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Datta BK, Gummadi A, Coughlin SS. Role of life satisfaction, emotional support, and feeling of social isolation on adherence to breast cancer screening recommendations among US women. J Cancer Policy 2024; 39:100467. [PMID: 38253239 DOI: 10.1016/j.jcpo.2024.100467] [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: 10/12/2023] [Revised: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Psychosocial factors can play important roles in promoting preventive health behaviors. This study aimed to assess how life satisfaction, receipt of emotional support, and feeling of social isolation were associated with adherence to the USPSTF recommendation of breast cancer screening in a nationally representative US population. METHODS Using data on 71,583 women aged 50 to 74 years, from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey, we estimated multivariable logistic regressions to assess the odds of adherence across different categories of the respective psychosocial constructs. We accounted for various demographic and socioeconomic correlates and checked the robustness of the relationship within income and educational sub-groups. RESULTS We found that women who were dissatisfied with their life were 52.0% less likely to adhere compared to women who reported to be very satisfied. Similarly, women who rarely/never got emotional support and who always/usually felt socially isolated were 51.6% and 39.9% less likely to adhere, compared to women who always got support and never felt isolated, respectively. These results were robust across different levels of income and educational attainment. CONCLUSION Our findings demonstrated a strong association between social environment, psychological wellbeing, and adherence to breast cancer screening, and thus suggested scope of potential psychosocial interventions to improve adherence. POLICY SUMMARY Efforts to improve women's psychosocial wellbeing could facilitate compliance with breast cancer screening recommendations.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA; Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA.
| | - Aneesha Gummadi
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA; Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA
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Baeker Bispo J, Lee H, Pal Choudhury P, Bailey Z, Jemal A, Islami F. Government Housing Assistance and Cancer Screening Among Adults With Low Income. Am J Prev Med 2024; 66:205-215. [PMID: 37943202 DOI: 10.1016/j.amepre.2023.10.005] [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] [Received: 05/11/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Access to affordable housing may support cancer control for adults with low income by alleviating financial barriers to preventive care. This study examines relationships between cancer screening and receipt of government housing assistance among adults with low income. METHODS Data are from the 2019 and 2021 National Health Interview Survey. Eligible respondents were classified as up-to-date or not with breast cancer (BC), cervical cancer (CVC) and colorectal cancer (CRC) screening guidelines. Multivariable logistic regression was used to model guideline-concordant screening by receipt of government housing assistance, overall and stratified by urban-rural status, race/ethnicity, and age. Analyses were performed in 2023. RESULTS Analyses for BC, CVC and CRC screening included 2,258, 3,132, and 3,233 respondents, respectively. There was no difference in CVC screening by housing assistance status, but screening for BC and CRC was higher among those who received assistance compared to those who did not (59.7% vs. 50.8%, p<0.01 for BC; 57.1% vs. 44.1%, p<0.01 for CRC). In models adjusted for sociodemographic characteristics, health status and insurance, these differences were not statistically significant for either BC or CRC screening. In stratified adjusted models, housing assistance was statistically significantly associated with increased BC screening in urban areas (aOR=1.35, 95% CI=1.00-1.82) and among Hispanic women (aOR=2.20, 95% CI=1.01-4.78) and women 45-54 years of age (aOR=2.10, 95% CI=1.17-3.75). CONCLUSIONS Policies that address housing affordability may enhance access to BC screening for some subgroups, including women in urban areas, Hispanic women, and younger women. More research on the mechanisms that link housing assistance to BC screening is needed.
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Affiliation(s)
- Jordan Baeker Bispo
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Hyunjung Lee
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Parichoy Pal Choudhury
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zinzi Bailey
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Paladino AJ, Pebley K, Kocak M, Krukowski RA, Waters TM, Vidal G, Schwartzberg LS, Curry AN, Graetz I. An examination of health care utilization during the COVID-19 pandemic among women with early-stage hormone receptor-positive breast cancer. BMC Health Serv Res 2022; 22:1403. [PMID: 36419005 PMCID: PMC9684812 DOI: 10.1186/s12913-022-08705-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Women undergoing treatment for breast cancer require frequent clinic visits for maintenance of therapy. With COVID-19 causing health care disruptions, it is important to learn about how this population's access to health care has changed. This study compares self-reported health care utilization and changes in factors related to health care access among women treated at a cancer center in the mid-South US before and during the pandemic. METHODS Participants (N = 306) part of a longitudinal study to improve adjuvant endocrine therapy (AET) adherence completed pre-intervention baseline surveys about their health care utilization prior to AET initiation. Questions about the impact of COVID-19 were added after the pandemic started assessing financial loss and factors related to care. Participants were categorized into three time periods based on the survey completion date: (1) pre-COVID (December 2018 to March 2020), (2) early COVID (April 2020 - December 2020), and later COVID (January 2021 to June 2021). Negative binomial regression analyses used to compare health care utilization at different phases of the pandemic controlling for patient characteristics. RESULTS Adjusted analyses indicated office visits declined from pre-COVID, with an adjusted average of 17.7 visits, to 12.1 visits during the early COVID period (p = 0.01) and 9.9 visits during the later COVID period (p < 0.01). Hospitalizations declined from an adjusted average 0.45 admissions during early COVID to 0.21 during later COVID, after vaccines became available (p = 0.05). Among COVID period participants, the proportion reporting changes/gaps in health insurance coverage increased from 9.5% participants during early-COVID to 14.8% in the later-COVID period (p = 0.05). The proportion reporting financial loss due to the pandemic was similar during both COVID periods (34.3% early- and 37.7% later-COVID, p = 0.72). The proportion of participants reporting delaying care or refilling prescriptions decreased from 15.2% in early-COVID to 4.9% in the later-COVID period (p = 0.04). CONCLUSION COVID-19 caused disruptions to routine health care for women with breast cancer. Patients reported having fewer office visits at the start of the pandemic that continued to decrease even after vaccines were available. Fewer patients reported delaying in-person care as the pandemic progressed.
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Affiliation(s)
- Andrew J. Paladino
- grid.267301.10000 0004 0386 9246College of Medicine, The University of Tennessee Health Science Center, Memphis, TN USA
| | - Kinsey Pebley
- grid.56061.340000 0000 9560 654XDepartment of Psychology, University of Memphis, Memphis, TN USA
| | - Mehmet Kocak
- grid.411781.a0000 0004 0471 9346International School of Medicine, Biostatistics and Medical Informatics, Istanbul Medipol University, Uskudar, Istanbul, Turkey
| | - Rebecca A. Krukowski
- grid.27755.320000 0000 9136 933XDepartment of Public Health Sciences, University of Virginia, University of Virginia Cancer Center, Charlottesville, VA USA
| | - Teresa M. Waters
- grid.266539.d0000 0004 1936 8438Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington, KY USA
| | - Gregory Vidal
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA
| | - Lee S. Schwartzberg
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA ,Medical Oncology and Hematology, Renown Institute for Cancer, Reno, USA
| | - Andrea N. Curry
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA
| | - Ilana Graetz
- grid.189967.80000 0001 0941 6502Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA USA
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Abstract
BACKGROUND It is unclear which psychological factors (stressors, emotional correlates, and psychophysiological markers) induce cancer risk. This currently limits the potential for prevention strategies. PURPOSE The aim of this review is to bring forth evidence of stress as a determinant of cancer risk from a public health perspective, written for a broad public of practitioners and scientists. METHODS Based on a semisystematic literature search, the impact of different aspects/types of stress and the potential physiological and behavioral pathways are summarized, while highlighting further research, public health and clinical implications. RESULTS Between 2007 and 2020, 65 case-control or cohort studies have been identified. Apart from overall cancer ( N = 24), 12 cancer types have been associated with psychological stress with most for breast ( N = 21), colorectal ( N = 11) and lung/prostate/pancreas cancer ( N = 8 each). Although the evidence regarding the mechanisms is still scarce, cancer development in relation to stress might be due to interacting and combined effects of different stress(or) types, but such interaction has not really been tested yet. The path from stress towards cancer incidence consists of a biological pathway with endocrinology and immunology as well as stress-induced behavioral pathways, including smoking, alcoholism, sleep disruption, an unhealthy diet, and low physical activity together with the related phenomenon of obesity. CONCLUSION Not only the stress but also the stress-induced lifestyle should be targeted for cancer prevention and treatment. Future research should include a more diverse spectrum of cancer types (not only hormonal related like breast cancer) and of stress measures while also considering behavioral covariates.
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Affiliation(s)
- Ananyaa Mohan
- Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France and Departments of
| | - Nathalie Michels
- Public Health and Primary Care
- Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Ezema RN, Igbokwe CC, Iwuagwu TE, Agbaje OS, Ofuebe JI, Abugu LI, Eze DD, Wamanyi Y. Association of Sociodemographic Factors, Breast Cancer Fear, and Perceived Self-Efficacy With Breast Cancer Screening Behaviors Among Middle-Aged Nigerian Women. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2021; 15:11782234211043651. [PMID: 34616153 PMCID: PMC8488520 DOI: 10.1177/11782234211043651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022]
Abstract
Introduction: Breast cancer (BC) is a major public health problem among women. However, BC screening uptake is abysmally low among Nigerian women. This study evaluated the association of BC fear and perceived self-efficacy with BC screening (clinical breast exam [CBE] and mammography) among middle-aged Nigerian women. Methods: A community-based cross-sectional study was conducted among middle-aged women in Enugu State, southeast Nigeria. The data were collected between September 2019 and February 2020. The BC screening uptake, fear, and self-efficacy were assessed using the validated Breast Cancer Screening Questionnaire (BCSQ), Champion Breast Cancer Fear Scale (CBCFS), and Champion’s Mammography Self-Efficacy Scale (CMSES). Data were analyzed using frequencies and percentages, chi-square test, and univariate analysis of variance. Bivariate and multivariable logistic regression models were used to examine independent associations between selected sociodemographic factors, cancer fear, perceived self-efficacy, and BC screening. Results: The mean age of the participants was 55.3 years (SD: 5.75). More than half of the women (51%) reported having a BC screening in the past 12 months. However, only 12.5% and 16.9% reported having a CBE or mammogram in the past 12 months. The prevalence of a high, moderate, and low level of fear was 68%, 22.3%, and 9.8%, respectively. The prevalence of a high, moderate, and low self-efficacy level was 50.6%, 37.5%, and 12.0%, respectively. The multivariable logistics regression analysis showed that women aged 50-59 years and 60-64 years were 3.5 times (adjusted odds ratio [AOR] = 3.50, 95% confidence interval [CI]: 2.07-5.89, P < .0001), and 5.92 times (AOR = 5.92 95% CI: 2.63-13.35, P < .0001), respectively, more likely to perform mammogram than those aged 40-49 years. Women with a high level of self-efficacy were 2.68 times (AOR = 2.68, 95% CI: 1.15-6.26, P < .0001) more likely to use mammographic screening than those with low self-efficacy. Although not statistically significant, women with a moderate level of BC fear were 0.56 times less likely to use mammogram than women with a low level of BC fear. Conclusion: A low proportion of women underwent CBE or mammography. Women had a high level of BC fear and a moderate level of self-efficacy for BC screening. The findings emphasize the need for health educational and psychosocial interventions that improve self-efficacy and promote regular BC screening among middle-aged women.
