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Jolidon V, De Prez V, Bracke P, Cullati S, Burton-Jeangros C. Lack of social support, gender and colorectal cancer screening participation across Europe: How do screening programmes mitigate the effect of social support for men and women? SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 38761366 DOI: 10.1111/1467-9566.13791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/16/2024] [Indexed: 05/20/2024]
Abstract
This study investigates how a lack of social support differentially affects men and women's colorectal cancer (CRC) screening participation, considering different screening strategies implemented across European countries. Although health sociology has stressed gender differences in social support and its effects on health behaviours, this was overlooked by cancer screening research. Using a data set of 65,961 women and 55,602 men in 31 European countries, we analysed the effect of social support variables on CRC screening uptake. We found that living alone and lower perceived social support were associated with lower screening uptake for both men and women. These effects were, however, stronger among men. Population-based screening programmes mitigated these effects, particularly for women, but not for men living alone. In countries with opportunistic screening programmes, social support variables remained associated with screening uptake. We conclude that cancer screening interventions should pay attention to social support and its gender-differentiated effects.
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Affiliation(s)
- Vladimir Jolidon
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
| | - Vincent De Prez
- Department of Sociology, Ghent University, Ghent, Belgium
- Health Services Research, Sciensano, Brussels, Belgium
| | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| | - Stéphane Cullati
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
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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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Kawamura C, Iwagami M, Sun Y, Komiyama J, Ito T, Sugiyama T, Bando H, Tamiya N. Factors associated with non-participation in breast cancer screening: analysis of the 2016 and 2019 comprehensive survey of living conditions in Japan. Breast Cancer 2023; 30:952-964. [PMID: 37488365 DOI: 10.1007/s12282-023-01486-x] [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: 05/09/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The participation rate for breast cancer screening remains to be suboptimal in Japan. Therefore, it is important to identify factors associated with non-participation and identify people at high risk for non-participation. METHODS We carried out a cross-sectional study using the data of women aged 40-74 years from the 2016 and 2019 Comprehensive Survey of Living Conditions. We selected candidate predictor variables from the survey sheets and conducted a multivariable logistic regression for non-participation in breast cancer screening for the past 2 years. In addition, using data from 2016, we created an integer risk score for non-participation and tested its predictive performance in 2019. RESULTS The proportion of participants in breast cancer screening in 2016 and 2019 were 46.7% (50,177/107,513) and 48.7% (49,498/101,716), respectively. In multivariable logistic regression analysis, age over 50 years, single/divorced/widowed, lower education level, lower household expenditure, being insured for National Health Insurance, employed to small/middle scale company, non-regularly employed, current smoker, never/quit drinking or middle/high-risk drinking, lower self-rated health status, higher Kessler Psychological Distress Scale score, non-participation in the annual health checkups for diseases other than cancer, not constantly visiting hospitals/clinics showed a positive association with non-participation. The 9-item risk score (age, marital status, education, health insurance plan, employment, smoking, drinking, non-participation in the annual health checkups for diseases other than cancer, and not constantly visiting hospitals/clinics) and 3-item risk score (age, health insurance plan, non-participation in the annual health checkups for diseases other than cancer) showed the area under the receiver operating characteristic curve of 0.744 and 0.720, respectively. CONCLUSION We identified factors associated with non-participation in breast cancer screening. The simple risk score would be useful for public health sectors to identify people at risk for non-participation.
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Affiliation(s)
- Chitose Kawamura
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Masao Iwagami
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan.
| | - Yu Sun
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Jun Komiyama
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Tomoko Ito
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroko Bando
- Department of Breast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
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Alenezi AM, Alshariyah MMH, Alanazi MN, Abdel-Salam DM, Al-Hazmi AH, Thirunavukkarasu A, Alhuwaydi AM, Alsabilah RH, Mohamed RA. Assessment of Psychosocial Correlates and Associated Factors of Colorectal Cancer Screening among Southwestern Saudi Population: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2791. [PMID: 37893864 PMCID: PMC10606086 DOI: 10.3390/healthcare11202791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Psychosocial correlates are one of the crucial determinants for the uptake of colorectal cancer (CRC) screening by the pre-eligible population. The present study aimed to identify the psychosocial correlates of colorectal cancer screening and determine their associated factors among the Saudi population in the Najran region, Saudi Arabia. Using a validated questionnaire, we assessed five constructs of psychosocial correlates of CRC screening among 790 participants aged 45 years and above. The five constructs were salience and coherence, cancer worries, perceived susceptibility, response efficacy, and social influence. Of the studied population, less than 50% agreed with most of the five constructs' statements, and 27.5% preferred to follow their family members' advice. Significantly higher mean scores (±SD) were identified for the male gender (7.38 ± 2.15, p = 0.027) and participants working in government sectors (7.60 ± 2.03, p = 0.027) in the cancer worries construct, while the mean (±SD) scores of perceived susceptibility were significantly higher among married participants (14.38 ± 4.10, p = 0.023) and smokers (14.95 ± 3.92, p = 0.041). Our survey results could help policymakers to implement focused health education programs for the pre-eligible population on the importance of the uptake of CRC screening. Furthermore, it is recommended to carry out exploratory mixed-method surveys in other regions of Saudi Arabia to understand the region's specific psychosocial correlates towards CRC screening.
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Affiliation(s)
| | | | - Maryam Nazal Alanazi
- Department of Psychological Counseling, College of Sciences and Arts, Qurrayat Campus, Jouf University, Qurrayat 77425, Saudi Arabia;
| | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Ahmad Homoud Al-Hazmi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ahmed M. Alhuwaydi
- Department of Internal Medicine, Division of Psychiatry, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | | | - Rehab A. Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
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Sterlingova T, Nylander E, Almqvist L, Møller Christensen B. Factors affecting women's participation in mammography screening in Nordic countries: A systematic review. Radiography (Lond) 2023; 29:878-885. [PMID: 37421878 DOI: 10.1016/j.radi.2023.06.010] [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: 04/18/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION Mammography screening programs have been implemented in European countries as prevention tools aimed at reducing breast cancer mortality through early detection in asymptomatic women. Nordic countries (Denmark, Finland, Iceland, Norway, Sweden, the Faroe Islands, and Greenland) demonstrated high participation rates; however, breast cancer mortality could be limited by further optimizing screening. This review aimed to explore factors that affect women's participation in mammography screening in Nordic countries. METHOD A systematic review of segregated mixed research synthesis using a deductive approach was conducted. The following databases and platforms were searched to identify relevant studies: CINAHL with Full Text (EBSCOHost), MEDLINE (EBSCOHost), PsycInfo (ProQuest), Scopus (Elsevier) and Web of Science Core Collection (SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, and ESCI). The Critical Appraisal Skills Program was used for quality assessment. The Health Promotion Model was applied to integrate findings from qualitative and qualitative research. All methodological steps followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS The final selection (16 articles) included studies from three Nordic countries: Denmark (four quantitative studies), Norway (one qualitative and four quantitative studies), and Sweden (three qualitative and seven quantitative studies). Sixty-three factors were identified as barriers, facilitators, or factors with no influence. CONCLUSION A substantial number of obtained factors, spread across a wide spectrum, describe (non-)participation in mammography screening as a versatile phenomenon. IMPLICATIONS FOR PRACTICE The findings of this review could benefit the mammography staff and providers regarding possible interventions aimed at improving screening participation rates.
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Affiliation(s)
- T Sterlingova
- Research School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11 Jönköping, Sweden.
| | - E Nylander
- Jönköping University Library, Jönköping University, P.O. Box 1026, 551 11 Jönköping, Sweden
| | - L Almqvist
- School of Health, Care and Social Welfare, Mälardalen University, P.O. Box 883, 721 23 Västerås, Sweden
| | - B Møller Christensen
- School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11 Jönköping, Sweden
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Montoro CI, Alcaraz MDC, Galvez-Sánchez CM. Experience of Pain and Unpleasantness during Mammography Screening: A Cross-Sectional Study on the Roles of Emotional, Cognitive, and Personality Factors. Behav Sci (Basel) 2023; 13:bs13050377. [PMID: 37232614 DOI: 10.3390/bs13050377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Breast cancer is the most frequent cause of malignant tumors among women worldwide. Its successful prevention depends on the degree of participation in screening programs, which can be influenced by psychological factors, including fear. METHOD A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. Twenty-six healthy women aged 50-69 years took part in this study, all of whom were summoned for routine mammography screening and were randomly selected. Prior mammography screening, breast pain intensity, unpleasantness (visual analog scale), and psychological (catastrophizing, state anxiety, and fear of pain) and personality (neuroticism, psychoticism, and extraversion) variables were evaluated. Pain, unpleasantness, and state anxiety were further evaluated pre- and post-mammography screening. RESULTS During the mammography screening, pain and unpleasantness levels were higher than those observed pre- and post-screening. Residual unpleasantness remained post-screening. State anxiety was positively associated with pain, and psychoticism with unpleasantness, as reported by participants during the mammography screening. CONCLUSIONS Anxiety levels influence the pain experienced in association with the mammography procedure. Women subjected to mammography screenings might benefit from relaxation strategies aimed at reducing anxiety to pre-mammography levels and, by extension, pain and unpleasantness during mammography. The inclusion of these strategies in breast cancer prevention campaigns could improve the rates of mammography reattendance, and therefore, benefit cancer prevention efforts.
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Affiliation(s)
| | - María Del Carmen Alcaraz
- Department of Psychology, University of Jaén, 23071 Jaén, Spain
- Diagnostic Mammography Unit, Health Center of Martos, Distrito Jaén Sur, 23600 Jaén, Spain
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Pett L, Hollenberg B, Mahoney J, Paz J, Siu N, Sun A, Zhang R, von Euler-Chelpin M. Participation and adherence to mammography screening in the Capital Region of Denmark: The importance of age over time. PLoS One 2023; 18:e0280790. [PMID: 36689434 PMCID: PMC9870097 DOI: 10.1371/journal.pone.0280790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/05/2022] [Indexed: 01/24/2023] Open
Abstract
Mammography screening's effectiveness depends on high participation levels. Understanding adherence patterns over time is important for more accurately predicting future effectiveness. This study analyzed longitudinal adherence to the biennial invitations in the Capital Region of Denmark from 2008-2017. We analyzed participation rates for five-year age groups along with their percent changes in each invitation round using linear regressions. Participation in the mammography screening program increased from 73.1% to 83.1% from 2008-2017. The participation rate among all age groups increased from the first to the fifth round, with the oldest age group having the largest increase (average percent change = 3.66; p-value = 0.03).
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Affiliation(s)
- Lindsay Pett
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Becky Hollenberg
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Mahoney
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jake Paz
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nathan Siu
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amanda Sun
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rachel Zhang
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Sawma T, Choueiri P. The influence of family functioning on the severity of fear of cancer recurrence: A cross-sectional study in a sample of breast cancer survivors of Lebanese women. Eur J Oncol Nurs 2022; 60:102169. [DOI: 10.1016/j.ejon.2022.102169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
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Sun Y, Yuan J, Liu W, Qin B, Hu Z, Li J, He Y. Predicting Rural Women's Breast Cancer Screening Intention in China: A PLS-SEM Approach Based on the Theory of Planned Behavior. Front Public Health 2022; 10:858788. [PMID: 35480590 PMCID: PMC9035887 DOI: 10.3389/fpubh.2022.858788] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIt was reported that the incidence of breast cancer (BC) was the highest among cancers worldwide. The breast cancer screening (BCS) program is regarded as an effective preventive measure. However, rural women's willingness to participate in the BCS program is relatively low. To provide measures to prevent BC, it is necessary for the government to identify the influencing factors of rural women's BCS intention.MethodsA cross-sectional study was conducted among 3,011 rural women by a convenience sampling method through face-to-face interviews on a self-designed questionnaire based on the theory of planned behavior (TPB). The partial least square structural equation model (PLS-SEM) was conducted to determine the predictors of BCS intention, and a multi-group analysis (MGA) of age was performed to identify if there were differences in all hypotheses between different age groups.ResultsThere were still rural women who have not been screened for BC in five years (41.7%). The research model of rural women's intention to accept this prevention against BC was rational. All of the hypotheses are supported. Especially, subjective norm (SN) (β = 0.345, p < 0.001) is found to be the strongest predictor followed by the perceived behavioral control 1 (PBC 1) (personal factors, including distance, transportation, busyness, etc.) (β = 0.165, p < 0.001), attitude (β = 0.152, p < 0.001), past behavior (PB) (β = 0.150, p < 0.001), knowledge (β = 0.121, p < 0.001), and perceived behavioral control 2 (PBC 2) (pain and cultural-social factors including embarrassment from a physician, etc.) (β = 0.042, p < 0.05). The advocacy and education (A&E), medical level and service attitude (ML&SA) of township health centers and village clinics can affect behavior intention (BI) via attitude, SN, and PBC. The results of MGA of age indicate that there are significant differences among rural women of different ages regarding the relationship between A&E and PBC 2 (p < 0.01) and the effect of PB on BI (p < 0.001).ConclusionThe TPB with the addition of PB, knowledge, ML&SA, and A&E can provide the theoretical basis for the policy intervention that aims to enhance the rural women's BCS willingness. MGA of age is conducive to promoting the implementation of the BCS policy. The findings are of great significance to improve rural women's health levels.
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Affiliation(s)
- Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Jiawei Yuan
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Wuqianhui Liu
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Banghui Qin
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Jianwei Li
- Department of Material and Child Health, Lianyungang Material and Child Health Hospital, Lianyungang, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan He
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Ding L, Wang J, Greuter MJW, Goossens M, Van Hal G, de Bock GH. Determinants of Non-Participation in Population-Based Breast Cancer Screening: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:817222. [PMID: 35311110 PMCID: PMC8924365 DOI: 10.3389/fonc.2022.817222] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer (BC) screening can be performed in a screening program (BCSP) or in opportunistic screening. The existing reviews on the determinants of non-participation depend on self-reported data which may be biased. Furthermore, no distinction was made between the probably different determinants of both screening strategies. Objective To find the determinants of non-participation in BCSP by means of a meta-analysis. Methods PubMed, Embase, and Web of Science were searched for observational studies which quantified factors associated with non-participation in BCSP in a general population. Studies on opportunistic screening and studies using self-reported data were excluded. A random-effect model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by stratification of the results. Results Twenty-nine studies with in a total of 20,361,756 women were included. Low income (OR: 1.20, 95% CI: 1.10–1.30), low education (OR: 1.18, 95% CI: 1.05–1.32), living far from an assigned screening unit (OR: 1.15, 95% CI: 1.07–1.24), being immigrant (OR: 2.64, 95% CI: 2.48–2.82), and having a male family doctor (OR: 1.43, 95% CI: 1.20–1.61) was associated with higher non-participation in screening. Reminders sent to non-attenders and estimations of ORs (adjusted or not) partly explained substantial heterogeneity. Conclusion In this meta-analysis excluding studies on the non-participation in opportunistic screening, or with self-reported data on non-participation, the well-known determinants for non-participation are still significant, but less strong. This analysis only supports the relevance of meta-analysis of studies with registered non-participation in a BCSP. Systematic Review Registration PROSPERO, CRD42020154016.
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Affiliation(s)
- Lilu Ding
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - J Wang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - M J W Greuter
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Robotics and Mechatronics, University of Twente, Enschede, Netherlands
| | - M Goossens
- Center for Cancer Detection, Flanders, Belgium
| | - Guido Van Hal
- Center for Cancer Detection, Flanders, Belgium.,Department of Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Allen CG, Todem D, Williams KP. Adherence to Mammography and Pap Screening Guidelines Among Medically Underserved Women: the Role of Family Structures and Network-Level Behaviors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1155-1162. [PMID: 33107009 PMCID: PMC8076331 DOI: 10.1007/s13187-020-01879-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Poor adherence to screening recommendations is an important contributing factor to disparities in breast and cervical cancer outcomes among women in the USA. Screening behaviors are multifactorial, but there has been limited focus on how family network beliefs and behaviors influence individual's likelihood to complete screening. This research aims to fill this gap by evaluating the role of family network composition and screening behaviors on women's likelihood to adhere to mammogram and pap screening recommendations. We used an ego network approach to analyze data from 137 families and their networks. Primary outcomes were whether an individual had received a mammogram in the past year and whether she had received a pap screening in the past 3 years. Network-level predictors included network composition (size of network, average age of network members, satisfaction with family communication) and network screening behaviors. We conducted multivariable logistic regressions to assess the influence of network-level variables on both mammogram and pap smears, adjusting for potential individual-level confounders. Each network had an average age of 47.9 years, and an average size of 3.05 women, with the majority of members being sisters (57.7%). We found differences in network screening behaviors by race, with Arab networks being less likely to have completed self-breast exams (OR = 0.21, 95%CI = 0.05-0.76, p = 0.02), ever a gotten pap screen (OR = 0.11, 95%CI = 0.01-0.85, p = 0.04), and gotten pap screening in the last 3 years (OR = 0.31, 95%CI = 0.10-0.99, p = 0.04) compared with African American networks. Network screening behaviors also strongly influenced the likelihood of an individual completing a similar screening behavior. This analysis sheds light on family network characteristics that influence screening behaviors among medically underserved women. These findings support the development and dissemination of screening interventions among female's family networks.
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Affiliation(s)
- Caitlin G Allen
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - David Todem
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Mottram R, Knerr WL, Gallacher D, Fraser H, Al-Khudairy L, Ayorinde A, Williamson S, Nduka C, Uthman OA, Johnson S, Tsertsvadze A, Stinton C, Taylor-Phillips S, Clarke A. Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis. BMJ Open 2021; 11:e046660. [PMID: 34848507 PMCID: PMC8634222 DOI: 10.1136/bmjopen-2020-046660] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Attendance at population-based breast cancer (mammographic) screening varies. This comprehensive systematic review and meta-analysis assesses all identified patient-level factors associated with routine population breast screening attendance. DESIGN CINAHL, Cochrane Library, Embase, Medline, OVID, PsycINFO and Web of Science were searched for studies of any design, published January 1987-June 2019, and reporting attendance in relation to at least one patient-level factor. DATA SYNTHESIS Independent reviewers performed screening, data extraction and quality appraisal. OR and 95% CIs were calculated for attendance for each factor and random-effects meta-analysis was undertaken where possible. RESULTS Of 19 776 studies, 335 were assessed at full text and 66 studies (n=22 150 922) were included. Risk of bias was generally low. In meta-analysis, increased attendance was associated with higher socioeconomic status (SES) (n=11 studies; OR 1.45, 95% CI: 1.20 to 1.75); higher income (n=5 studies; OR 1.96, 95% CI: 1.68 to 2.29); home ownership (n=3 studies; OR 2.16, 95% CI: 2.08 to 2.23); being non-immigrant (n=7 studies; OR 2.23, 95% CI: 2.00 to 2.48); being married/cohabiting (n=7 studies; OR 1.86, 95% CI: 1.58 to 2.19) and medium (vs low) level of education (n=6 studies; OR 1.24, 95% CI: 1.09 to 1.41). Women with previous false-positive results were less likely to reattend (n=6 studies; OR 0.77, 95% CI: 0.68 to 0.88). There were no differences by age group or by rural versus urban residence. CONCLUSIONS Attendance was lower in women with lower SES, those who were immigrants, non-homeowners and those with previous false-positive results. Variations in service delivery, screening programmes and study populations may influence findings. Our findings are of univariable associations. Underlying causes of lower uptake such as practical, physical, psychological or financial barriers should be investigated. TRIAL REGISTRATION NUMBER CRD42016051597.
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Affiliation(s)
- Rebecca Mottram
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Wendy Lynn Knerr
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Daniel Gallacher
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Hannah Fraser
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Lena Al-Khudairy
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Abimbola Ayorinde
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sian Williamson
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chidozie Nduka
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Olalekan A Uthman
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Samantha Johnson
- University of Warwick Library, University of Warwick, Coventry, West Midlands, UK
| | - Alexander Tsertsvadze
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Christopher Stinton
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Aileen Clarke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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13
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Young B, Robb KA. Understanding patient factors to increase uptake of cancer screening: a review. Future Oncol 2021; 17:3757-3775. [PMID: 34378403 DOI: 10.2217/fon-2020-1078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Early detection of cancer through organized screening is a central component of population-level strategies to reduce cancer mortality. For screening programs to be effective, it is important that those invited to screening participate. However, uptake rates are suboptimal in many populations and vary between screening programs, indicating a complex combination of patient factors that require elucidation to develop evidence-based strategies to increase participation. In this review, the authors summarize individual-level (sociodemographic and psychosocial) factors associated with cancer screening uptake and evidence for the effectiveness of behavioral interventions to increase uptake. The authors reflect on current trends and future directions for behavioral cancer screening research to overcome challenges and address unmet needs in reducing cancer mortality.
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Affiliation(s)
- Ben Young
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| | - Kathryn A Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
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Muñoz-Sanz JJ, Jiménez-Palomares M, Garrido-Ardila EM, Rodríguez-Mansilla J. Non-Participation in Breast Cancer Screening in Spain and Potential Application in the Present and Future: A Cross Sectional Study. Cancers (Basel) 2021; 13:cancers13174331. [PMID: 34503140 PMCID: PMC8430829 DOI: 10.3390/cancers13174331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Breast cancer screening programmes have the aim of reducing breast cancer mortality. This article is an observational, descriptive, cross-sectional and retrospective study of 2507 women who were invited to participate in the Breast Cancer Prevention Programme in Extremadura (Spain) and did not attend their appointment. We analysed the different reasons why women do not participate in the Breast Cancer Early Detection Programme in Extremadura (Spain) and discuss the results offering possible tools to improve the screening programs. Women who did not participate in the breast cancer screening programme in Extremadura had low educational levels and were older women. Abstract Background: Currently, we are beginning to observe a stabilisation and even a decrease in breast cancer mortality in the world, which may be related, among other reasons, to breast cancer screening. Methods: The objective of this study was to analyse the different reasons why women do not participate in the Breast Cancer Early Detection Programme in Extremadura (Spain) and to discuss the results, offering possible tools to improve the screening programs. This is an observational, descriptive, cross-sectional and retrospective study. A questionnaire with 14 questions was carried out by telephone or mail. Results: A total of 3970 questionnaires were collected. However, only 2507 were valid. A total of 70.36% of young and educated women underwent mammographic controls. The type of women who did not attend the screening programme appointment corresponded to a woman of approximately 60 years of age, with no formal studies, married, with children, who does not work outside their home and who lived in the health area of Badajoz. Among the main reasons for not going to the appointment, 53.9% of the women surveyed indicated that they had check-ups with their gynaecologist, and this specialist referred them for a mammograph. These women were younger and have a higher level of education. Women with a lower educational level and older women did not have any mammography done and did not undergo screening. They indicated that they did not go to the appointment because they were afraid of having a mammography (44%) or because they did not receive the appointment in time (31.6%). A total of 26.9% of the women who did not attend the appointment for other reasons stated that they had problems in attending because they had a physical limitation (dependency). Conclusions: Women who did not participate in the breast cancer screening programme in Extremadura had low educational levels and were older women. Specifically, fear of having a mammogram was the main argument raised by these women. In addition, a small group stated that they did not consider mammography to be useful. At present and in the future, good quality screening programs must be carried out to contribute to the reduction in breast cancer mortality. Furthermore, enhancing the participation of women is essential to increase the attendance rate and, therefore, the success of the screening programmes.
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Affiliation(s)
- Juan José Muñoz-Sanz
- Merida University Center (Badajoz), Department of Nursing, Extremadura University, 06800 Badajoz, Spain;
| | - María Jiménez-Palomares
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (M.J.-P.); (J.R.-M.)
| | - Elisa María Garrido-Ardila
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (M.J.-P.); (J.R.-M.)
- Correspondence: ; Tel.: +34-653369655
| | - Juan Rodríguez-Mansilla
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (M.J.-P.); (J.R.-M.)
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15
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Elovainio M, Lumme S, Arffman M, Manderbacka K, Pukkala E, Hakulinen C. Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study. SSM Popul Health 2021; 15:100826. [PMID: 34189239 PMCID: PMC8219898 DOI: 10.1016/j.ssmph.2021.100826] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023] Open
Abstract
Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis. We studied the effect of living alone on cancer incidence and mortality in total Finnish population. Excess cancer incidence risk was only found consistently in women. We found persistent excess cancer-specific mortality in cancer patients living alone. Cancer patients living alone had also a higher all-cause mortality risk. Further studies should study pathways to care among socially isolated individuals.
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Affiliation(s)
- Marko Elovainio
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sonja Lumme
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Martti Arffman
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kristiina Manderbacka
- Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.,Department of Health and Social Care Systems, Finnish Institute for Health and Welfare, Helsinki, Finland
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16
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Cadet T, Burke SL, Naseh M, Grudzien A, Kozak RS, Romeo J, Bullock K, Davis C. Examining the Family Support Role of Older Hispanics, African Americans, and Non-Hispanic Whites and Their Breast Cancer Screening Behaviors. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:38-53. [PMID: 33427579 PMCID: PMC7925380 DOI: 10.1080/19371918.2020.1852993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Disparities in breast cancer mortality rates among older Black and Hispanic women are due in part to low participation in cancer screening. Participation in cancer screening could be affected by an array of factors, including social support. Understanding the complex interplay between social support and breast cancer screening among older female adults, specifically among groups with higher mortality rates, is extremely important for timely and appropriate interventions to increase survival rates. Thus, utilizing the social network theory as the conceptual framework, this study aims to examine effects of social support on receiving a mammogram among a representative sample of older adults, specifically African American and Hispanic populations in the United States. Logistic regression models were conducted using the 2008 and 2012 Health and Retirement Study data. Findings from this study indicate that specific aspects of social support influence breast cancer screening participation among older Hispanic and non-Hispanic White women. However, this was not the case for the older Black women after adjusting for the sociodemographic factors. Given the role that family members play in the care of older adults, it is critical that social workers consider both the possible positive and negative interactions older women may have and how these interactions may affect their cancer screening behaviors. Findings can provide formative data to develop public health and social work interventions to increase positive social support and reduce negative social support by spouses and children to enhance breast cancer screening among older adults.
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Affiliation(s)
- Tamara Cadet
- School of Social Work, Simmons University, Boston, Massachusetts, USA
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shanna L Burke
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Mitra Naseh
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Adrienne Grudzien
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | | | - Jessica Romeo
- Hope House Addiction Services, Boston, Massachusetts, USA
| | - Karen Bullock
- School of Social Work, North Carolina State University, Raleigh, North Carolina, USA
| | - Cindy Davis
- University of the Sunshine Coast, Sippy Downs, Australia
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17
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The prevalence and predictive factors of breast cancer screening among older Ghanaian women. Heliyon 2020; 6:e03838. [PMID: 32373741 PMCID: PMC7191248 DOI: 10.1016/j.heliyon.2020.e03838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/13/2020] [Accepted: 04/21/2020] [Indexed: 12/09/2022] Open
Abstract
Background Breast cancer cases are on the rise in Ghana, with older adult women being more at risk of the disease. However, there is a paucity of current studies on factors that predict breast cancer screening among older adult women using nationally representative data. The present study, therefore, addressed this gap by estimating the prevalence of and identifying the factors that predict breast cancer screening among older adult women in Ghana. Methods We used the cross-sectional survey dataset of the 2014/2015 (wave II) Study on global AGEing and adult health (SAGE). A complex survey design methodology was employed to estimate the prevalence of breast cancer screening and the descriptive statistics of the demographic characteristics of the respondents. We used the firth logistic regression for the bivariate and multivariate analysis. Results The estimated breast cancer prevalence among older Ghanaian adult women was 4.5%. Older Ghanaian adult women who have screened for cervical cancer [AOR: 13.29; CI: 6.12, 28.84], had attained some primary education [AOR: 3.70; CI: 1.94, 7.07], junior secondary [AOR: 4.02; CI: 1.75, 9.21], senior secondary and higher [AOR: 4.57; CI: 2.15, 9.71], and have ever participated in a club meeting [AOR: 1.85; CI: 1.05, 3.24] were more likely to screen for breast cancer. Conclusion The significant predictors of breast cancer screening were cervical cancer screening status, formal education, and participation in club meetings. Given that the prevalence of breast cancer screening among the older adult women in Ghana is low, we recommend that policies and programs dedicated to encouraging women to screen for breast cancer should aim at giving women the opportunity to obtain higher formal education, encouraging women to be actively involved in club meetings and to intensify efforts to encourage women to screen for breast cancer.
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18
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Lee E, Natipagon-Shah B, Sangsanoi-Terkchareon S, Warda US, Lee SY. Factors Influencing Colorectal Cancer Screening Among Thais in the U.S. J Community Health 2020; 44:230-237. [PMID: 30341745 DOI: 10.1007/s10900-018-0578-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study examined factors related to colorectal cancer (CRC) screening uptake among Thais in the United States. A total of 121 Thais between 50 and 75 years of age, who were married and living in southern California participated in the survey (mean age = 61 years). Out of all the participants, only 21% of the participants had fecal occult blood tests, 21% had sigmoidoscopy, and 45% had colonoscopy that were within the recommended period. Overall, 55% of participants met CRC screening adherence criteria. Participants who had had regular checkups in the previous 2 years without having any symptoms were 16 times more likely to have obtained CRC screening than their counterparts (OR 16.01, CI 3.75-68.75) in the multivariable logistic regression model. Other significant predictors of screening adherence included older age (OR 1.08, 95% CI 1.00-1.17), having lived in the U.S. 15 years or longer (OR 6.65, 95% CI 1.55-28.59), having had at least some college education (OR 3.74, 95% CI 1.23-11.37), and higher levels of perceived self-efficacy (OR 1.88, 95% CI 1.01-3.50) to obtain CRC screening. Targeted interventions for Thais who are less likely receive CRC screening could be effective in improving CRC screening. Interventions to improve the populations' awareness of the importance of preventive measures when they are not sick could be also effective.
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Affiliation(s)
- Eunice Lee
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave., #-4-258, Los Angeles, CA, 90095, USA
| | - Bulaporn Natipagon-Shah
- School of Nursing, California State University, San Marcos, 333 S. Twin Oaks Valley Rd., San Marcos, CA, 92096, USA
| | | | - Umme Shefa Warda
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave., #-4-258, Los Angeles, CA, 90095, USA
| | - Shin-Young Lee
- Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759, Republic of Korea.
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19
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Tai YH, Chen TL, Cherng YG, Yeh CC, Chang CC, Liao CC. Previous Use of Mammography as a Proxy for General Health Checks in Association with Better Outcomes after Major Surgeries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224432. [PMID: 31726700 PMCID: PMC6888288 DOI: 10.3390/ijerph16224432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 12/27/2022]
Abstract
Although previous studies have shown that health checks may improve several risk factors for chronic diseases, the effect of preoperative health checks on postoperative recovery in surgical patients remains unknown. We aimed to investigate the association between preoperative use of mammography and the risk of perioperative complications. We conducted a matched cohort study of 152,411 patients aged ≥47 years who received mammography screening and later underwent major surgery from 2008 to 2013. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 152,411 controls who underwent surgery but were not screened were selected. We collected patients’ characteristics and medical conditions from claims data of Taiwan’s National Health Insurance. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative complications and in-hospital mortality associated with mammography screening. Patients receiving mammography prior to major surgery had significantly lower risks of perioperative complications, including pneumonia, septicemia, acute renal failure, stroke, urinary tract infection, deep wound infection, acute myocardial infarction, intensive care unit stay, and 30 day in-hospital mortality (OR 0.45, 95% CI 0.38–0.53). The association was consistent across each stratum of age, number of hospitalizations, emergency visits, and comorbidities. In conclusion, preoperative use of mammography was strongly associated with fewer perioperative complications and less in-hospital mortality after major surgeries. The evidence provided by this study justifies the implementation of preoperative health checks in clinical practice.
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Affiliation(s)
- Ying-Hsuan Tai
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 110, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
| | - Yih-Giun Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 110, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Department of Surgery, University of Illinois, Chicago, IL 60607, USA
| | - Chuen-Chau Chang
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
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20
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Predicting Behavioral Intentions Related to Cervical Cancer Screening Using a Three-Level Model for the TPB and SCT in Nanjing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193575. [PMID: 31554338 PMCID: PMC6801508 DOI: 10.3390/ijerph16193575] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/18/2019] [Accepted: 09/18/2019] [Indexed: 11/16/2022]
Abstract
: Objective: Exploring how the theory of planned behavior (TPB), social capital theory (SCT), cervical cancer knowledge (CCK), and demographic variables predict behavioral intentions (BI) related to cervical cancer screening among Chinese women. METHODS Self-administered questionnaires were distributed to 496 women, followed by a path analysis. RESULTS The three-level model was acceptable, χ2(26, 470) = 26.93, p > 0.05. Subjectively overcoming difficulties, support from significant others, screening necessity, and the objective promotion factor promoted BI, with effect sizes of 0.424, 0.354, 0.199, and 0.124. SCT and CCK promoted BI through TPB, with effect sizes of 0.262 and 0.208. Monthly income, education, age, and childbearing condition affected BI through TPB, SCT, and CCK, with effect sizes of 0.269, 0.105, 0.065, and -0.029. CONCLUSION The three-level model systematically predicted behavioral intentions relating to cervical cancer screening.
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21
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Khazaee-Pool M, Bahrami M, Luque JS, Pashaei T, Taymoori P, Roshani D. Validation of the Farsi version of the medical outcomes study-social support survey for mammography. BMC Public Health 2018; 18:1280. [PMID: 30458735 PMCID: PMC6247754 DOI: 10.1186/s12889-018-6174-2] [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] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social support can provide psychosocial benefits to promote positive health behaviors such as mammography screening. The purpose of this study was to assess the psychometric properties of the Mammography Social Support (MSS) scale among Iranian woman. METHODS Participants were selected from women referring to healthcare centers in Sanandaj, Iran. A total of 434 questionnaires were completed (response rate 91%). The study sample for study 1 included 204 participants for the Exploratory Factor Analysis (EFA). Construct validity was determined by confirmatory factor analysis (CFA) using a study sample of 230 women in study 2. The reliability coefficient for each scale was calculated using Cronbach's alpha, corrected item-total correlations and test-retest respectively. RESULTS CFA affirmed the three-factor structure of the MSS in measuring the functional dimensions of social support for mammography behavior consisting of 19 items. Initial results of the CFA did not fully support the proposed three-factor model. After the model was modified, the fit indices indicated, x2 was 2.3, Comparative Fit Index (CFI) = 0.96, Tucker- Lewis Index (TLI) = 0.95 providing a strong fit to the data. Cronbach's alphas for the subscales ranged from 0.82 and 0.90, whereas the alpha for the overall scale was 0.91. The 2-week test-retest reliability of MSS was 0.95. CONCLUSION This study provides evidence for the psychometric properties to support the Farsi version of the MSS when applied to Iranian women. Exploring the three-factor model in relation to related concepts is suggested for future studies.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mitra Bahrami
- Health Education and Promotion, Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - John S Luque
- Institute of Public Health, Florida A&M University, Science Research Center, Tallahassee, Florida, USA
| | - Tahereh Pashaei
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Parvaneh Taymoori
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Deam Roshani
- Faculty of Medicine, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Stafford M, von Wagner C, Perman S, Taylor J, Kuh D, Sheringham J. Social connectedness and engagement in preventive health services: an analysis of data from a prospective cohort study. LANCET PUBLIC HEALTH 2018; 3:e438-e446. [PMID: 30143472 PMCID: PMC6123501 DOI: 10.1016/s2468-2667(18)30141-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence of the possible health benefits of social connectedness is increasing. We aimed to examine poor social connectedness as a possible barrier to participation in preventive health services among older people (aged 53-69 years). METHODS We analysed data from a prospective cohort study of 5362 socially stratified births from the Medical Research Council National Survey of Health and Development enrolled in England, Scotland, and Wales in March 1946. At ages 68-69 years, participants reported participation in blood pressure and cholesterol measurement, eyesight and dental check-ups, influenza immunisation, and bowel and breast cancer screening. Our primary outcome measure summed participation across all these tests and services at ages 68-69 years. We tested associations between structural and functional social connectedness from ages 53 years to 69 years and total count of participation in these preventive services in Poisson models controlling for sex, education, occupational class, employment, chronic illnesses, and general practitioner consultations for health problems. FINDINGS 940 (44%) of 2132 participants attended all preventive services within the recommended timeframes. At ages 68-69 years, being unmarried or not cohabiting (incident rate ratio [IRR] 1·33, 95% CI 1·20-1·47) and small personal social networks (IRR 1·51, 1·32-1·71) were independently associated with non-participation in more services, with associations consistent across most services. High social relationship quality at ages 68-69 years (IRR 0·91, 95% CI 0·87-0·95) and increasing social relationship quality from ages 53 years to 69 years (IRR 0·93, 0·89-0·97) were associated with low risk of non-participation. INTERPRETATION Individuals with poor social connectedness appear to be at greater risk of not engaging in the full range of preventive services than individuals with good social connectedness. Improvement of access to social contacts and networks in older ages is already recommended for the maintenance of good mental health. This study suggests that social connectedness could also improve participation in a wide range of preventive health services, and hence could improve use of the health-care system and population health. FUNDING UK Medical Research Council.
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Affiliation(s)
- Mai Stafford
- The Health Foundation, London, UK; MRC Unit for Lifelong Health and Ageing, University College London, London, UK.
| | - Christian von Wagner
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sarah Perman
- Screening Quality Assurance Service, Public Health England, London, UK
| | - Jayne Taylor
- London Borough of Hackney & City of London Corporation, Hackney Service Centre, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jessica Sheringham
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care North Thames, Department of Applied Health Research, University College London, London, UK
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