVE To understand patient motivators and barriers to cancer screening and preferences about reminder strategies. DESIGN We conducted 11 focus groups among adults recommended for cancer screening within Kaiser Permanente Washington. We held separate focus groups with women aged 21 to 49 years, women 50 to 75 years, and men 50 to 75 years. We used an inductive, validated coding scheme for analysis. MAIN OUTCOME MEASURES Motivators and barriers to obtaining recommended cancer screening and general cancer screening reminder content and modality preferences. RESULTS Half of our participants were women aged 50 to 75 years, and 25% were men aged 50 to 75 years. Differences by age, sex, insurance status, financial status, and health beliefs all drove the participants' preferences for whether they seek these recommended services and how and when they wish to be reminded about recommended cancer screening. Most participants preferred personalized reminders, and many favored receiving reminders less than 3 months before the recommended procedure date rather than a consolidated annual reminder. Younger participants more commonly requested electronic reminders, such as texts and e-mails. CONCLUSION Optimizing cancer screening reminders within a health care system involves a multifaceted approach that enables members to request which form of reminder they prefer (eg, electronic, paper, telephone) and the timing with which they want to be reminded, while staying affordable and manageable to the health care system.
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Affiliation(s)
- Susan D Brandzel
- Insights Director at Health Stories Project Insights in Seattle, WA.
| | - Erin J Aiello Bowles
- Research Associate for Kaiser Permanente Washington Health Research Institute in Seattle.
| | - Arika Wieneke
- Student in the School of Medicine at Western Michigan University in Kalamazoo.
| | | | - Kilian Kimbel
- Research Specialist for Kaiser Permanente Washington Health Research Institute in Seattle.
| | - Hongyuan Gao
- Programmer at Kaiser Permanente Washington Health Research Institute in Seattle.
| | - Diana Sm Buist
- Scientific Investigator for Kaiser Permanente Washington Health Research Institute in Seattle.
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Chambers JA, Gracie K, Millar R, Cavanagh J, Archibald D, Cook A, O'Carroll RE. A pilot randomized controlled trial of telephone intervention to increase Breast Cancer Screening uptake in socially deprived areas in Scotland (TELBRECS). J Med Screen 2015; 23:141-9. [PMID: 26566950 DOI: 10.1177/0969141315608212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/03/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine whether a brief telephone support intervention could increase breast cancer screening uptake among lower socio-demographic women in Scotland, via eliciting and addressing barriers to screening attendance. METHODS In a pilot randomized controlled trial, participants receiving a reminder letter for a missed screening appointment (February-June 2014) were randomized to four arms: No telephone call (control), Simple telephone reminder (TEL), Telephone support (TEL-SUPP), or Telephone support plus anticipated regret (TEL-SUPP-AR). Primary outcomes were making an appointment and attending breast screening. RESULTS Of 856 women randomized and analysed on intention-to-treat basis, compared with controls, more women in the telephone intervention groups made an appointment (control: 8.8%, TEL: 20.3%, TEL-SUPP: 14.1%; TEL-SUPP-AR: 16.8%, χ(2)(3) = 12.0, p = .007) and attended breast screening (control: 6.9%, TEL: 16.5%, TEL-SUPP: 11.3%; TEL-SUPP-AR: 13.1%, χ(2)(3) = 9.8, p = .020). Of 559 women randomized to the three telephone groups, 404 were successfully contacted and 247 participated in the intervention. Intervention participants (ie. per protocol analysis) were more likely to make (17% versus 10%, χ(2)(1) = 7.0, p = .008) and attend (13% versus 7%, χ(2)(1) = 5.5, p = .019) an appointment than non-participants, but there were no differences in attendance between the three telephone groups. CONCLUSIONS A simple telephone reminder doubled attendance at breast screening in women from lower socio-demographic areas who had not attended their initial appointment, compared with a reminder letter only (odds ratio 2.12, 95% CI (1.2, 3.8)). However, contacting women proved problematic and there was no additional effect of telephone support or anticipated regret.
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Affiliation(s)
- Julie A Chambers
- Psychology, School of Natural Sciences, Stirling University, Stirling, FK9 4LA, UK
| | - Kerry Gracie
- Psychology, School of Natural Sciences, Stirling University, Stirling, FK9 4LA, UK
| | - Rosemary Millar
- Directorate of Public Health, Tayside NHS Board, Kings Cross, Clepington Rd, Dundee DD3 8EA, UK
| | - Julie Cavanagh
- Directorate of Public Health, Tayside NHS Board, Kings Cross, Clepington Rd, Dundee DD3 8EA, UK
| | - Debbie Archibald
- East of Scotland Breast Screening Service, Ninewells Hospital, Dundee DD1 9SY, UK
| | - Alan Cook
- Department of Radiology, Ninewells Hospital, Dundee DD1 9SY, UK
| | - Ronan E O'Carroll
- Psychology, School of Natural Sciences, Stirling University, Stirling, FK9 4LA, UK
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Sun Y, Sarma EA, Moyer A, Messina CR. Promoting mammography screening among Chinese American women using a message-framing intervention. PATIENT EDUCATION AND COUNSELING 2015; 98:878-83. [PMID: 25858632 DOI: 10.1016/j.pec.2015.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 03/12/2015] [Accepted: 03/21/2015] [Indexed: 05/14/2023]
Abstract
OBJECTIVES This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography. METHODS One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up. RESULTS Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message. CONCLUSIONS Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women. PRACTICE IMPLICATIONS The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive.
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Affiliation(s)
- Yiyuan Sun
- School of Nursing, Stony Brook University, Stony Brook, USA
| | | | - Anne Moyer
- Department of Psychology, Stony Brook University, Stony Brook, USA
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