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Affiliation(s)
- Rita Ngozi Ezema
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria.,College of Nursing Science and Health Technology, Nsukka, Nigeria
| | - Charles Chima Igbokwe
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Tochi Emmanuel Iwuagwu
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Olaoluwa Samson Agbaje
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Justina Ifeoma Ofuebe
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Lawretta Ijeoma Abugu
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Dorothy Doris Eze
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
| | - Yohanna Wamanyi
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nsukka, Nigeria
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Hoge EA, Acabchuk RL, Kimmel H, Moitra E, Britton WB, Dumais T, Ferrer RA, Lazar SW, Vago D, Lipsky J, Schuman-Olivier Z, Cheaito A, Sager L, Peters S, Rahrig H, Acero P, Scharf J, Loucks EB, Fulwiler C. Emotion-related constructs engaged by mindfulness-based interventions: A systematic review and meta-analysis. Mindfulness (N Y) 2021; 12:1041-1062. [PMID: 34149957 PMCID: PMC8210838 DOI: 10.1007/s12671-020-01561-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. METHODS Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. RESULTS Seventy-two studies (N=7,378) were included (MBSR k=47, MBCT k = 21, Modified k=4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d=0.58; k =36), and in all constructs assessed: depression (d=0.66; k=26), anxiety (d =0.63; k=19), combined mental health (d =0.75; k=7 ) and stress (d =0.44; k=11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population-type did not moderate results, but MBI-type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. CONCLUSIONS This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA
| | - Rebecca L. Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, 06269, USA
| | - Hannah Kimmel
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Willoughby B. Britton
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Travis Dumais
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA
| | - Jonah Lipsky
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
| | - Aya Cheaito
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Lauren Sager
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Sarah Peters
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Hadley Rahrig
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Pamela Acero
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Jodi Scharf
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Eric B. Loucks
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Carl Fulwiler
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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7
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Gupta S, Singh M, Vora A, Babu G, Walia M, Nautial V, Saha R, Smruti BK, Sharma JB, Koul R, Parikh PM, Aggarwal S. Practical consensus recommendations on duration of adjuvant hormonal therapy in breast cancer. South Asian J Cancer 2020; 7:142-145. [PMID: 29721482 PMCID: PMC5909293 DOI: 10.4103/sajc.sajc_122_18] [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] [Indexed: 11/17/2022] Open
Abstract
Optimization of adjuvant systemic therapy in women with early-stage hormone receptor-positive breast cancer includes the consideration of chemotherapy and duration of hormone therapy. Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). Expert oncologist discussed on the duration of adjuvant hormonal therapy for improvement of OS and quality of life of breast cancer patients by providing reduction in recurrence and mortality. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- S Gupta
- Department of Medical Oncology, Tata Memorial Center, Mumbai, Maharashtra, India
| | - M Singh
- Department of Medical Oncology, Mahaveer Cancer Sansthan, Patna, Bihar, India
| | - Amish Vora
- Department of Medical Oncology, Hope Clinic, New Delhi, India
| | - G Babu
- Department of Medical Oncology, KMIO, Bengaluru, Karnataka, India
| | - M Walia
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - V Nautial
- Department of Medical Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - R Saha
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - B K Smruti
- Department of Medical Oncology, Bombay Hospital, Mumbai, Maharashtra, India
| | - J B Sharma
- Department of Medical Oncology, Action Balajee Cancer Hospital, New Delhi, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Diekmann A, Heuser C, Schellenberger B, Bohmeier B, Holmberg C, Ansmann L, Ernstmann N. Patient participation in multidisciplinary tumor conferences: Providers' perceptions of patients' need satisfaction and emotional experiences. Psychooncology 2020; 29:1263-1271. [PMID: 32419276 DOI: 10.1002/pon.5413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/16/2020] [Accepted: 05/08/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In some breast and gynecological cancer centers in Germany, patients participate in multidisciplinary tumor conferences (MTCs) during the discussion of their own case. The aim of this study was to explore providers' perceptions concerning patients' emotional experiences during participation in an MTC by comparing the perspectives of providers with and without experience with patient participation. METHODS In this study, semi-structured interviews with n = 30 providers in n = 6 breast and gynecological cancer centers in North Rhine-Westphalia, Germany, were conducted. One half of the providers had no experience and the other half had experience with patient participation in MTCs. The interviews were audiotaped and transcribed, and content analysis was performed. RESULTS The results of this study show a mixed picture of met, unmet and disappointed needs of patients and their emotional reactions, which mainly overlap between both provider groups. Our results show that both provider groups report positive and negative experiences or expectations. CONCLUSION The mixed results regarding expected and perceived patient experiences from the providers' perspective suggest that patient participation in MTCs may not be exclusively of benefit. Further research on advantages and disadvantages for patients and on feasibility from the providers' perspective is necessary and will be conducted within the PINTU project.
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Affiliation(s)
- Annika Diekmann
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Bonn (CIO), University Hospital Bonn, Bonn, Germany
| | - Christian Heuser
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Bonn (CIO), University Hospital Bonn, Bonn, Germany
| | - Barbara Schellenberger
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Bonn (CIO), University Hospital Bonn, Bonn, Germany
| | - Barbara Bohmeier
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Bonn (CIO), University Hospital Bonn, Bonn, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Lena Ansmann
- Division for Organizational Health Services Research, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Bonn (CIO), University Hospital Bonn, Bonn, Germany
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9
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Döbrössy B, Girasek E, Susánszky A, Koncz Z, Győrffy Z, Bognár VK. "Clicks, likes, shares and comments" a systematic review of breast cancer screening discourse in social media. PLoS One 2020; 15:e0231422. [PMID: 32294139 PMCID: PMC7159232 DOI: 10.1371/journal.pone.0231422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/23/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Unsatisfactory participation rate at population based organised breast cancer screening is a long standing problem. Social media, with 3.2 billion users in 2019, is potentially an important site of breast cancer related discourse. Determining whether these platforms might be used as channels by screening providers to reach under-screened women may have considerable public health significance. OBJECTIVES By systematically reviewing original research studies on breast cancer related social media discourse, we had two aims: first, to assess the volume, participants and content of breast screening social media communication and second, to find out whether social media can be used by screening organisers as a channel of patient education. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After searching PubMed, ScienceDirect, Web of Science, Springer and Ebsco, 17 studies were found that met our criteria. A systematic narrative framework was used for data synthesis. Owing to the high degree of heterogeneity in social media channels, outcomes and measurement included in this study, a meta-analytic approach was not appropriate. RESULTS The volume of breast cancer related social media discourse is considerable. The majority of participants are lay individuals as opposed to healthcare professionals or advocacy groups. The lay misunderstandings surrounding the harms and benefits of mammography is well mirrored in the content of social media discourse. Although there is criticism, breast cancer screening sentiment on the social media ranges from the neutral to the positive. Social media is suitable for offering peer emotional support for potential participants. CONCLUSION Dedicated breast screening websites operated by screening organisers would ensure much needed quality controlled information and also provide space for reliable question and answer forums, the sharing of personal experience and the provision of peer and professional support.
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Affiliation(s)
- Bence Döbrössy
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Edmond Girasek
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Anna Susánszky
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Zsuzsa Koncz
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Virág Katalin Bognár
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
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Edmonds MC, Sutton AL, He J, Perera RA, Sheppard VB. Correlates of Adjuvant Therapy Attitudes in African American Breast Cancer Patients. J Natl Med Assoc 2020; 112:167-175. [PMID: 32197898 DOI: 10.1016/j.jnma.2020.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/11/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE Black breast cancer patients delay and underutilize adjuvant breast cancer therapies; yet, very few studies have specifically examined Black women's attitudes toward breast cancer therapy. This study observed the influence of self-reported interpersonal processes of care (e.g. self-efficacy) clinical and sociodemographic factors and sociocultural (e.g. religiosity), related to Black breast cancer patients' attitudes toward radiation and systemic therapies (chemotherapy and adjuvant endocrine therapy - "AET"). METHODS This was a secondary analysis of data from the Narrowing Gaps in Adjuvant Therapy Study (2006-2011). The analysis included 210 Black women who were newly diagnosed with breast cancer. Bivariate and multiple regression analyses were performed between independent variables (e.g., demographics) and three outcome variables (chemotherapy, AET, and radiation therapy) to asses women's perceptions of therapy type. The lasso method was used to select variables correlated with therapy attitudes. RESULTS Most women reported negative attitudes toward AET (56%) and radiation (54%); fewer negative attitudes were observed toward chemotherapy (47%). Higher education and greater perceived susceptibility of a recurrence were associated with more positive attitudes toward chemotherapy. Regarding radiation therapy, women with greater patient satisfaction were more likely to have more positive attitudes. CONCLUSIONS Our study findings may aid in the development of behavioral interventions targeted to mitigate Black women breast cancer treatment disparities. We found modifiable factors (e.g. communication, satisfaction ratings) that support opportunities for clinicians to better address Black women's needs regarding adjuvant treatment options. The development of tailored interventions for newly diagnosed Black breast cancer patients on patient related factors in health care are warranted for Black women with lower educational levels.
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Affiliation(s)
- Megan C Edmonds
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA.
| | - Arnethea L Sutton
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA
| | - Jun He
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Robert A Perera
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA
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Jang M, Hershberger P, Kim S, Collins E, Quinn L, Park C, Ferrans C. Factors Influencing Surveillance Mammography Adherence Among Breast Cancer Survivors. Oncol Nurs Forum 2019; 46:701-714. [DOI: 10.1188/19.onf.701-714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Feliu J, Heredia-Soto V, Gironés R, Jiménez-Munarriz B, Saldaña J, Guillén-Ponce C, Molina-Garrido MJ. Management of the toxicity of chemotherapy and targeted therapies in elderly cancer patients. Clin Transl Oncol 2019; 22:457-467. [PMID: 31240462 DOI: 10.1007/s12094-019-02167-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/16/2019] [Indexed: 12/22/2022]
Abstract
The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, so cancer treatment in the older patient remains a therapeutic challenge. The physiological changes associated with aging increase the risk of developing a serious toxicity induced by chemotherapy treatment, as well as other undesirable consequences as hospitalizations, dependence and non-compliance with treatment, that can negatively affect survival, quality of life and treatment efficacy. The use of hematopoietic growth factors and other active supportive interventions in the elderly can help prevent and/or alleviate these toxicities. However, we have little data on the efficacy and tolerance of support treatments in the older patient. The objective of this work is to review the most frequent toxicities of oncological treatments in the elderly and their management.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - V Heredia-Soto
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - R Gironés
- Medical Oncology Department, H. Lluís Alcanyís. Xàtiva, Valencia, Spain
| | - B Jiménez-Munarriz
- Medical Oncology Department, H. Universitario Clara Campal, Madrid, Spain
| | - J Saldaña
- Medical Oncology Department, Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, H. Universitario Ramón Y Cajal, Madrid, Spain
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Molina Y, Scheel JR, Endeshaw M, Turan JM, Lambert N, Cohn SE, Rao D. Enacted HIV-related stigma and breast-health beliefs and practices among African American women living with HIV: The mediating roles of internalized HIV-related stigma and depressive symptoms. STIGMA AND HEALTH 2018; 3:377-384. [PMID: 30525110 DOI: 10.1037/sah0000105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reducing HIV-related stigma among African American women living with HIV is a priority to improve HIV-specific health outcomes, but may also impact other health beliefs and practices. Testing this hypothesis is important because African American women experience worse health outcomes, including for breast cancer. This study examines the relationship between enacted HIV-related stigma and breast health beliefs and practices and the mediating effects of depressive symptoms and internalized HIV-related stigma. We use baseline data from a stigma reduction intervention trial for adult African American women living with HIV in Chicago, IL and Birmingham, AL (n = 237). Data were collected using computer-assisted self-interviewing software. After adjusting for covariates, enacted HIV-related stigma was associated with greater perceived threat of breast cancer, specifically in terms of breast cancer fear (p <0.0001), but not regular breast healthcare engagement (p = .17). Internalized HIV-related stigma and depressive symptoms were associated with enacted HIV-related stigma, perceived threat of breast cancer, and regular breast healthcare engagement (all p <.05). Internalized HIV-related stigma mediated the relationship between enacted HIV-related stigma and perceived threat of breast cancer (p = .001); depressive symptoms did not (p = .84). We provide evidence concerning broader influences of internalized HIV-related stigma for the health of African American women living with HIV. Future studies should consider the impact of HIV stigma on other health beliefs and behaviors.
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Affiliation(s)
- Yamile Molina
- University of Illinois-Chicago, 649 SPHPI MC923, 1601 West Taylor Street, Chicago, IL 60607
| | - John R Scheel
- Department of Radiology, University of Washington, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, G2-600, Seattle, WA 98109
| | - Meheret Endeshaw
- Harborview Medical Center, Ninth and Jefferson Bldg, 13th floor, Box 359931, Seattle, WA 98104
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, 1665 University Blvd, Birmingham, AL 35233
| | - Nina Lambert
- 645 North Michigan Avenue, Suite 900, Room 926, Chicago, IL 60611
| | - Susan E Cohn
- 645 North Michigan Avenue, Suite 900, Room 926, Chicago, IL 60611
| | - Deepa Rao
- Harborview Medical Center, 325 9th Ave, Seattle, WA 98104
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14
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Smalls BL, Aroh A, McQuerry K, Adegboyega A, Schoenberg N, Hatcher J. Social support and breast cancer screening in rural Appalachia. Psychooncology 2018; 27:2281-2288. [PMID: 29956391 PMCID: PMC8015397 DOI: 10.1002/pon.4828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/05/2018] [Accepted: 06/19/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Women in the Appalachian region have a high mortality rate attributable to cancer in spite of lower incidence of cancer compared with the general US population. Empirical evidence suggests that social support influences cancer outcomes, including adherence to screening guidelines and treatment recommendations. The purpose of this study is to examine the impact of social support on breast cancer screening patterns in a sample of rural Appalachian women. METHODS This paper reports the results of analyses of baseline cross-sectional data on breast cancer screening collected during a community-based group-randomized trial. We used the 2010 National Health Institute Survey questionnaires and the Medical Outcomes Study Social Support Survey to assess screening behavior and perceived social support, respectively. Data were analyzed using ANCOVA and ANOVA to assess the mean social support on breast cancer screening patterns (frequently, irregularly, and rarely/never) and relevant sociodemographic variables. FINDINGS Of the eligible participant records analyzed (N = 289), 50% were married, 36% were employed, 20% attended college, 40% had no mammogram in 6 years, and 20% never had mammograms. Overall social support score was high at 73.1 (SD = 18.2). Association between breast cancer screening patterns and social support scores was not statistically significant at α < 0.05 (P value = 0.09). CONCLUSIONS Although social support as it measured in this study does not show significant associations with screening patterns, it is important to understand how social network structures may influence screening patterns. Familial and social roles/responsibilities that result in reported social support may also be the barrier to cancer screening and other prevention health behaviors.
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Affiliation(s)
- Brittany L. Smalls
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Adaeze Aroh
- College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Kristen McQuerry
- Department of Statistics, University of Kentucky, Lexington, Kentucky
| | | | - Nancy Schoenberg
- College of Public Health, University of Kentucky, Lexington, Kentucky
- Department of Behavioral and Social Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky
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Akiyama S, Goren A, Basurto E, Komori T, Harada T. Treatment preferences among Japanese women with dysmenorrhea: results from a discrete choice experiment study. Patient Prefer Adherence 2018; 12:1627-1640. [PMID: 30214165 PMCID: PMC6124802 DOI: 10.2147/ppa.s166332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To examine patient preferences for oral and intrauterine system treatments for dysmenorrhea in Japan. PATIENTS AND METHODS A discrete choice experiment was conducted to assess the willingness to accept trade-offs among hypothetical treatment profiles. An internet-based survey was administered to women 18-49 years of age who self-reported a dysmenorrhea diagnosis or experienced dysmenorrhea at least once in the past 6 months (N=309). Choice questions included pairs of treatments presented with different attributes: mode of administration, reduction in bleeding after 6 months, chance of symptoms becoming "improved", nausea, weight gain, irregular bleeding, and risk of venous thromboembolism. Relative importance (RI) estimates were computed. RESULTS The mean respondent age was 35.8 years (standard deviation =7.0), and 85 women (27.5%) reported that they had previously used hormonal therapy for dysmenorrhea. Treatment preference was most strongly associated with mode of administration (RI=49.8%), followed by chance of irregular bleeding (RI=17.3%). In contrast, treatment preference was most weakly associated with chance of weight gain (RI=2.4%) and reduction in bleeding after 6 months (RI=0.8%). Respondents preferred oral treatments: for twice-daily regimen, odds ratio (OR)=4.90; for once-daily fixed cyclic regimen, OR=4.20; and for once-daily flexible extended regimen, OR=2.44; whereas for intrauterine system, OR=0.02 (p<0.001 for all). Those with prior hormonal therapy experience exhibited the same pattern. CONCLUSION Mode of administration factored heavily in dysmenorrhea treatment preferences. Women of reproductive age preferred oral medication, especially twice-daily regimen and once-daily fixed cyclic regimen. Findings can potentially help to improve physician-patient communication and treatment decision making. Physicians should consider factors that can influence patient preference to optimize treatment acceptance and adherence.
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Affiliation(s)
| | - Amir Goren
- Health Outcomes Practice, Kantar Health, New York, NY, USA
| | | | | | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan
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Perez LG, Elder JP, Haughton J, Martinez ME, Arredondo EM. Socio-demographic Moderators of Associations Between Psychological Factors and Latinas' Breast Cancer Screening Behaviors. J Immigr Minor Health 2018; 20:823-830. [PMID: 28752364 PMCID: PMC5787042 DOI: 10.1007/s10903-017-0633-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study tested whether socio-demographic factors moderated associations between psychological factors and Latinas' breast cancer screening behaviors. 222 churchgoing Latinas (40-65 years) in San Diego, CA completed surveys assessing socio-demographics (e.g., income and acculturation), psychological factors (e.g., perceived barriers to screening), and cancer screening behaviors. Multilevel models examined associations of socio-demographic and psychological factors (and their interactions) with adherence to annual mammography or clinical breast exam (CBE) screening. Although no main effects were found, there were moderation effects. Acculturation moderated associations between perceived barriers to screening and both screening outcomes, with inverse associations only among the high-acculturation group. Education moderated the relationship between perceived barriers to screening and CBE screening, with an inverse association only among the low-education group. Marital status moderated the relationship between depressive symptoms and CBE screening, with an inverse association only among single/non-partnered participants. Interventions are needed targeting psychological barriers to breast cancer screening among Latinas.
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Affiliation(s)
- L G Perez
- Joint Doctoral Program in Public Health, University of California, San Diego/San Diego State University, San Diego, CA, USA.
- Institute for Behavioral and Community Health, San Diego, CA, USA.
| | - J P Elder
- Institute for Behavioral and Community Health, San Diego, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - J Haughton
- Institute for Behavioral and Community Health, San Diego, CA, USA
| | - M E Martinez
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - E M Arredondo
- Institute for Behavioral and Community Health, San Diego, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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Britton WB, Davis JH, Loucks EB, Peterson B, Cullen BH, Reuter L, Rando A, Rahrig H, Lipsky J, Lindahl JR. Dismantling Mindfulness-Based Cognitive Therapy: Creation and validation of 8-week focused attention and open monitoring interventions within a 3-armed randomized controlled trial. Behav Res Ther 2018; 101:92-107. [PMID: 29106898 PMCID: PMC5801080 DOI: 10.1016/j.brat.2017.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND While mindfulness-based interventions (MBIs) employ two distinct practices, focused attention (FA) and open monitoring (OM), the integrated delivery of these practices in MBIs precludes understanding of their practice-specific effects or mechanisms of action. The purpose of this study is to isolate hypothesized active ingredients and practice-specific mechanistic target engagement by creating structurally equivalent interventions that differ only by the active ingredient (meditation practice) offered and to test whether the hypothesized components differentially engage the mechanistic targets that they are purported to engage. METHODS Participants were intended to be representative of American meditators and had mild to severe affective disturbances. Measures of structural equivalence included participant-level (sample characteristics), treatment-level (program structure and duration, program materials, class size, attendance, homework compliance, etc.), and instructor-level variables (training, ratings and adherence/fidelity). Measures of differential validity included analysis of program materials and verification of differential mechanistic target engagement (cognitive and affective skills and beliefs about meditation acquired by participants after the 8-week training). RESULTS The results indicate successful creation of structurally equivalent FA and OM programs that were matched on participant-level, treatment-level, and instructor-level variables. The interventions also differed as expected with respect to program materials as well as mechanistic targets engaged (skills and beliefs acquired). CONCLUSIONS These validated 8-week FA and OM training programs can be applied in future research to assess practice-specific effects of meditation.
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Affiliation(s)
- Willoughby B Britton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States.
| | - Jake H Davis
- Virtues of Attention Project, New York University, New York, United States
| | - Eric B Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Barnes Peterson
- Director of Mental Health and Substance Abuse Recovery Services, Cheshire County Department of Corrections, Keene, NH, United States
| | - Brendan H Cullen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Laura Reuter
- Stanley Street Treatment and Resource, Fall River, MA, United States
| | - Alora Rando
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Hadley Rahrig
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Jonah Lipsky
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Jared R Lindahl
- Cogut Center for the Humanities, Brown University, Providence, RI, United States
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Marmarà D, Marmarà V, Hubbard G. Lifetime utilization of mammography among Maltese women: a cross-sectional survey. BMC Public Health 2018; 18:182. [PMID: 29370835 PMCID: PMC5785821 DOI: 10.1186/s12889-018-5093-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The knowledge of Maltese women not attending the Maltese Breast Screening Programme (MBSP) for mammography screening is scarce. Previous research has identified two distinct groups of non-attendees: those who do not attend because a mammogram was taken elsewhere and those who never attended for mammography anywhere. It is however unknown which determinants are predictive of lifetime attendance 'anywhere' and 'real' non-attendance. The present study examines the relationship between ever-using (Lifetime attendees) or never using mammography (Lifetime non-attendees) and psychosocial - as well as sociodemographic factors, with the aim to identify predictors that can inform practice. METHODS Women's characteristics, knowledge, health beliefs and illness perceptions were compared, based on prior data of 404 women, aged 50-60 years at the time of their first MBSP invitation. The main variable of interest described women's attendance to mammography (LIFETIME ATTENDEES) and no mammography (LIFETIME NON-ATTENDEES). Data were analyzed using descriptive statistics, chi-square tests, Mann Whitney test, Independent Samples t-test, Shapiro Wilk test and logistic regression. RESULTS During their lifetime, 86.1% of Maltese women (n = 348) were attendees, while 13.9% (n = 56) were non-attendees. Non-attendees were more likely to be women with a lower family income (χ2 = 13.1, p = 0.011), widowers (χ2 = 9.0, p = 0.030), non-drivers (χ2 = 7.7, p = 0.006), without a breast condition (χ2 = 14.2, p < 0.001), who had no relatives or close friends with cancer (χ2 = 8.3, p = 0.016), and who were less encouraged by a physician (χ2 = 4.9, p = 0.027), unsure of the screening frequency (χ2 = 28.5, p < 0.001), more anxious (p = 0.040) and fearful (p = 0.039). Perceived benefits, barriers, cues to action, self-efficacy and emotional representations were the most significant variables to describe the differences between lifetime attendees and non-attendees. Perceived barriers and cues to action were the strongest predictors for lifetime non-attendance (p < 0.05 respectively). CONCLUSIONS The health beliefs of women who have never attended for mammography during their lifetime should be targeted, particularly perceived barriers and cues to action. Further research should focus on understanding knowledge gaps, attitudinal barriers and emotional factors among 'real' non-attendees who require a more targeted approach.
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Affiliation(s)
- Danika Marmarà
- Faculty of Health Sciences, University of Stirling, Room E9, Pathfoot, Stirling, FK9 4LA, Scotland.
- Ministry for Health, Cancer Care Pathways Directorate, Sir Anthony Mamo Oncology Centre, Level -1, Dun Karm Psaila Street, Msida, MSD 2090, Malta.
| | | | - Gill Hubbard
- Faculty of Health Sciences, University of Stirling, Room E9, Pathfoot, Stirling, FK9 4LA, Scotland
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Lee M, Zhu L, Wang MQ, Wei Z, Tan Y, Nguyen MT, Ogunwobi OO, Ma GX. Psychosocial Predictors of HBV Screening Behavior among Vietnamese Americans. Am J Health Behav 2017; 41:561-570. [PMID: 28760178 PMCID: PMC5633084 DOI: 10.5993/ajhb.41.5.5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We evaluated the influence of psychosocial factors on HBV screening. METHODS Sample consisted of 1716 Vietnamese participants in our previous HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using the Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. RESULTS Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening; knowledge had the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. CONCLUSION To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits, decreasing perceived barriers, and accounting for the dynamic cognitive processing.
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Affiliation(s)
- Minsun Lee
- Postdoctoral Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Lin Zhu
- Postdoctoral Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Min Qi Wang
- Professor, Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD
| | - Zhengyu Wei
- Research Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | | | - Minhhuyen T Nguyen
- Director, Section of Clinical Gastroenterology, Department of Medicine, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Olorunseun O Ogunwobi
- Associate Professor, Department of Biological Sciences, Hunter College of the City University of New York, New York, NY
| | - Grace X Ma
- Associate Dean for Health Disparities, Director, Center for Asian Health, Laura H. Carnell Professor and Professor in Clinical Sciences, Lewis Katz School of Medicine, Temple University Philadelphia, PA;,
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Cadet TJ, Burke SL, Stewart K, Howard T, Schonberg M. Cultural and emotional determinants of cervical cancer screening among older Hispanic women. Health Care Women Int 2017; 38:1289-1312. [PMID: 28825525 DOI: 10.1080/07399332.2017.1364740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.
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Affiliation(s)
- Tamara J Cadet
- a Simmons College School of Social Work , Boston , Massachusetts , USA.,b Harvard School of Dental Medicine Department of Oral Health Policy and Epidemiology , Boston , Massachusetts , USA
| | - Shanna L Burke
- c Florida International University , Robert Stempel College of Public Health and Social Work , Miami , Florida, USA
| | | | - Tenial Howard
- a Simmons College School of Social Work , Boston , Massachusetts , USA
| | - Mara Schonberg
- e Harvard Medical School , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA
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21
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Eliasson L, de Freitas HM, Dearden L, Calimlim B, Lloyd AJ. Patients' Preferences for the Treatment of Metastatic Castrate-resistant Prostate Cancer: A Discrete Choice Experiment. Clin Ther 2017; 39:723-737. [PMID: 28366592 DOI: 10.1016/j.clinthera.2017.02.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 01/28/2023]
Abstract
PURPOSE Patient treatment preferences are increasingly being used to inform health care decision making. This discrete choice experiment assessed how men perceive the risks and benefits of hypothetical treatment options for metastatic castrate-resistant prostate cancer (mCRPC). METHODS Treatment attributes for inclusion were identified through a review of the literature and product labels. Expert interviews confirmed clinical appropriateness and patient relevance of the attributes, which included effectiveness (delay in months before chemotherapy), steroid use, possible drug interactions (additional hospital visits for monitoring), fogginess (effects on cognition and memory), fatigue (extreme tiredness), food restrictions, and bone pain. Following a pilot, the final discrete choice experiment included 18 choice sets presenting treatments for mCRPC and was completed by men with mCRPC in France, Germany, and the United Kingdom. Data were analyzed using a conditional logit model, with odds ratios (ORs) used to indicate preference for attributes, and tradeoff measures (TOM) were estimated using the ratio of coefficients. FINDINGS Within each attribute category and with all other factors being equal, participants (N = 285) indicated a strong preference for treatments that fully control bone pain (OR = 12.069 [95% CI, 10.555-13.800]) and for treatments that delay chemotherapy (OR, 1.727 [95% CI, 1.548-1.927]). They also preferred treatments that were associated with the lowest risk of fogginess (OR, 2.115 [95% CI, 1.849-2.420]), a lower risk of fatigue (OR, 1.365 [95% CI 1.219-1.528]), and fewer additional hospital visits (OR, 1.245 [95% CI 1.111-1.397]) than the respective reference categories. Participants preferred to use steroids under advice from a physician (OR, 1.275 [95% CI 1.132-1.437]). Food restrictions related to taking medication were not a significant concern for participants. TOM results indicated that large tradeoffs in effectiveness, fogginess, and fatigue are required for patients to prefer a treatment with uncontrolled bone pain that is very difficult to live with. IMPLICATIONS Men with mCRPC consider a wide range of factors when making decisions regarding their treatment. They showed a strong preference for treatment associated with better control of bone pain. They also placed value on treatments that could delay the need for chemotherapy, and they preferred to avoid side effects such as cognition and memory loss, and extreme tiredness. TOMs highlighted the importance of symptom control, even compared with potential side effects. An understanding of the degree to which patients value the attributes associated with various treatment options will assist clinicians and health care professionals when making decisions regarding the management of men with mCRPC.
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Affiliation(s)
- Lina Eliasson
- Clinical Outcomes Assessment, ICON Clinical Research Plc, UK.
| | | | | | - Brian Calimlim
- Medical Affairs Statistical Analysis, ICON plc, San Francisco, California
| | - Andrew J Lloyd
- Clinical Outcomes Assessment, ICON Clinical Research Plc, UK
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22
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Cadet TJ, Stewart K, Howard T. Psychosocial correlates of cervical cancer screening among older Hispanic women. SOCIAL WORK IN HEALTH CARE 2017; 56:124-139. [PMID: 27960632 PMCID: PMC5890332 DOI: 10.1080/00981389.2016.1263268] [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] [Indexed: 06/06/2023]
Abstract
Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women's participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Kathleen Stewart
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Tenial Howard
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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Abstract
Similar to other Middle Eastern countries, breast cancer is the most common cancer among women in Qatar with increasing incidence and mortality rates. High mortality rates of breast cancer in the Middle Eastern countries are primarily due to delayed diagnosis of the disease. Thus screening and early detection of breast cancer are important in reducing cancer morbidity and mortality. With the aim of updating knowledge on existing interventions and developing effective intervention programs to promote breast cancer screening in Arabic populations in Qatar, this review addresses the question: What interventions are effective in increasing breast cancer knowledge and breast cancer screening rates in Arabic populations in Arabic countries and North America? Systematic literature review was performed to answer the proposed question. As the result of the search, six research studies were identified and appraised. From the findings, we infer several insights: (a) a language-appropriate and culturally sensitive educational program is the most important component of a successful intervention regardless of the study setting, (b) multi-level interventions that target both women, men, health care professionals, and/or larger health care system are more likely to be successful than single educational interventions or public awareness campaigns, and (c) more vigorous, personal and cognitive interventions that address psychosocial factors are likely to be more effective than less personal and informative interventions. This review has important implications for health care providers, intervention planners, and researchers.
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Affiliation(s)
- Tam Truong Donnelly
- University of Calgary-Qatar, Doha, Qatar
- Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB Canada
| | - Jasmine Hwang
- Faculty of Nursing, University of Calgary, 23 Edgeland Close NW, Calgary, AB Canada
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April-Sanders A, Oskar S, Shelton RC, Schmitt KM, Desperito E, Protacio A, Tehranifar P. Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population. Womens Health Issues 2016; 27:237-244. [PMID: 27863982 DOI: 10.1016/j.whi.2016.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/01/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Worry about developing breast cancer (BC) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. METHODS We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry), or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for BC (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and logistic regression. RESULTS In multivariable models, women who perceived higher absolute BC risk (odds ratio, 1.66 [95% confidence interval, 1.28-2.14] for a one-unit increase in perceived lifetime risk) and comparative BC risk (e.g., odds ratio, 2.73, 95% confidence interval, 1.23-6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. CONCLUSIONS In Hispanic women undergoing screening mammography, higher perceptions of BC risk, in both absolute and comparative terms, were associated independently with high BC worry, and were stronger predictors of BC worry than indicators of objective BC risk, including family history, mammographic density, and personal BC risk estimates.
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Affiliation(s)
- Ayana April-Sanders
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sabine Oskar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Karen M Schmitt
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Division of Academics, School of Nursing, Columbia University, New York, New York; Avon Foundation Breast Imaging Center-New York Presbyterian, New York, New York
| | - Elise Desperito
- Department of Radiology, Columbia University Medical Center-New York Presbyterian, New York, New York
| | - Angeline Protacio
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.
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Farajzadegan Z, Fathollahi-Dehkordi F, Hematti S, Sirous R, Tavakoli N, Rouzbahani R. The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:122. [PMID: 28331508 PMCID: PMC5348838 DOI: 10.4103/1735-1995.193513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/08/2016] [Accepted: 08/05/2016] [Indexed: 11/10/2022]
Abstract
Background: Participation of Iranian women with a family history of breast cancer in breast cancer screening programs is low. This study evaluates the compliance of women having a family history of breast cancer with clinical breast exam (CBE) according to the stage of transtheoretical model (TTM) and health belief model (HBM). Materials and Methods: In this cross-sectional study, we used Persian version of champion's HBM scale to collect factors associated with TTM stages applied to screening from women over 20 years and older. The obtained data were analyzed by SPSS, using descriptive statistics, Chi-square test, independent t-test, and analysis of covariance. Results: Final sample size was 162 women. Thirty-three percent were in action/maintenance stage. Older women, family history of breast cancer in first-degree relatives, personal history of breast disease, insurance coverage, and a history of breast self-examination were associated with action/maintenance stage. Furthermore, women in action/maintenance stages had significantly fewer perceived barriers in terms of CBE in comparison to women in other stages (P < 0.05). There was no significant difference in other HBM subscales scores between various stages of CBE screening behavior (P > 0.05). Conclusion: The finding indicates that the rate of women in action/maintenance stage of CBE is low. Moreover, results show a strong association between perceived barriers and having a regular CBE. These clarify the necessity of promoting national target programs for breast cancer screening, which should be considered as the first preference for reducing CBE barriers.
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Affiliation(s)
- Ziba Farajzadegan
- Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Simin Hematti
- Department of Radiotherapy, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Sirous
- Department of Radiology, University of Mississippi, Mississippi, USA
| | - Neda Tavakoli
- Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rouzbahani
- Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Uemura H, Matsubara N, Kimura G, Yamaguchi A, Ledesma DA, DiBonaventura M, Mohamed AF, Basurto E, McKinnon I, Wang E, Concialdi K, Narimatsu A, Aitoku Y. Patient preferences for treatment of castration-resistant prostate cancer in Japan: a discrete-choice experiment. BMC Urol 2016; 16:63. [PMID: 27814714 PMCID: PMC5095997 DOI: 10.1186/s12894-016-0182-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/21/2016] [Indexed: 01/11/2023] Open
Abstract
Background Up to a fifth of patients diagnosed with prostate cancer (PC) will develop castration-resistant prostate cancer (CRPC), which has been associated with a poor prognosis. The aim of this study was to consider the patient perspective as part of the overall treatment decision-making process for CRPC, given that an alignment between patient preference and prescribing has been shown to benefit patient outcomes. This study examines preferences of patients with CRPC in Japan for treatment features associated with treatments like RA-223, abiraterone, and docetaxel and to examine the extent to which treatment preferences may vary between symptomatic and asymptomatic patients. Methods A two-phase research approach was implemented. In Phase 1, N = 8 patients with CRPC were recruited from a single hospital to complete a qualitative interview to provide feedback on the draft survey. In Phase 2, N = 134 patients with CRPC were recruited from five hospitals to complete a paper survey. The survey included 6 treatment choice questions, each asking patients to choose between two hypothetical treatments for their CRPC. Each treatment alternative was defined by the following attributes: length of overall survival (OS), time to a symptomatic skeletal event (SSE), method of administration, reduction in the risk of bone pain, treatment-associated risk of fatigue and lost work days. A hierarchical Bayesian logistic regression was used to estimate relative preference weights for each attribute level and mean relative importance. Results A total of N = 133 patients with CRPC completed the survey and were included in the final analysis. Patients had a mean age of 75.4 years (SD = 7.4) and had been diagnosed with PC a mean of 6.5 years prior (SD = 4.4). Over the attribute levels shown, fatigue (relative importance [RI] = 24.9 %, 95 % CI: 24.7 %, 25.1 %) was the most important attribute, followed by reduction in the risk of bone pain (RI = 23.2 %, 95 % CI: 23.0 %, 23.5 %), and OS (RI = 19.2 %, 95 % CI: 19.0 %, 19.4 %). Although symptomatic patients placed significantly more importance on delaying an SSE (p < .05), no other preference differences were observed. Conclusions CRPC patients were more concerned about reduced quality of life from side effects of treatment rather than extension of survival, which may have implications for shared decision-making between patients and physicians.
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Affiliation(s)
- Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Nobuaki Matsubara
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Go Kimura
- Department of Urology, Nippon Medical School, Tokyo, Japan
| | - Akito Yamaguchi
- Division of Urology, Harasanshin General Hospital, Fukuoka, Japan
| | | | | | | | | | | | - Ed Wang
- Bayer Healthcare, Whippany, NJ, USA
| | | | - Aya Narimatsu
- Bayer Yakuhin, Ltd., 2-4-9, Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Yasuko Aitoku
- Bayer Yakuhin, Ltd., 2-4-9, Umeda, Kita-ku, Osaka, 530-0001, Japan.
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Cadet TJ, Berrett-Abebe J, Stewart K. Mental health and breast cancer screening utilization among older Hispanic women. J Women Aging 2016; 29:163-172. [DOI: 10.1080/08952841.2015.1113726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Wallace BH, Reese AM, Chard S, Roth EG, Quinn C, Eckert JK. Understanding the Subjective Experience of Medication Adherence for Older Urban African Americans With Type 2 Diabetes and a History of Illicit Drug Addiction. J Aging Health 2016; 29:489-509. [PMID: 26965082 DOI: 10.1177/0898264316636840] [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: 01/12/2023]
Abstract
OBJECTIVE African Americans experience high rates of type 2 diabetes mellitus (T2D). Self-management strategies, such as medication adherence, are key to mitigating negative T2D outcomes. This article addresses a gap in the literature by examining the intersections of drug abuse histories and medication adherence among urban, older African Americans with T2D. METHOD In-depth interview data were collected as part of a larger ethnographic study examining the subjective experience of T2D among urban older adults. Two representative focal cases were selected and thematic analysis performed to illustrate how former illicit drug addicts perceive prescription medication usage. RESULTS Narratives reveal that participants are displeased about having to take prescription drugs and are making lifestyle changes to reduce medication usage and maintain sobriety. DISCUSSION Previous drug abuse not only complicates medication adherence but is also a significant part of how older African Americans who are former drug users frame their understanding of T2D more broadly.
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Affiliation(s)
| | | | - Sarah Chard
- 1 University of Maryland, Baltimore County, Baltimore, USA
| | - Erin G Roth
- 1 University of Maryland, Baltimore County, Baltimore, USA
| | - Charlene Quinn
- 3 University of Maryland School of Medicine, Baltimore, USA
| | - J Kevin Eckert
- 1 University of Maryland, Baltimore County, Baltimore, USA
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Mitchell AM, Pössel P, Van Voorhees BW, Eaton WW. Associations of depression status and hopelessness with breast cancer: A 24-year follow-up study. J Health Psychol 2016; 22:1322-1331. [DOI: 10.1177/1359105315626998] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study extended the literature by examining whether three profiles of depression predicted breast cancer status. In 1076 women of the Baltimore Epidemiologic Catchment Area study, depression status and hopelessness were measured at baseline and breast cancer status was ascertained 24 years later. Double depression, but not major depression or dysthymia, was associated with breast cancer. Hopelessness predicted fewer new cases of breast cancer. When double depression and hopelessness were simultaneously entered as predictors, the regression weights of both predictors increased. The role of severe and extended duration depression as well as possible explanations for unexpected findings are discussed.
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Noel L, Connors SK, Goodman MS, Gehlert S. Improving breast cancer services for African-American women living in St. Louis. Breast Cancer Res Treat 2015; 154:5-12. [PMID: 26409834 PMCID: PMC4621693 DOI: 10.1007/s10549-015-3584-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022]
Abstract
A mixed methods, community-based research study was conducted to understand how provider-level factors contribute to the African-American and white disparity in breast cancer mortality in a lower socioeconomic status area of North St. Louis. This study used mixed methods including: (1) secondary analysis of Missouri Cancer Registry data on all 885 African-American women diagnosed with breast cancer from 2000 to 2008 while living in the geographic area of focus; (2) qualitative interviews with a subset of these women; (3) analysis of data from electronic medical records of the women interviewed; and (4) focus group interviews with community residents, patient navigators, and other health care professionals. 565 women diagnosed with breast cancer from 2000 to 2008 in the geographic area were alive at the time of secondary data analysis; we interviewed (n = 96; 17 %) of these women. Provider-level obstacles to completion of prescribed treatment included fragmented navigation (separate navigators at Federally Qualified Health Centers, surgical oncology, and medical oncology, and no navigation services in surgical oncology). Perhaps related to the latter, women described radiation as optional, often in the same words as they described breast reconstruction. Discontinuous and fragmented patient navigation leads to failure to associate radiation therapy with vital treatment recommendations. Better integrated navigation that continues throughout treatment will increase treatment completion with the potential to improve outcomes in African Americans and decrease the disparity in mortality.
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Affiliation(s)
- Lailea Noel
- George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Shahnjayla K Connors
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Melody S Goodman
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA
| | - Sarah Gehlert
- George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
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Farhadifar F, Taymoori P, Bahrami M, Zarea S. The relationship of social support concept and repeat mammography among Iranian women. BMC WOMENS HEALTH 2015; 15:92. [PMID: 26497048 PMCID: PMC4620002 DOI: 10.1186/s12905-015-0253-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/13/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Breast cancer ranks as the first most common cancer among the Iranian women. The regular repeat of mammography with 1-2 year intervals leads to the increased efficiency of early detection of breast cancer. The present study examined the predictors of repeat mammography. It was hypothesized that higher social support is connected with mammography repeat. METHODS A cross-sectional study was carried out among 400 women 50 years and older in Sanandaj, Iran. Data was collected by the questionnaire including information on socio demographical variables and measuring social support level. Data was analyzed by SPSS16 software. Multiple logistic regression was used to determine the predictive power of demographic variables and dimensions of social support for repeat mammography. RESULTS Women aged 50-55 years had three times odds of repeat mammography compared to women aged 56-60 years) OR, 3.02). Married women had greater odds of repeat mammography compared to single women (P < 0.006). The probability of repeat mammography in women with higher social support was 0.93 times greater than the women with lower social support (OR, 0.93; 95 % CI, 0.91-0.95; P < 0.0001). CONCLUSIONS Iranian women are less likely repeat mammography than other Asian women. Identifying the associations between perceived social support and repeat mammography may offer detailed information to allow for future study and guide the development of interventions not only for Iranian women but also for similar cultural that received pay too little attention to date in the breast cancer literature.
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Affiliation(s)
- Fariba Farhadifar
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, PO Box 66177-13391, Pasdaran Street, Sanandaj, Iran.
| | - Mitra Bahrami
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, PO Box 66177-13391, Pasdaran Street, Sanandaj, Iran.
| | - Shamsy Zarea
- Department of Genicology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Abstract
Attachment style is the dispositional way in which a person relates to others, and differences in attachment characteristics may offer insight into why many women do not adhere to breast screening guidelines. While mammograms involve contact with medical professionals, breast self-examination (BSE) does not, and may be preferable for women who dislike interpersonal vulnerability. As such, differences in the attachment characteristics that predict mammography versus BSE utilisation may indicate whether attachment related motivations are relevant to both interpersonal examinations and independent self-care behaviours. The current report examined how attachment dimensions predicted the frequency of mammography and BSE in a sample of 1204 ethnically diverse women from Brooklyn, New York. Participants completed measures of mammography and BSE frequency, and attachment, together with demographic, health care context and emotional predictors of screening. Multiple regressions showed that attachment dimensions predicted both mammography and BSE screening even when controlling for established predictors and emotion relevant variables. As hypothesised, fearful avoidance predicted fewer mammograms and BSEs, while preoccupation predicted more frequent BSEs. Consistent with some prior work in male cancer screening, greater attachment security also predicted fewer mammograms while degree of dismissiveness was not associated with screening frequencies. Understanding the psychosocial predictors of screening may help identify low screeners, and guide the development of targeted interventions that are better suited to the interpersonal preferences of older women.
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Affiliation(s)
- Natalie L Tuck
- a Faculty of Medical and Health Sciences, Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand
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Moudatsou MM, Kritsotakis G, Alegakis AK, Koutis A, Philalithis AE. Social capital and adherence to cervical and breast cancer screening guidelines: a cross-sectional study in rural Crete. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:395-404. [PMID: 24450830 DOI: 10.1111/hsc.12096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2013] [Indexed: 06/03/2023]
Abstract
Breast and cervical cancers are among the leading causes of female mortality. The reasons that make women adhere, or not, to screening guidelines are not only related to individual and health characteristics but are also placed in a wider social and cultural context. Social capital might facilitate the dissemination of relevant knowledge of and the adherence to cancer screening guidelines. This cross-sectional study explored the associations of individual-level social capital with breast and cervical cancer screening and the knowledge for the existence of relevant screening tests (Pap test and mammography) in the municipality of Gorgolaini, a rural area in Crete, Greece. A random sample of 131 of the 592 women of the 2001 electoral register were invited to participate in the study and 125 completed the Social Capital Questionnaire and two questions on self-reported health knowledge and behaviour (participation rate 95.4%). Women were eligible to participate if they were aged 35-75, had lived in the area for the last 10 years and were of Greek origin. Multiple logistic regressions were performed to establish associations among each social capital factor (total, participation in the community, value of life, tolerance for diversity, feelings of safety, family/friends connections) and knowledge of and adherence to breast and cervical cancer screening guidelines after adjustment for confounders. Our results suggest that early detection of breast and cervical cancers may be facilitated when taking into account the social context of the population.
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Affiliation(s)
- Maria M Moudatsou
- Department of Medicine, Faculty of Social Medicine, University of Crete, Heraklion, Greece
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Vanderpool RC, Swanberg JE, Chambers MD. A Narrative Review of the Confluence of Breast Cancer and Low-wage Employment and Its Impact on Receipt of Guideline-recommended Treatment. Glob Adv Health Med 2014; 2:75-85. [PMID: 24416698 PMCID: PMC3833560 DOI: 10.7453/gahmj.2013.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Breast cancer is the leading cause of cancer among women in the United States, costing the healthcare system, employers, and society billions of dollars each year. Despite improvements in screening and treatment, significant breast cancer treatment and survivorship disparities exist among various groups of women. One variable that has not been explored extensively as a possible contributor to breast cancer treatment disparities is employment. This is concerning, given the changing economic and employment trends in the United States favoring low-wage employment. Currently, one-quarter to one-third of all US workers are considered to be working poor, and women are disproportionally represented in this group. Characteristics of low-wage work-limited paid time off, minimal health benefits, schedule inflexibility, and economic insecurity-may become even more significant in the event of a breast cancer diagnosis. To date, there has been limited research into how job conditions inherent to low-wage work may influence working poor survivors' receipt of guideline-recommended breast cancer treatment. Therefore, the purpose of this narrative review was to critically examine the current literature to further our understanding of how employment context may impact treatment decisions and adherence-and therefore receipt of guideline-recommended care-among newly diagnosed, working poor breast cancer survivors. After undertaking a comprehensive review, we failed to identify any published literature that explicitly addressed low-wage employment and receipt of guideline-recommended breast cancer treatment. Four articles reported circumstances where women delayed, missed, or quit treatments due to work interference, or alternatively, developed strategies that allowed them to continue to work and obtain their breast cancer treatment concurrent with medical and economic challenges. An additional five articles, while focused on other cancer and employment outcomes, described the need for increased patient-provider communication about the influence of work on treatment decisions and the development of alternative treatment plans. Due to the paucity of research in this area, future policy, practice, and research efforts should focus on the employment context of working poor breast cancer survivors as a potential contributor to cancer disparities. Engagement of women, employers, oncology providers, healthcare systems, and interdisciplinary researchers is warranted to improve cancer outcomes among this disparate population of working women.
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Affiliation(s)
- Robin C Vanderpool
- University of Kentucky College of Public Health, Department of Health Behavior, Lexington, United States
| | | | - Mara D Chambers
- University of Kentucky College of Medicine, Markey Cancer Center, Comprehensive Breast Care Center, Lexington, United States
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Denckla CA, Fiori KL, Vingerhoets AJJM. Development of the Crying Proneness Scale: associations among crying proneness, empathy, attachment, and age. J Pers Assess 2014; 96:619-31. [PMID: 24730588 DOI: 10.1080/00223891.2014.899498] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Crying is a unique form of human emotional expression that is associated with both positive and negative evocative antecedents. This article investigates the psychometric properties of a newly developed Crying Proneness Scale by examining the factor structure, test-retest reliability, and theoretically hypothesized relationships with empathy, attachment, age, and gender. Based on an analysis of data provided by a Dutch panel (Time 1: N = 4,916, Time 2: N = 4,874), exploratory and confirmatory factor analyses suggest that crying proneness is a multidimensional construct best characterized by four factors called attachment tears, societal tears, sentimental/moral tears, and compassionate tears. Test-retest reliability of the scale was adequate and associations with age, gender, empathy, and attachment demonstrated expected relations. Results suggest that this scale can be used to measure crying proneness, and that it will be useful in future studies that aim to gain a better understanding of normal and pathological socioemotional development.
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Affiliation(s)
- Christy A Denckla
- a Gordon F. Derner Institute of Advanced Psychological Studies , Adelphi University
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Iskandarsyah A, de Klerk C, Suardi DR, Sadarjoen SS, Passchier J. Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer. Psychooncology 2014; 23:1118-24. [PMID: 24664984 DOI: 10.1002/pon.3534] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer. METHODS Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer. RESULTS Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions. CONCLUSIONS Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers.
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Affiliation(s)
- Aulia Iskandarsyah
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Clinical Psychology, VU University, Amsterdam, the Netherlands; Department of Clinical Psychology, Padjadjaran University, Bandung, Indonesia
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Corrigan PW, Rüsch N, Ben-Zeev D, Sher T. The rational patient and beyond: implications for treatment adherence in people with psychiatric disabilities. Rehabil Psychol 2014; 59:85-98. [PMID: 24446671 PMCID: PMC4032025 DOI: 10.1037/a0034935] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Many people with psychiatric disabilities do not benefit from evidence-based practices because they often do not seek out or fully adhere to them. One way psychologists have made sense of this rehabilitation and health decision process and subsequent behaviors (of which adherence might be viewed as one) is by proposing a "rational patient"; namely, that decisions are made deliberatively by weighing perceived costs and benefits of intervention options. Social psychological research, however, suggests limitations to a rational patient theory that impact models of health decision making. DESIGN The research literature was reviewed for studies of rational patient models and alternative theories with empirical support. Special focus was on models specifically related to decisions about rehabilitation strategies for psychiatric disability. RESULTS Notions of the rational patient evolved out of several psychological models including the health belief model, protection motivation theory, and theory of planned behavior. A variety of practice strategies evolved to promote rational decision making. However, research also suggests limitations to rational deliberations of health. (1) Rather than carefully and consciously considered, many health decisions are implicit, potentially occurring outside awareness. (2) Decisions are not always planful; often it is the immediate exigencies of a context rather than an earlier balance of costs and benefits that has the greatest effects. (3) Cool cognitions often do not dictate the process; emotional factors have an important role in health decisions. Each of these limitations suggests additional practice strategies that facilitate a person's health decisions. CONCLUSION Old models of rational decision making need to be supplanted by multiprocess models that explain supradeliberative factors in health decisions and behaviors.
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Affiliation(s)
| | | | | | - Tamara Sher
- Department of Psychology, Northwestern University
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Forsythe LP, Alfano CM, Kent EE, Weaver KE, Bellizzi K, Arora N, Aziz N, Keel G, Rowland JH. Social support, self-efficacy for decision-making, and follow-up care use in long-term cancer survivors. Psychooncology 2014; 23:788-96. [PMID: 24481884 DOI: 10.1002/pon.3480] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 11/26/2013] [Accepted: 12/12/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Cancer survivors play an important role in coordinating their follow-up care and making treatment-related decisions. Little is known about how modifiable factors such as social support are associated with active participation in follow-up care. This study tests associations between social support, cancer-related follow-up care use, and self-efficacy for participation in decision-making related to follow-up care (SEDM). We also identified sociodemographic and clinical factors associated with social support among long-term survivors. METHODS The FOllow-up Care Use among Survivors study is a cross-sectional, population-based survey of breast, prostate, colon, and gynecologic cancer survivors (n=1522) 4-14 years post-diagnosis. Multivariable regression models were used to test associations between perceived social support (tangible and emotional/informational support modeled separately), follow-up care use (past 2 years), and SEDM, as well as to identify factors associated with perceived support. RESULTS Neither support type was associated with follow-up care use (all p>0.05), although marital status was uniquely, positively associated with follow-up care use (p<0.05). Both tangible support (B for a standard deviation increase (SE)=9.75(3.15), p<0.05) and emotional/informational support (B(SE)=12.61(3.05), p<0.001) were modestly associated with SEDM. Being married, having adequate financial resources, history of recurrence, and better perceived health status were associated with higher perceived tangible and emotional support (all p<0.05). CONCLUSIONS While perceived social support may facilitate survivor efficacy for participation in decision-making during cancer follow-up care, other factors, including marital satisfaction, appear to influence follow-up care use. Marital status and social support may be important factors to consider in survivorship care planning.
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Affiliation(s)
- Laura P Forsythe
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC, USA; Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH/DHHS, Bethesda, MD, USA; Cancer Prevention Fellowship Program, Center for Cancer Training, National Cancer Institute, NIH/DHHS, Bethesda, MD, USA
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Griva F, Anagnostopoulos F, Potamianos G. Time perspective and perceived risk as related to mammography screening. Women Health 2013; 53:761-76. [PMID: 24215271 DOI: 10.1080/03630242.2013.836140] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study explored the relation of time perspective to perceived risk for breast cancer and mammography screening. Women free from breast cancer (N = 194), eligible for mammography screening in terms of age, completed the Zimbardo Time Perspective Inventory (Zimbardo & Boyd, 1999) and measures of perceived risk, attitude toward performing mammography screening, intention to get a mammogram, and mammography screening behavior. Hierarchical multiple regression analysis revealed that perceived risk of breast cancer (β= .18, p < .01) and intention to be screened (β = .35, p < .01) were significantly associated with mammography screening, after controlling for the effects of sociodemographic (e.g., age, education, and economic level) and health-related variables (e.g., family history of breast cancer and previous benign breast disease). Path analyses including the main psychological variables indicated that perceived risk was indirectly related to intention via attitude (β = .17, p < .01), and to mammography screening through attitude and intention (β = .06, p < .01). Attitude was indirectly related to mammography screening via intention (β = .20, p < .01). Also, a significant indirect association was observed between future orientation and mammography screening, via perceived risk (β = .10, p < .01). Theoretical implications of study findings and suggestions for future research on use of mammography are presented.
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Affiliation(s)
- Fay Griva
- a Department of Psychology , Panteion University of Social and Political Sciences , Athens , Greece
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Vyas A, Madhavan S, LeMasters T, Atkins E, Gainor S, Kennedy S, Kelly K, Vona-Davis L, Remick S. Factors influencing adherence to mammography screening guidelines in Appalachian women participating in a mobile mammography program. J Community Health 2012; 37:632-46. [PMID: 22033614 DOI: 10.1007/s10900-011-9494-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The objectives of this study were to evaluate the characteristics (demographic, access to care, health-related behavioral, self and family medical history, psychosocial) of women age 40 years and above who participated in a mobile mammography screening program conducted throughout West Virginia (WV) to determine the factors influencing their self-reported adherence to mammography screening guidelines. Data were analyzed using the Andersen Behavioral Model of Healthcare Utilization framework to determine the factors associated with adherence to mammography screening guidelines in these women. Of the 686 women included in the analysis, 46.2% reported having had a mammogram in the past 2 years. Bivariate analyses showed predisposing factors such as older age and unemployed status, visit to a obstetrician/gynecologist (OB/GYN) in the past year (an enabling factor) and need-related factors such as having a family history of breast cancer (BC), having had breast problems in the past, having had breast biopsy in the past, having had a Pap test in past 2 years, and having had all the screenings for cholesterol, blood glucose, bone mineral density and high blood pressure in past 2 years to be significant predictors of self-reported adherence to mammography guidelines. In the final model, being above 50 years (OR=2.132), being morbidly obese (OR=2.358), having BC-related events and low knowledge about mammography were significant predictors of self-reported adherence. Breast cancer related events seem to be associated with mammography screening adherence in this rural Appalachian population. Increasing adherence to mammography screening may require targeted, community-based educational interventions that precede and complement visits by the mobile mammography unit.
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Affiliation(s)
- Ami Vyas
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, Robert C. Byrd Health Sciences Center (North), West Virginia University, Morgantown, WV 26506-9510, USA.
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Neugut AI, Hillyer GC, Kushi LH, Lamerato L, Nathanson SD, Ambrosone CB, Bovbjerg DH, Mandelblatt JS, Magai C, Tsai WY, Jacobson JS, Hershman DL. The Breast Cancer Quality of Care Study (BQUAL): a multi-center study to determine causes for noncompliance with breast cancer adjuvant therapy. Breast J 2012; 18:203-13. [PMID: 22487337 DOI: 10.1111/j.1524-4741.2012.01240.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In oncology, quality of care is a major issue for patients and providers. Significant variations in care, including nonreceipt of adjuvant systemic therapy, nonadherence to therapy, and/or early discontinuation of therapy, occur frequently and may impact survival. Reasons for these variations are not well understood, but may play a role in the prominent disparity in breast cancer survival between blacks and whites. Since May 2006, the Breast Cancer Quality of Care Study (BQUAL) has recruited 1158 women with nonmetastatic breast cancer from several centers across the country, with completed data on 1057 participants to date. Detailed information on demographic, behavioral, biomedical, and emotional factors related to chemotherapy use was collected on each participant at baseline and at two follow-up interviews during the first 6 months. In addition, for women with ER+ tumors, further questionnaires were completed every 6 months regarding hormonal therapy use. Each participant was also asked to provide a DNA sample, and to allow medical record review. We surveyed physicians providing care to the study participants regarding attitudes toward adjuvant treatment. The mean age of participants was 58 years (SD 11.6), and 15% (n = 160) were black. The majority had an annual household income <$90,000 (n = 683), had college education or higher (n = 802), 55.9% were married, and 57.9% were not currently employed. Seventy-six percent had hormone-receptor-positive tumors, 49.9% initiated chemotherapy and 82.7% started hormonal therapy. Blacks were more likely to have lower annual household income (p < 0001), less education (p = 0.0005), ER negative tumor status (p = 0.02), and poorly differentiated cancer (p = 0.0002). The main endpoints of the study are noninitiation of chemotherapy or hormonal therapy, nonadherence to therapy and early discontinuation of therapy. Treatment and outcomes will be compared on the 15% of participants who are black versus other participants. The BQUAL Study will be a rich ongoing source of information regarding reasons for differences in receipt of both adjuvant chemotherapy and hormonal therapy. This information may be useful in planning interventions to improve quality of care.
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Affiliation(s)
- Alfred I Neugut
- Department of Medicine, and Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, School of Public Health, Columbia University Medical Center, 722 W 168th Street, New York, NY 10032, USA.
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Consedine NS, Reddig MK, Ladwig I, Broadbent EA. Gender and ethnic differences in colorectal cancer screening embarrassment and physician gender preferences. Oncol Nurs Forum 2012; 38:E409-17. [PMID: 22037340 DOI: 10.1188/11.onf.e409-e417] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine colorectal cancer (CRC) screening embarrassment among men and women from three ethnic groups and the associated physician gender preference by patient gender and ethnicity. DESIGN Cross-sectional, purposive sampling. SETTING Urban community in Brooklyn, NY. SAMPLE A purpose-derived, convenience sample of 245 European American, African American, and immigrant Jamaican men and women (aged 45-70 years) living in Brooklyn, NY. METHODS Participants provided demographics and completed a comprehensive measure of CRC screening embarrassment. MAIN RESEARCH VARIABLES Participant gender and ethnicity, physician gender, and CRC screening embarrassment regarding feces or the rectum and unwanted physical intimacy. FINDINGS As predicted, men and women both reported reduced fecal and rectal embarrassment and intimacy concern regarding same-gender physicians. As expected, Jamaicans reported greater embarrassment regarding feces or the rectum compared to European Americans and African Americans; however, in contrast to expectations, women reported less embarrassment than men. Interactions indicated that rectal and fecal embarrassment was particularly high among Jamaican men. CONCLUSIONS Men and women have a preference for same-gender physicians, and embarrassment regarding feces and the rectum shows the most consistent ethnic and gender variation. IMPLICATIONS FOR NURSING Discussing embarrassment and its causes, as well as providing an opportunity to choose a same-gender physician, may be promising strategies to reduce or manage embarrassment and increase CRC screening attendance.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, New Zealand.
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Given BA, Spoelstra SL, Grant M. The challenges of oral agents as antineoplastic treatments. Semin Oncol Nurs 2011; 27:93-103. [PMID: 21514479 DOI: 10.1016/j.soncn.2011.02.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Given the increasing use of oral antineoplastic agents in cancer management, patient adherence is critical to successful treatment outcomes. This article reviews the scope of the problem and issues of adherence to oral antineoplastic agents. DATA SOURCES Research-based and other articles, newsletters, and conference presentations. CONCLUSION Suboptimal adherence to oral antineoplastic agents is a significant clinical problem that may result in disease or treatment complications, adjustment in treatment regimen, disease progression, and premature death. IMPLICATIONS FOR NURSING PRACTICE Healthcare providers need to monitor and facilitate adherence by identifying barriers and implementing strategies to assure adherence, and therefore, improve clinical outcomes.
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Affiliation(s)
- Barbara A Given
- Michigan State University, College of Nursing, East Lansing, MI 48824, USA.
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Tsai HW, Twu NF, Ko CC, Yen MS, Yang MJ, Chao KC, Wen L, Chen CY, Chou YH, Chen YJ. Compliance with screening mammography and breast sonography of young Asian women. Eur J Obstet Gynecol Reprod Biol 2011; 157:89-93. [PMID: 21439713 DOI: 10.1016/j.ejogrb.2011.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 12/16/2010] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We evaluated compliance with mammography and breast sonography and the factors related to compliance. STUDY DESIGN From August 2005 through July 2006, 1239 asymptomatic women, aged 40-49 years, were enrolled in the study. Compliance in the second year was calculated. Telephone interviews examined the impact of the women's experience during mammography or sonography on adherence to rescreening. RESULTS The rates of compliance with mammography and sonography for breast cancer screening were 73.5% and 80.1%, respectively (p=0.006). More women receiving mammography (12.2%) reported unsatisfactory results (BI-RADS category 0) than those undergoing sonography (6.2%) (p<0.001). During the telephone interview, 74.9% of the women complained of pain during mammography, but none (0%) during sonography (p<0.001); 69.8% felt embarrassed during mammography and 55.6% during sonography (p<0.001). Multivariate logistic regression analysis showed that pain (OR 0.096, 95% CI 0.044-0.213) and unsatisfactory examination results (BI-RADS category 0) (OR 0.042, 95% CI 0.020-0.090) were barriers to not following up mammography. Embarrassment (OR 0.645, 95% CI 0.419-0.994) and unsatisfactory examination results (OR 0.169, 95% CI 0.085-0.336) were barriers to not following up sonography. CONCLUSIONS For young Asian women with dense breast tissue, compliance with sonography for breast cancer screening was better than that with mammography.
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Affiliation(s)
- Hsiao-Wen Tsai
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
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Fiori KL, Consedine NS, Merz EM. Attachment, Social Network Size, and Patterns of Social Exchange in Later Life. Res Aging 2011. [DOI: 10.1177/0164027511401038] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dispositional styles of relating to significant others—adult attachment—are linked to social relatedness across the life span. Prior work has concentrated on the receipt of perceived social support and not examined links between attachment and patterns of exchange. Data from a sample of older adults ( N 1,118) were used to examine how secure, dismissive, and fearfully avoidant dimensions were associated with network size and patterns of exchange in kin and non-kin networks. Security was related to larger network size, greater reciprocity, and less “giving” to kin, whereas dismissiveness was associated with smaller non-kin networks, greater reciprocity, less “giving” to kin and non-kin, and more relationships involving “receiving” from kin. Levels of fearful avoidance were associated with fewer reciprocal relationships and more “receiving” from kin. Data are interpreted in light of attachment’s manifestations in motivational and interpersonal systems and may help explain variations in later life social network functioning.
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Affiliation(s)
| | | | - Eva-Maria Merz
- Netherlands Interdisciplinary Demographic Institute, The Hague, THE NETHERLANDS
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Sheppard VB, Adams IF, Lamdan R, Taylor KL. The role of patient-provider communication for black women making decisions about breast cancer treatment. Psychooncology 2010; 20:1309-16. [DOI: 10.1002/pon.1852] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Revised: 08/10/2010] [Accepted: 08/17/2010] [Indexed: 01/22/2023]
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Lee SJ, Faucett J, Gillen M, Krause N, Landry L. Factors associated with safe patient handling behaviors among critical care nurses. Am J Ind Med 2010; 53:886-97. [PMID: 20698021 DOI: 10.1002/ajim.20843] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment. METHODS A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors. RESULTS More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort-reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior. CONCLUSIONS Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury.
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Affiliation(s)
- Soo-Jeong Lee
- Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, California, USA.
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Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY, Fehrenbacher L, Gomez SL, Miles S, Neugut AI. Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol 2010; 28:4120-8. [PMID: 20585090 DOI: 10.1200/jco.2009.25.9655] [Citation(s) in RCA: 618] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE While studies have found that adjuvant hormonal therapy for hormone-sensitive breast cancer (BC) dramatically reduces recurrence and mortality, adherence to medications is suboptimal. We investigated the rates and predictors of early discontinuation and nonadherence to hormonal therapy in patients enrolled in Kaiser Permanente of Northern California health system. PATIENTS AND METHODS We identified women diagnosed with hormone-sensitive stage I-III BC from 1996 to 2007 and used automated pharmacy records to identify hormonal therapy prescriptions and dates of refill. We used Cox proportional hazards regression models to analyze factors associated with early discontinuation and nonadherence (medication possession ratio < 80%) of hormonal therapy. RESULTS We identified 8,769 patients with BC who met our eligibility criteria and who filled at least one prescription for tamoxifen (43%), aromatase inhibitors (26%), or both (30%) within 1 year of diagnosis. Younger or older age, lumpectomy (v mastectomy), and comorbidities were associated with earlier discontinuation, while Asian race, being married, earlier year at diagnosis, receipt of chemotherapy or radiotherapy, and longer prescription refill interval were associated with completion of 4.5 years of therapy. Of those who continued therapy, similar factors were associated with full adherence. Women age younger than 40 years had the highest risk of discontinuation (hazard ratio, 1.51; 95% CI, 1.23 to 1.85). By 4.5 years, 32% discontinued therapy, and of those who continued, 72% were fully adherent. CONCLUSION Only 49% of patients with BC took adjuvant hormonal therapy for the full duration at the optimal schedule. Younger women are at high risk of nonadherence. Interventions to improve adherence and continuation of hormonal therapy are needed, especially for younger women.
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Affiliation(s)
- Dawn L Hershman
- Mailman School of Public Health, Columbia University Medical Center, 161 Fort Washington Ave, New York, NY 10032, USA.
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Inconsistent mammography perceptions and practices among women at risk of breast cancer following a pediatric malignancy: a report from the Childhood Cancer Survivor Study. Cancer Causes Control 2010; 21:1585-95. [PMID: 20506037 DOI: 10.1007/s10552-010-9587-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 05/15/2010] [Indexed: 01/19/2023]
Abstract
Women treated with chest radiation for a pediatric cancer have low mammography screening rates despite their high risk for breast cancer. This study characterized the relationship between perceptions of mammography and screening practices. A cross-sectional survey was administered to 523 women in North America who were treated with chest radiation before 21 years of age. Women with inconsistent mammography perceptions and practices were identified using the Pros and Cons of Mammography for perceptions and Transtheoretical Model stages of adoption for prior and intended screening practices. Classification and regression tree (CART) analysis was used to identify barriers to and facilitators of screening among women with positive and negative perceptions. Nearly one-third of the cohort had inconsistent perceptions and practices: 37.4% had positive perceptions and were not having mammograms; 27.6% had negative/neutral perceptions and were having mammograms. Regardless of perceptions, a recent physician's recommendation for mammography, age ≥ 40, and interest in routine health care were universally associated with mammography practices. For women with positive perceptions and a physician's recommendation, barriers to screening included high acceptance coping, low active-planning coping, and high internal health locus of control. For women with negative perceptions, acknowledging the importance of asymptomatic screening was associated with mammography.
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Porzsolt F. Lessons learned from prevention programs: different endpoints should be used in secondary and tertiary prevention. Recent Results Cancer Res 2010; 188:11-20. [PMID: 21253786 DOI: 10.1007/978-3-642-10858-7_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It is mandatory to compare cost and consequences of healthcare services if public support is requested. This request will apply to all healthcare services including prevention. As the demand for health care will always exceed the available resources, methods that make it possible to select the "best" programs for implementation have to be developed. The selection of the "best" programs is not easy because there exist so far no generally accepted quality criteria that can be used to identify the "best" prevention programs.Based on a model on structural and functional properties of a disease, it is concluded that the traditional outcomes of treatment and prevention may be useful for the evaluation of tertiary prevention programs, but not of secondary prevention programs. Neither the traditional endpoints of treatment studies nor traditional surrogate parameters are useful for the evaluation of secondary prevention programs.Using the assumptions of the model and a list of available data in secondary prevention programs we recommend to assess five indicators for description of the value of a secondary prevention program: quality of life, surrogates for life expectancy, the perspective of the assessor, the conditions of assessment, and finally the payment. As each of these five items offers two possible values prevention programs may be classified into 32 different groups.
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