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Effects of Interventions Based on Health Behavior Models on Breast Cancer Screening Behaviors of Migrant Women in Turkey. Cancer Nurs 2017; 39:E40-50. [PMID: 26018817 DOI: 10.1097/ncc.0000000000000268] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Antalya is a city receiving internal and external migration in Turkey, including migrant women in need of developing breast cancer screening behaviors. OBJECTIVE The aim of this study was to develop breast cancer screening behaviors of migrant women through nursing interventions based on the Health Belief Model and the Health Promotion Model. METHODS This quasi-experimental study was conducted with 200 women (100 women in the intervention group, 100 women in the control group) in Antalya. The intervention group received training, consultancy service, and reminders and was followed up at 3 and 6 months after interventions. RESULTS The rates of breast self-examination, clinical breast examination and mammography were higher at months 3 and 6 in women in the intervention group compared with the women in the control group. In the intervention group, perceptions of susceptibility and barriers decreased after the interventions, and benefit, health motivation, and self-efficacy perceptions increased. According to month 6 data, in the intervention group, the decrease of each unit in perception of barriers increased the rate of breast self-examination 0.8 times and the rate of mammography 0.7 times. An increase of each unit in health motivation increased the rate of clinical breast examination 1.3 times and the rate of mammography 1.5 times. CONCLUSION Interventions based on health behavior models positively affected breast cancer screening behaviors of migrant women. Health motivations and perceptions of barriers are determinants in performing the screening behaviors. IMPLICATIONS FOR PRACTICE Migrant women should be supported more by healthcare professionals regarding recognition of breast health and disease and in transportation to screening centers in their new location.
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Yost KJ, Bauer MC, Buki LP, Austin-Garrison M, Garcia LV, Hughes CA, Patten CA. Adapting a Cancer Literacy Measure for Use Among Navajo Women. J Transcult Nurs 2016; 28:278-285. [PMID: 26879319 DOI: 10.1177/1043659616628964] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The authors designed a community-based participatory research study to develop and test a family-based behavioral intervention to improve cancer literacy and promote mammography among Navajo women. METHOD Using data from focus groups and discussions with a community advisory committee, they adapted an existing questionnaire to assess cancer knowledge, barriers to mammography, and cancer beliefs for use among Navajo women. Questions measuring health literacy, numeracy, self-efficacy, cancer communication, and family support were also adapted. RESULTS The resulting questionnaire was found to have good content validity, and to be culturally and linguistically appropriate for use among Navajo women. CONCLUSIONS It is important to consider culture and not just language when adapting existing measures for use with AI/AN (American Indian/Alaskan Native) populations. English-language versions of existing literacy measures may not be culturally appropriate for AI/AN populations, which could lead to a lack of semantic, technical, idiomatic, and conceptual equivalence, resulting in misinterpretation of study outcomes.
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Demers AA, Decker KM, Kliewer EV, Musto G, Shu E, Biswanger N, Fradette K, Elias B, Griffith J, Turner D. Mammography rates for breast cancer screening: a comparison of First Nations women and all other women living in Manitoba, Canada, 1999-2008. Prev Chronic Dis 2015; 12:E82. [PMID: 26020546 PMCID: PMC4454407 DOI: 10.5888/pcd12.140571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction First Nations (FN) women historically have low rates of preventive care, including breast cancer screening. We describe the frequency of breast cancer screening among FN women living in Manitoba and all other Manitoba (AOM) women after the introduction of a provincial, organized breast screening program and explore how age, area of residence, and time period influenced breast cancer screening participation. Methods The federal Indian Registry was linked to 2 population-based, provincial data sources. A negative binomial model was used to compare breast cancer screening for FN women with screening for AOM women. Results From 1999 through 2008, 37% of FN and 59% of AOM women had a mammogram in the previous 2 years. Regardless of area of residence, FN women were less likely to have had a mammogram than AOM women (relative rate [RR] = 0.69 in the north, RR = 0.55 in the rural south, and RR = 0.53 in urban areas). Conclusions FN women living in Manitoba had lower mammography rates than AOM women. To ensure equity for all Manitoba women, strategies that encourage FN women to participate in breast cancer screening should be promoted.
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Affiliation(s)
- Alain A Demers
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, and Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Kathleen M Decker
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, and Screening Programs, CancerCare Manitoba, Winnipeg, Manitoba
| | - Erich V Kliewer
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, and Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia
| | - Grace Musto
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba
| | - Emma Shu
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba
| | | | - Katherine Fradette
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba
| | - Brenda Elias
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Jane Griffith
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, and Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
| | - Donna Turner
- Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot, Winnipeg, Manitoba R3E 0V9.
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Strickland CJ, Hillaire E. Conducting a Feasibility Study in Women's Health Screening Among Women in a Pacific Northwest American Indian Tribe. J Transcult Nurs 2014; 27:42-8. [PMID: 24848352 DOI: 10.1177/1043659614526251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast and cervical cancers continue to contribute to high cancer mortality rates in American Indian/Alaska Native women; culturally appropriate interventions are needed to influence screening behaviors and to reduce delays in obtaining care. In a pilot feasibility study designed to influence Pacific Northwest American Indian/Alaska Native women's health screening knowledge and behaviors (breast and cervical), we employed a community-based participatory research approach. Data from interviews with study participants, those involved in implementation of the study and observations were included in the analysis. Study questions focused on training of staff, recruitment of participants, and implementation of the protocol and data management. The complexities of translational, transcultural research and the importance of reporting pilot feasibility studies to the advancement of transcultural research are highlighted in the findings of this research effort.
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Tuzcu A, Bahar Z. Barriers and facilitators to breast cancer screening among migrant women within Turkey. J Transcult Nurs 2014; 26:47-56. [PMID: 24692336 DOI: 10.1177/1043659614526245] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM The purpose of this study was to examine facilitators and barriers that migrant women in Turkey identified related to breast self-examination, clinical breast examination, and mammography. DESIGN Focus group method was conducted with 39 women. An interview guide based on the Health Belief Model (HBM) and the Health Promotion Model (HPM) was used. RESULTS Three main themes became apparent as a result of data analysis: (a) knowledge and awareness about breast cancer, (b) personal factors, and (c) medical service provider and social environment. CONCLUSIONS Focus groups conducted in line with HBM and HPM were effective in explaining barriers and facilitators toward participation of women in screening behaviors. Lack of information, indifference, and cultural factors are the most important barriers of women. RECOMMENDATIONS FOR PRACTICE The study will shed light on health care professionals working in primary health care organizations for developing the health training programs and consulting strategies in order to increase breast cancer screening practices of migrant women.
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Eschiti V, Lauderdale J, Burhansstipanov L, Weryackwe-Sanford S, Weryackwe L, Flores Y. Developing cancer-related educational content and goals tailored to the Comanche Nation. Clin J Oncol Nurs 2014; 18:E26-31. [PMID: 24675267 DOI: 10.1188/14.cjon.e26-e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cancer-related educational content and goals should be modified to the needs of Native Americans to ensure adherence to healthy lifestyles. The current article describes the development of cancer-related educational modules that include creating behavioral goals specific to the people of the Comanche Nation. A community-based participatory research approach was used to conduct focus groups in the Comanche Nation and obtain feedback related to cancer-related educational modules and behavioral goals. Content analysis, verbatim transcriptions, field notes, and observations were used to analyze data and create five major themes. Comanche people need cancer educational modules and goals tailored to their culture to become engaged and maintain interest, thereby improving the likelihood of increasing cancer-related knowledge. Oncology nurses should respect guidance provided by Comanche community members to adapt cancer-related education materials and processes, as well as goal development, to address cultural concepts. When Comanche community members become knowledgeable and work toward healthy behavioral change, cancer health disparities may decrease.
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Affiliation(s)
| | - Jana Lauderdale
- Office of Diversity and Inclusion in the School of Nursing, Vanderbilt University, Nashville, TN
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James RD, Gold DE, St John-BlackBird A, Brown Trinidad S. Factors that influence mammography use among older American Indian and Alaska Native women. J Transcult Nurs 2014; 26:137-45. [PMID: 24626283 DOI: 10.1177/1043659614523994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION American Indian and Alaska Native (AIAN) women have relatively high breast cancer mortality rates despite the availability of free or low-cost screening. PURPOSE This qualitative study explored issues that influence the participation of older AIAN women in mammography screening through tribally directed National Breast and Cervical Cancer Early Detection Programs (NBCCEDPs). METHODS We interviewed staff (n = 12) representing five tribal NBCCEDPs and conducted four focus groups with AIAN women ages 50 to 80 years (n = 33). RESULTS Our analysis identified four main areas of factors that predispose, enable, or reinforce decisions around mammography: financial issues and personal investments, program characteristics including direct services and education, access issues such as transportation, and comfort zone topics that include cultural or community-wide norms regarding cancer prevention. CONCLUSION This study has implications for nurse education and training on delivering effective mammography services and preventive cancer outreach and education programs in AIAN communities.
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Ndikum-Moffor FM, Braiuca S, Daley CM, Gajewski BJ, Engelman KK. Assessment of mammography experiences and satisfaction among American Indian/Alaska Native women. Womens Health Issues 2014; 23:e395-402. [PMID: 24183414 DOI: 10.1016/j.whi.2013.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/19/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND American Indian/Alaska Native (AI/AN) women have lower breast cancer (BCA) screening and 5-year survival rates than non-Hispanic Whites. Understanding reasons for low screening rates is important to combatting later stage diagnoses. The purpose of this study was to assess mammography experiences and satisfaction among AI/AN women. METHODS Nine focus groups were held with rural (N = 15) and urban (N = 38) AI/AN women 40 years and older in Kansas and Kansas City, Missouri, living both near and far from Indian Health Service (IHS) and tribal facilities, to examine experiences and satisfaction with mammography. Transcripts were coded and themes identified using a community-based participatory research approach. FINDINGS Themes were classified under knowledge, communication, and awareness of BCA; barriers to mammography; mammogram facility size; impressions of mammogram technologist; motivations for getting a mammogram; and how to improve the mammogram experience. Participants had knowledge of prevention, but described cultural reasons for not discussing it and described better experiences in smaller facilities. Participants indicated having a mammogram technologist who was friendly, knowledgeable, respectful, competent, and explained the test was a determining factor in satisfaction. Other factors included family history, physician recommendation, and financial incentives. Barriers included transportation, cost, perceptions of prejudice, and time constraints. Participants on reservations or near IHS facilities preferred IHS over mainstream providers. Suggestions for improvement included caring technologists, better machines with less discomfort, and education. CONCLUSIONS Interventions to enhance the professionalism, empathy, and cultural awareness of mammogram technologists; reduce barriers; and provide positive expectations and incentives could improve satisfaction and compliance with screening mammography.
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Affiliation(s)
- Florence M Ndikum-Moffor
- Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Cancer Center, Kansas City, Kansas; Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas.
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Tolma E, Batterton C, Hamm RM, Thompson D, Engelman KK. American Indian Women and Screening Mammography. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2012.10599214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eleni Tolma
- a Department of Health Promotion Sciences , University of Oklahoma Health Sciences Center , Oklahoma City , OK , 73190
| | - Chasity Batterton
- b Department of Health Administration and Policy College of Public Health , University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma , 73190
| | - Robert M. Hamm
- c Department of Family and Preventive Medicine , University of Oklahoma Health Sciences Center , Oklahoma City , OK , 73104
| | - David Thompson
- d Department of Biostatistics and Epidemiology, College of Public Health , University of Oklahoma Health Science Center , Oklahoma City , Oklahoma , 73190
| | - Kimberly K. Engelman
- e Department of Preventive Medicine and Public Health , University of Kansas School of Medicine , Kansas City , KS , 66160
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Haozous EA, Eschiti V, Lauderdale J, Hill C, Amos C. Use of the talking circle for Comanche women's breast health education. J Transcult Nurs 2010; 21:377-85. [PMID: 20601548 DOI: 10.1177/1043659609360847] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND As breast cancer screening is critical to early detection and treatment, it is imperative to furnish health care providers with effective educational materials for the populations they serve. To do so for Comanche American Indian women requires understanding the cultural constructs that influence the use of screening and treatment recommendations. PURPOSE The purpose of this article is to describe the health-illness beliefs and barriers to breast health for a group of Comanche women. DESIGN This was a descriptive, qualitative study guided by the principles of community-based participatory research. