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Kamyab A, Mohammadkhah F, Asadi S, Ghalehgolab F, Khani Jeihooni A. The Effect of an Educational Intervention on Breast Cancer Screening of Rural Women: Application of the Theory of Planned Behavior. Cancer Control 2024; 31:10732748241266788. [PMID: 39052977 PMCID: PMC11282563 DOI: 10.1177/10732748241266788] [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: 02/13/2024] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Early diagnosis of breast cancer is a key factor affecting patient survival, so screening can reduce the burden of this disease. The present study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on breast cancer screening in rural women. METHODS In this quasi-experimental study, 480 women referring to the health care centers in the cities of Fasa and Shiraz were divided into two groups, intervention (n = 240) and control (n = 240), using cluster random sampling method, in 2021-2022. We randomly selected two health care centers in Shiraz and Fasa and invited them to participate in the study. The demographic information questionnaire and a researcher-made questionnaire based on the TPB were used to collect the data. The intervention included 50-minute sessions on topics such as breast cancer basics, screening methods, barriers to mammography, and the role of peer groups. Data were collected before and 4 months after the intervention. RESULTS The results showed no difference between the two groups in awareness, attitude, perceived behavioral control, subjective norms, behavioral intention, and breast cancer screening performance before the intervention. Four months after the intervention, a significant increase was found in the intervention group in awareness (7.46 ± 1.50 to 18.54 ± 1.20), attitude (28.55 ± 4.62 to 58.69 ± 4.35), perceived behavioral control (22.52 ± 3.32 to 40.88 ± 3.84), and subjective norms (20.37 ± 3.34 to 21.99 ± 3.38). Instead, no significant difference in the mentioned constructs (P < 0.05) was observed in the control group. CONCLUSION This study demonstrated that TPB-based education enhanced awareness, attitude, perceived behavioral control, subjective norms, and behavioral intention towards breast cancer screening. The TPB empowers women in rural communities to prioritize their health and seek timely breast cancer screening. Continued efforts and improved access to screening services are crucial for improved outcomes.
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Affiliation(s)
- Amirhossein Kamyab
- Department of Community Medicine, School of Medicine, Fasa University of Medical Science, Fasa, Iran
| | - Fatemeh Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - Saeedeh Asadi
- Department of Gynecology, School of Medicine, Fasa University of Medical Science, Fasa, Iran
| | | | - Ali Khani Jeihooni
- Departement of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Nduka IJ, Ejie IL, Okafor CE, Eleje GU, Ekwunife OI. Interventions to increase mammography screening uptake among women living in low-income and middle-income countries: a systematic review. BMJ Open 2023; 13:e066928. [PMID: 36750281 PMCID: PMC9906257 DOI: 10.1136/bmjopen-2022-066928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE To systematically identify interventions that increase the use of mammography screening in women living in low-income and middle-income countries (LMICs). DESIGN Systematic review. DATA SOURCES MEDLINE, Embase, Global Health, CINAHL, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, Google Scholar and African regional databases. ELIGIBILITY CRITERIA Studies conducted in LMICs, published between 1 January 1990 and 30 June 2021, in the English language. Studies whose population included asymptomatic women eligible for mammography screening. Studies with a reported outcome of using mammography by either self-report or medical records. No restrictions were set on the study design. DATA EXTRACTION AND SYNTHESIS Screening, data extraction and risk-of-bias assessment were conducted by two independent reviewers. A narrative synthesis of the included studies was conducted. RESULTS Five studies met the inclusion criteria consisting of two randomised controlled trials, one quasi-experiment and two cross-sectional studies. All included studies employed client-oriented intervention strategies including one-on-one education, group education, mass and small media, reducing client out-of-pocket costs, reducing structural barriers, client reminders and engagement of community health workers (CHWs). Most studies used multicomponent interventions, resulting in increases in the rate of use of mammography than those that employed a single strategy. CONCLUSION Mass and small media, group education, reduction of economic and structural barriers, client reminders and engagement of CHWs can increase use of mammography among women in LMICs. Promoting the adoption of these interventions should be considered, especially the multicomponent interventions, which were significantly effective relative to a single strategy in increasing use of mammography. PROSPERO REGISTRATION NUMBER CRD42021269556.
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Affiliation(s)
- Ifeoma Jovita Nduka
- Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - Izuchukwu Loveth Ejie
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - Charles Ebuka Okafor
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia
- Menzies Health Institute, Southport, Queensland, Australia
| | - George Uchenna Eleje
- Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Obinna Ikechukwu Ekwunife
- Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
- Takemi Program in International Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Golets A, Farias J, Pilati R, Costa H. COVID-19 pandemic and tourism: The impact of health risk perception and intolerance of uncertainty on travel intentions. CURRENT PSYCHOLOGY 2023; 42:2500-2513. [PMID: 34539156 PMCID: PMC8436199 DOI: 10.1007/s12144-021-02282-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 10/26/2022]
Abstract
Understanding tourist behavior during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic - a period of uncertainty and risk - makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behavior during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out at the beginning of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1150 Brazilian participants from April to May 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of infection, and expected duration of the pandemic are significant predictors of travel intentions for both years. This paper contributes to a deeper understanding of crisis-resistant tourists' characteristics and provides insights for destinations' recovery.
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Affiliation(s)
- Anastasiya Golets
- grid.7632.00000 0001 2238 5157Centre of Sustainable Development, University of Brasilia, Brasilia, Brazil
| | - Jéssica Farias
- grid.7632.00000 0001 2238 5157Institute of Psychology, University of Brasilia, Brasilia, Brazil
| | - Ronaldo Pilati
- grid.7632.00000 0001 2238 5157Institute of Psychology, University of Brasilia, Brasilia, Brazil
| | - Helena Costa
- grid.7632.00000 0001 2238 5157Faculty of Business Administration, Accounting, Economics and Public Policy Management, University of Brasilia, Brasilia, Brazil
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Chinese Tourists’ Health Risk Avoidance Behavior in the Context of Regular Epidemic Prevention and Control: An Empirical Analysis. SUSTAINABILITY 2022. [DOI: 10.3390/su14116750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The health risk avoidance behavior of tourists in China, a country actively combating COVID-19, is of research significance. This study proposes and tests a model based on three theories—stimulus-organism-response model, motivation-opportunity-ability model, and health belief model—to examine the impact mechanism of tourists’ health risk avoiding behavior under COVID-19′s regular epidemic prevention and control situations and the moderating effect of health risk perception. The results reveal that, from the stimulus perspective, tourists’ motivation, opportunities to travel, and the ability to travel negatively affect tourists’ health risk avoidance behavior. That is to say, the stronger the motivation of tourists to undertake tourist activities, the stronger the safeguards provided by the government, and the better that tourists are informed of the virus and more equipped with healthy habits and skills, the more likely it is that tourists will not take avoidance behavior. From the organism perspective, perceived severity and perceived susceptibility, as mediating factors, positively influence tourists’ health risk avoidance behavior. In contrast, if tourists are more likely to believe in the controllability of the health risk of the epidemic, then they are more likely to travel and less likely to show avoidance behavior. Managerial implications and theoretical contributions are also provided.
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Keshavarzi A, Asadi S, Asadollahi A, Mohammadkhah F, Khani Jeihooni A. Tendency to Breast Cancer Screening Among Rural Women in Southern Iran: A Structural Equation Modeling (SEM) Analysis of Theory of Planned Behavior. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2022; 16:11782234221121001. [PMID: 36091183 PMCID: PMC9452820 DOI: 10.1177/11782234221121001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran. Methods: This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/df were evaluated. The significance level in all tests was considered 0.05. Results: The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model. Conclusions: The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.
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Affiliation(s)
- Ameneh Keshavarzi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeedeh Asadi
- Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abdolrahim Asadollahi
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mohammadkhah
- Department of Community Health, Child Nursing and Aging, Ramsar School of Nursing, Babol University of Medical Sciences, Babol, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Haghighat S, Omidi Z, Koosha M, Nazeri N, Khosravi N, Zolfaghari S. Status of breast cancer screening strategies and indicators in Iran: A scoping review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:21. [PMID: 35419063 PMCID: PMC8995307 DOI: 10.4103/jrms.jrms_1390_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 11/04/2022]
Abstract
Background: Materials and Methods: Results: Conclusion:
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Noman S, Shahar HK, Rahman HA, Ismail S, Aljaberi MA, Abdulrahman MN. Factor structure and internal reliability of breast cancer screening Champion's Health Belief Model Scale in Yemeni women in Malaysia: a cross-sectional study. BMC Womens Health 2021; 21:437. [PMID: 34965865 PMCID: PMC8715606 DOI: 10.1186/s12905-021-01543-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The reliability and validity of the Champion's Health Belief Model Scale (CHBMS) used in assessing the belief of women regarding breast cancer (BC) and breast cancer screening (BCS) have been examined on various populations. However, the use of this tool has not been adequately assessed for its validity in ethnic minorities. This study assessed the validity and reliability of CHBMS by analyzing the factor structure and internal reliability of the factors among Yemeni women in Malaysia. METHODS A survey was conducted among 103 female teachers from 10 schools. SPSS version 22.0 was utilized in analyzing the data. Descriptive statistics were computed for the socio-demographic characteristics. The Cronbach's alpha coefficients were used in assessing the internal reliability. The Exploratory Factor Analysis (EFA) was used to analyze the factor structure of the translated items. Parallel analysis was performed to determine the number of factors accurately. RESULTS The alpha coefficients of the factors had acceptable values ranging between 0.76 and 0.87. The factor analysis yielded six and five factors for breast self-examination (BSE) and mammography (MMG), with a total explained variance of 47.69% and 52.63%, respectively. The Kaiser-Meyer-Olkin (KMO) index values of 0.64 and 0.72, and the Bartlett's Test of Sphericity (P = 0.0001) for BSE and MMG, respectively, verified the normality distribution and the adequacy of the sample size for EFA. All the items on each factor were from the same construct that were consistent with the number of factors obtained in the scale development study. The items achieved adequate factor loadings that ranged between 0.47 and 0.88. CONCLUSIONS The translated version of the CHBMS is a validated scale used in assessing the beliefs related to BC and BCS among Yemeni women living in Malaysia. Healthcare workers could use the scales to assess women's beliefs on BC and BCS. This instrument could be used to test the effectiveness of the intervention programs.
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Affiliation(s)
- Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen.
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Malaysian Research Institute of Ageing (MyAgeing), 43400, Serdang, Malaysia
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Musheer A Aljaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
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Mammography Self-efficacy Scale and Breast Cancer Fear Scale: Psychometric Properties of the Arabic Versions Among Saudi Women. Cancer Nurs 2021; 44:163-170. [PMID: 31652134 DOI: 10.1097/ncc.0000000000000767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early screening for breast cancer (BC) is critical for improving health outcomes and reducing mortality. Research has shown that self-efficacy and fear of BC can influence patients' screening behaviors. Validated measures to assess these constructs among Saudi women are lacking. OBJECTIVE The aim of this study was to assess the psychometric properties of the Arabic versions of the Champion Mammography Self-efficacy Scale (CMSES) and Champion Breast Cancer Fear Scale (CBCFS) in a sample of Saudi women. METHODS The CMSES and CBCFS were back-translated into Arabic using an established translation protocol. Reliability was assessed using Cronbach's α coefficients. Construct validity was evaluated using exploratory and confirmatory factor analytical procedures. RESULTS The findings from the factor analysis confirmed the unidimensional structure of both scales as reported by the original authors. Additionally, both scales exhibited high internal consistency (Cronbach's α coefficients) of .91 for the modified CMSES-Arabic and .94 for the CBCFS-Arabic. CONCLUSIONS This article provided initial evidence of reliability and construct validity for the modified CMSES-Arabic and the CBCFS-Arabic. IMPLICATIONS FOR PRACTICE Nurses and other allied health professionals can now use these measures to better understand how self-efficacy and fear of BC are related to compliance with cancer screening among Saudi women and in other Arabic-speaking contexts. The scales could also be useful for developing and testing the effectiveness of interventions aimed at improving mammography testing rates.
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Pirzadeh A, Ansari S, Golshiri P. The effects of educational intervention on breast self-examination and mammography behavior: Application of an integrated model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:196. [PMID: 34250130 PMCID: PMC8249975 DOI: 10.4103/jehp.jehp_1119_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/06/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory-based educational intervention on breast self-examination (BSE) behavior and mammography. MATERIALS AND METHODS The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t-test and repeated measure test were used for analysis in the intervention group and also independent t-test and paired t-test were employed to analyze data of the control group. RESULTS The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self-efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention. CONCLUSION The study showed that theory-based education by applying of constructs such as perceived benefits and self-efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.
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Affiliation(s)
- Asiyeh Pirzadeh
- Department of Health Education and Health Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sakine Ansari
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parastoo Golshiri
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Bashirian S, Barati M, Mohammadi Y, MoaddabShoar L, Dogonchi M. Evaluation of an Intervention Program for Promoting Breast Self-Examination Behavior in Employed Women in Iran. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2021; 15:1178223421989657. [PMID: 33716505 PMCID: PMC7917430 DOI: 10.1177/1178223421989657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/30/2020] [Indexed: 12/24/2022]
Abstract
Introduction: Breast cancer is the most common malignancy in the world. Screening is the basis for early detection. However, the mortality rate is still high in Iranian women related to not screening and timely check-ups. We offered a theory-based intervention program to improve breast cancer screening behavior in women. Methods: This interventional study was conducted in 135 employed women in 2019. Their screening behavior was investigated using a questionnaire based on the Protection Motivation and Social Support Theories. We compared the efficacy of 2 educational interventions (a workshop and an E-learning program) between 2 intervention groups and a control group. The results were collected 3 months after the interventions had taken place. Data were analyzed in SPSS 23 using descriptive statistics, chi-square, analysis of variance (ANOVA), and the paired sample t-test. Results: We found a significant difference between the mean score of knowledge and the theoretical constructs (P value < .001) before and after the interventions. Our results also showed that both the intervention methods had a similar effect and that there was a significant difference in the performance of breast self-examinations between the intervention and control groups after the intervention (P value < .001). Conclusion: Given the cost-effectiveness and feasibility of implementing an E-learning program, we would recommend that health care planners assist in designing and implementing this effective form of intervention to encourage many more women to perform self-examinations to aid breast cancer screening.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila MoaddabShoar
- Department of Radiation Oncology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mitra Dogonchi
- Department of Health Education & Promotion, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran.,School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Performance in Iranian Women: a Randomized Controlled Trial Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M. The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010263. [PMID: 33396424 PMCID: PMC7795851 DOI: 10.3390/ijerph18010263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 12/31/2022]
Abstract
There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
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Affiliation(s)
- Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
- Malaysian Research Institute of Ageing (MyAgeing), Serdang 43400, Malaysia
- Correspondence:
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Musheer Abdulwahid Al-Jaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Meram Azzani
- Community Medicine Department, Faculty of Medicine, MAHSA University, Saujana Putra Campus, Jenjarom 42610, Malaysia;
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Noman S, Shahar HK, Abdul Rahman H, Ismail S. Effectiveness of An Educational Intervention of Breast Cancer Screening Practices Uptake, Knowledge, and Beliefs among Yemeni Female School Teachers in Klang Valley, Malaysia: A Study Protocol for a Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041167. [PMID: 32059587 PMCID: PMC7068409 DOI: 10.3390/ijerph17041167] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 11/24/2022]
Abstract
Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-min session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group’s knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.
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Agide FD, Garmaroudi G, Sadeghi R, Shakibazadeh E, Yaseri M, Koricha ZB. How do reproductive age women perceive breast cancer screening in Ethiopia? A qualitative study. Afr Health Sci 2019; 19:3009-3017. [PMID: 32127876 PMCID: PMC7040313 DOI: 10.4314/ahs.v19i4.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Breast cancer remains one of the deadliest non-communicable diseases in the world. In Ethiopia, breast cancer accounts for 33.4% of total cancer diagnosis in women. Objective This study aims to explore perception about breast screening behavior among reproductive age women. Methods This qualitative study was conducted as a baseline to identify gaps to design interventions that will enhance breast screening uptake among reproductive age women. Six focus group discussions and 9 in-depth interviews were conducted with women and health workers respectively. Semi-structured questions were used. Data analysis was analyzed by Atlas.ti. 7 and the ideas were put in direct quotation and narration. Results Lack of awareness is the preceding problem for self-susceptibility to breast cancer as well as for having breast screening. Majority of women thought that the cause of breast cancer was a sin (supernatural power). Self-efficacy and cues to action were the most important correlates of the perception owing to fear of socio-cultural stigma and discrimination. Conclusion All health belief model constructs identified a critical problem for adaptation of behavior. Therefore, this gives the opportunity to design and develop community-based intervention and explore new intervention mechanism with an accurate method.
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Affiliation(s)
- Feleke Doyore Agide
- Department of Health Education and Promotion, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health officer, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Gholamreza Garmaroudi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zewdie Birhanu Koricha
- Department of Health, Behavior and Society, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
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15
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Bashirian S, Mohammadi Y, Barati M, Moaddabshoar L, Dogonchi M. Effectiveness of the Theory-Based Educational Interventions on Screening of Breast Cancer in Women: A Systematic Review and Meta-Analysis. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:219-236. [PMID: 31488039 DOI: 10.1177/0272684x19862148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Screening plays an essential role in the reduction of mortality and morbidity of breast cancer, which is one of the most common cancers in women worldwide. The aim of this study was to find out whether the use of health education model and theory-based behavioral interventions is effective in women’s breast cancer screening behavior. Applying different search strategies, we searched electronic databases including PubMed, ScienceDirect, Web of Science, and Scopus without time limit from January 12 to March 11, 2017. Keywords included “Breast neoplasm,” Screening,” “Women,” and “Health Education.” First, screening was conducted based on title, abstract, and full text. Then, the studies were screened according to the selection criteria of our study. The relevant and eligible studies were critically appraised by Delphi checklist. In addition, a meta-analysis of eligible studies was conducted with the random-effect approach. Twenty-six of 8,620 initial studies (with sample size of 10,681 in the intervention group and 8,854 in the control group) were included in the final analysis. The results of the meta-analysis showed that the probability of screening behavior in the intervention group is 1.4 times of that in the control group. Furthermore, subgroup analysis by the type of screening behavior indicates that the probabilities of conducting breast self-examination and mammography in the intervention group are 1.9 and 1.4 times of those in the control group. The health education program has a significant impact on breast cancer screening behaviors, particularly breast self-examination. Thus, given the positive effects of the educational screening programs in women, it is suggested that these programs must be continuously pursued with long-term follow-up and increasing rates of screening behaviors should be monitored.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Iran
| | - Majid Barati
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Leila Moaddabshoar
- Department of Radiation Oncology, School of Medicine, Hamadan University of Medical Sciences, Iran
| | - Mitra Dogonchi
- Department of public health, School of Public Health, Hamadan University of Medical Sciences, Iran
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16
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Bao Y, Chen S, Jiang R, Li Y, Chen L, Li F, Tai J. The physical activity of colorectal cancer survivors during chemotherapy : Based on the theory of planned behavior. Support Care Cancer 2019; 28:819-826. [PMID: 31154534 DOI: 10.1007/s00520-019-04873-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate the physical activity (PA) of colorectal cancer (CRC) survivors during chemotherapy and to explain it based on the theory of planned behavior (TPB). In addition, the effects of planning, past physical activity (P-PA), and self-efficacy on the PA of CRC survivors were analyzed. METHODS CRC survivors were recruited in a third-grade hospital of Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, PA, constructs from the TPB, P-PA, planning, and self-efficacy. RESULTS A total of 174 CRC survivors were included in this study. Only 7.5% (13) of these CRC survivors had sufficient PA, and 32.2% (56) of CRC survivors were completely sedentary. Gender, education level, working status, residential location, method of payment for medical expenses, and cancer stage were all associated with PA in these patients (P < 0.05). The path model was able to explain 54% (R2 = 0.54) of the PA variance in these CRC survivors. P-PA had the greatest impact on PA during chemotherapy, and P-PA affected PA both directly and indirectly through planning. CONCLUSIONS Insufficient PA in CRC survivors was associated with a variety of factors, with P-PA having the greatest impact on this outcome. The results of this study suggest that attention must be paid to survivors who had exhibited insufficient PA prior to initial diagnosis.
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Affiliation(s)
- Yinan Bao
- School of Nursing, Jilin University, Changchun, Jilin province, China.,School of Nursing, Inner Mongolia Medical College, Hohhot, Inner Mongolia, China
| | - Si Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Ruxin Jiang
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Lei Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin province, China.
| | - Jiandong Tai
- The First Hospital of Jilin University, Changchun, Jilin province, China.
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17
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Agide FD, Sadeghi R, Garmaroudi G, Tigabu BM. A systematic review of health promotion interventions to increase breast cancer screening uptake: from the last 12 years. Eur J Public Health 2019; 28:1149-1155. [PMID: 29351597 PMCID: PMC6241206 DOI: 10.1093/eurpub/ckx231] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The outcome of breast cancer treatment largely depends on the timing of detection. The health promotion interventions have an immense contribution to early detection and improved survival. Therefore, this review aimed to provide evidence on the efficacy of the health promotion interventions to increase the uptake of breast cancer screening and to develop effective interventions targeting women. Methods Online databases (PubMed/MEDLINE/PubMed Central, Ovid/MEDILINE, EMBASE, Web of Science and Google Scholar) were searched for studies published between January 2005 and January 2017. A quality coding system was assessed using Cochrane checklists for randomized controlled trial (RCT) and Downs and Black checklists for non-RCT. The score was rated for the included articles by each researcher independently and the average score is given accordingly. This study was registered in PROSPERO as [PROSPERO 2017: CRD42017060488]. Results The review dovetailed 22 studies. Thirteen studies (59.10%) were conducted in the Unite States, 4 in Iran (18.18%), 2 in India (9.09%) and 1 each in Turkey, Saudi Arabia and Israel. The interventions were classified as ‘individual-based’, ‘community-based’, ‘group-based teachings and training’ and ‘behavioral model based’. The majority of the studies showed favorable outcomes after health promotion interventions, including improvements in women’s view of breast screening, breast self-examination and knowledge of breast screening. Conclusion The review confirmed that most of the health promotion interventions targeting women boosted the breast screening in one or another way. However, the limited quality of the included studies showed that further research is needed to improve the trials in the next future.
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Affiliation(s)
- Feleke Doyore Agide
- Department of Health Education and Promotion, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran.,Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Gholamreza Garmaroudi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bereket Molla Tigabu
- Department of Pharmaco-economics and Pharmaceutical Administration, International Campus, Tehran University of Medical Sciences, Tehran, Iran
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18
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Moghaddam ES, Shahnazi H, Hassanzadeh A. Predictive Power of PEN-3 Model Constructs in Breast Cancer Screening Behaviors among Teachers: A Cross- Sectional Study in Central Iran. Eur J Breast Health 2019; 15:105-110. [PMID: 31001612 DOI: 10.5152/ejbh.2019.4417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 01/28/2019] [Indexed: 11/22/2022]
Abstract
Objective Identifying the factors influencing screening is necessary to promote early detection of breast cancer. This study aims to determine the predictive power of PEN-3 model structures in breast cancer screening behaviors among teachers of Isfahan city in Iran. Materials and Methods This cross-sectional study was conducted on 192 female teachers in Isfahan selected by the multi-stage random sampling method. A questionnaire based on PEN-3 model was used for data collection. Statistical analysis was conducted using SPSS version 20 (multiple linear regression analysis, independent t-test, Pearson correlation coefficient), and p<0.05 was considered statistically significant. Results The mean score of behavior, perceptual, enabling and nurturer factors in early detection of breast cancer was 36.5±30.5, 74.6±8.9, 65.5±19.9 and 68.1±20.7, respectively. The mean score of behavior in early detection of breast cancer in women with individual and familial history of breast disease was significantly higher than that of those who did not have such history. Perceptual and nurturer factors as the best predictors of screening behaviors were associated with screening behaviors. Conclusion The study results indicate that nurturer and perceptual factors were the best predictors of breast cancer screening behaviors among teachers. Therefore, attention to these constructs in developing educational interventions is highly recommended.
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Affiliation(s)
| | - Hossein Shahnazi
- Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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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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20
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Saei Ghare Naz M, Simbar M, Rashidi Fakari F, Ghasemi V. Effects of Model-Based Interventions on Breast Cancer Screening Behavior of Women: a Systematic Review. Asian Pac J Cancer Prev 2018; 19:2031-2041. [PMID: 30139040 PMCID: PMC6171373 DOI: 10.22034/apjcp.2018.19.8.2031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/23/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Breast cancer is a great concern for women’s health; early detection can play a key role in reducing associated morbidity and mortality. The objective of this study was to systematically assess the effectiveness of model-based interventions for breast cancer screening behavior of women. Methods: We searched Scopus, PubMed, Web of Science, Science Direct, Cochrane library and Google scholar search engines for systematic reviews, clinical trials, pre- and post-test or quasi-experimental studies (with limits to publication dates from 2000-2017), Keywords were: breast cancer, screening, systematic review, trials, and health model. In this review, qualitative analysis was used to assess the heterogeneity of data. Results: Thirty six articles with 17,770 female participants were included in this review. The Health belief model was used in twenty three articles as the basis for intervention. Two articles used both the Health belief model and the Health Promotion Model, 5 articles used Health belief model and The Trans theoretical Model, 2 used Hthe ealth belief model and Theory planned behavior, 2 used the Health belief model and the Trans theoretical Model, 2 used the Trans theoretical Model, 1 used social cognitive theory, and 1 used Systematic Comprehensive Health Education and Promotion Model. The results showed that model-based educational interventions are more effective for BSE and CBE and mammography screening behavior of women compare to no model based intervention. The Health belief model was the most popular model for promoting breast cancer screening behavior. Conclusions: Educational model-based interventions promote self-care and create a foundation for improving breast cancer screening behavior of women and increase policy makers’ awareness and efforts towards its enhancement breast cancer screening behavior.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Student Research committee, School of Nursing and Midwifery, Midwifery and Reproductive Health Research Center, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
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21
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Shirzadi S, Nadrian H, Asghari Jafarabadi M, Allahverdipour H, Hassankhani H. Determinants of mammography adoption among iranian women: What are the differences in the cognitive factors by the stages of test adoption? Health Care Women Int 2017; 38:956-970. [PMID: 28586294 DOI: 10.1080/07399332.2017.1338705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our aim in this cross-sectional study was to investigate the predictors of the stages of change in mammography adoption (MA) based on Health Belief Model among Iranian women. Through multistage cluster sampling, we recruited and interviewed 1131 women older than 40. After statistical adjustment for other risk factors, perceived barriers (OR D 0.84, 95% CI D .81-.87) and benefits (OR D 1.17, 95% CI D 1.11-1.24) were significant predictors for MA. Majority of the women were in the pre-contemplation and contemplation stages of change for MA. Our findings are informative for the development of targeted interventions to foster MA among women.
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Affiliation(s)
- Shayesteh Shirzadi
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Haidar Nadrian
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Asghari Jafarabadi
- b Road Traffic Injury Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,c Department of Biostatistics and Epidemiology , Faculty of Health, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Allahverdipour
- a Department of Health Education and Promotion, Faculty of Health , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hadi Hassankhani
- d Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery , Tabriz University of Medical Sciences , Tabriz , Iran
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22
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Moshki M, Shahgheibi S, Taymoori P, Moradi A, Roshani D, Holt CL. Psychometric properties of the mammography self-efficacy and fear of breast cancer scales in Iranian women. BMC Public Health 2017; 17:534. [PMID: 28569149 PMCID: PMC5452424 DOI: 10.1186/s12889-017-4404-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 05/09/2017] [Indexed: 11/30/2022] Open
Abstract
Background Research investigating mammography screening has often reported low mammography self-efficacy and breast cancer fear contribute to underutilization of mammography. This study aimed to examine the reliability and validity of Champion’s Mammography Self-efficacy Scale (CMSS) and Champion’s Breast Cancer Fear Scale (CBCFS) in a sample of Iranian women. Methods The adapted instruments were administered to a community sample of 482 women aged 40 years or older. They inhibited in Sanandaj, Iran. Cronbach’s α coefficients, item-total, and test-retest correlations were used to assess the reliability of the scales. Confirmatory factor analysis was applied to assess construct validity. Results The α coefficients for the Farsi 14-item CMSS and 8-item BCFS were .87 and.95, respectively. In terms of the CMSS confirmatory factor analysis, the proportion of x2/df was 2.4, Comparative Fit Index (CFI) = 0.93, Tucker Lewis Index (TLI) = 0.96 providing a strong fit to the data induced by two-factor model. With regard to CBCFS, x2/df was 86.33, CFI =0.99, and TLI =0.99 supporting one-factor model. Conclusion The CMSS and CBCFS exhibited strong initial psychometric properties; therefore, they are recommended to understand women’s breast cancer screening behaviors better.
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Affiliation(s)
- Mahdi Moshki
- Department of Public Health, School of Health Sciences; Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shole Shahgheibi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Moradi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Deam Roshani
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Cheryl L Holt
- Department of Behavioral and Community Health, Center for Health Behavior Research, University of Maryland School of Public Health, Maryland, USA
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23
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Lamyian M. Improving early detection behavior in women at risk of breast cancer: persuasion-based health monitoring model. Climacteric 2016; 19:409-10. [DOI: 10.1080/13697137.2016.1193138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Lamyian
- Associate Professor, Tarbiat Modares University, Iran, and Visiting Scholar, School of Public Health, Yale University
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24
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Kuo CS, Chen GR, Hung SH, Liu YL, Huang KC, Cheng SY. Women with abnormal screening mammography lost to follow-up: An experience from Taiwan. Medicine (Baltimore) 2016; 95:e3889. [PMID: 27310983 PMCID: PMC4998469 DOI: 10.1097/md.0000000000003889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Breast cancer has the highest incidence among all cancers for women in Taiwan. The current screening policy in Taiwan suggested a biennial mammography for all women 40 to 69 years of age. A recommendation for additional testing is recommended for women with a BI-RADS result of 0 or 4; a request made via postal mail. Approximately 20% of high-risk patients do not receive additional follow-up. Therefore, we aimed to explore the causes of these patients being lost to follow-up, despite an abnormal mammogram. Two questionnaires were designed separately according to the conceptual framework of the Health Belief Model. Study participants, women who received a screening mammography at the National Taiwan University Hospital in 2011 with a BI-RAD of 0 or 4, were interviewed via telephone. The dependent variable was receipt of follow-up or not. The analyses were performed by using χ tests and logistic regression models. In total, 528 women were enrolled in the study: 51.2% in BI-RADS 0 group and 56.6% in BI-RADS 4, respectively. In the BI-RADS 0 group, those patients who received a follow-up examination cited the most likely causes to be physician suggestion, health implications, and concerns regarding breast cancer. Patients who did not receive a follow-up examination cited a lack of time and a perception of good personal health as primary reasons. In the BI-RADS 4 group, those patients who received a follow-up examination cited the physician's recommendation and a recognition of the importance of follow-up examinations. Patients who did not receive a follow-up examination cited having received follow-up at another hospital and a desire for a second opinion. In the BI-RADS 0 group, multivariate analysis showed that patients with higher scores in the "perceived benefits" domain were statistically more likely to receive a follow-up examination. There was no significant difference in perceived threats, perceived barriers, action cues, or self-efficacy between groups. We conclude that additional education to raise breast cancer awareness in the general public and healthcare providers will be needed to improve the rate of follow-up examinations after an abnormal screening mammogram.
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Affiliation(s)
- Chia-Sheng Kuo
- Department of Community and Family Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin
- College of Public health, National Taiwan University
| | - Guan-Ru Chen
- Department of Community and Family Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin
| | - Shou-Hung Hung
- Department of Community and Family Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin
| | - Yi-Lien Liu
- Min-Sheng General Hospital, Taoyuan City, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital BeiHu Branch
| | - Shao-Yi Cheng
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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25
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Farhadifar F, Molina Y, Taymoori P, Akhavan S. Mediators of repeat mammography in two tailored interventions for Iranian women. BMC Public Health 2016; 16:149. [PMID: 26874508 PMCID: PMC4752754 DOI: 10.1186/s12889-016-2808-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 02/01/2016] [Indexed: 12/29/2022] Open
Abstract
Background Many theory-based interventions exist that incorporate theoretical constructs (e.g., self-efficacy, behavioral control) believed to increase the likelihood of mammography. Nonetheless, little work to date has examined if increased screening among women receiving such interventions occurs due to changes in these targeted constructs. The aim of this study is to address this gap in the literature in the context of two interventions for improving regular screening among Iranian women. Methods A sample of 176 women over 50 years old in Tehran, Iran were randomly allocated into one of these three conditions: 1) an intervention based on Health Belief Model (HBM); 2) an intervention based on an integration of the HBM and selected constructs from the TPB (TPB); and 3) a control group (CON). Questionnaires were administered before the intervention and after a 6-month follow-up. The Preacher and Hayes method of mediation was used in analytic models. Results Changes in susceptibility, self-efficacy, and perceived control appeared to mediate HBM-CON differences in screening. Barriers attenuated the mediating effect of self-efficacy. Changes in barriers and self-efficacy appeared to mediate TPB-CON differences in screening. Conclusion This study was successful in identifying which theory-based constructs appear to underlie the effectiveness of HBM- and TPB-based interventions. Specific constructs have been identified that should be targeted in clinical practice to increase mammography practices among Iranian women.
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Affiliation(s)
- Fariba Farhadifar
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yamile Molina
- Community Health Sciences, School Of Public Health, University of Illinois-Chicago, Chicago, USA
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Setareh Akhavan
- Tehran University of Medical Sciences, Imam Khomini Complex Hospital, Valiasr Hospital, Gynecology Oncology Ward, Tehran, Iran
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Cohen R, Lata JP, Lee Y, Hernández JCC, Nishimura N, Schaffer CB, Mukai C, Nelson JL, Brangman SA, Agrawal Y, Travis AJ. Use of Tethered Enzymes as a Platform Technology for Rapid Analyte Detection. PLoS One 2015; 10:e0142326. [PMID: 26605916 PMCID: PMC4659663 DOI: 10.1371/journal.pone.0142326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/19/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Rapid diagnosis for time-sensitive illnesses such as stroke, cardiac arrest, and septic shock is essential for successful treatment. Much attention has therefore focused on new strategies for rapid and objective diagnosis, such as Point-of-Care Tests (PoCT) for blood biomarkers. Here we use a biomimicry-based approach to demonstrate a new diagnostic platform, based on enzymes tethered to nanoparticles (NPs). As proof of principle, we use oriented immobilization of pyruvate kinase (PK) and luciferase (Luc) on silica NPs to achieve rapid and sensitive detection of neuron-specific enolase (NSE), a clinically relevant biomarker for multiple diseases ranging from acute brain injuries to lung cancer. We hypothesize that an approach capitalizing on the speed and catalytic nature of enzymatic reactions would enable fast and sensitive biomarker detection, suitable for PoCT devices. METHODS AND FINDINGS We performed in-vitro, animal model, and human subject studies. First, the efficiency of coupled enzyme activities when tethered to NPs versus when in solution was tested, demonstrating a highly sensitive and rapid detection of physiological and pathological concentrations of NSE. Next, in rat stroke models the enzyme-based assay was able in minutes to show a statistically significant increase in NSE levels in samples taken 1 hour before and 0, 1, 3 and 6 hours after occlusion of the distal middle cerebral artery. Finally, using the tethered enzyme assay for detection of NSE in samples from 20 geriatric human patients, we show that our data match well (r = 0.815) with the current gold standard for biomarker detection, ELISA-with a major difference being that we achieve detection in 10 minutes as opposed to the several hours required for traditional ELISA. CONCLUSIONS Oriented enzyme immobilization conferred more efficient coupled activity, and thus higher assay sensitivity, than non-tethered enzymes. Together, our findings provide proof of concept for using oriented immobilization of active enzymes on NPs as the basis for a highly rapid and sensitive biomarker detection platform. This addresses a key challenge in developing a PoCT platform for time sensitive and difficult to diagnose pathologies.
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Affiliation(s)
- Roy Cohen
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Hungerford Hill Rd., Ithaca, NY 14853, United States of America
| | - James P. Lata
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Hungerford Hill Rd., Ithaca, NY 14853, United States of America
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
| | - Yurim Lee
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
| | - Jean C. Cruz Hernández
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
| | - Nozomi Nishimura
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
| | - Chris B. Schaffer
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
| | - Chinatsu Mukai
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Hungerford Hill Rd., Ithaca, NY 14853, United States of America
| | - Jacquelyn L. Nelson
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Hungerford Hill Rd., Ithaca, NY 14853, United States of America
| | - Sharon A. Brangman
- Central New York ADAC, SUNY Upstate Medical University, Syracuse, NY 13210, United States of America
| | - Yash Agrawal
- New York Presbyterian Hospital-Cornell Campus, Cornell University, Ithaca, NY 10065, United States of America
| | - Alexander J. Travis
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Hungerford Hill Rd., Ithaca, NY 14853, United States of America
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, United States of America
- Atkinson Center for a Sustainable Future, Cornell University, Ithaca, NY 14853, United States of America
- * E-mail:
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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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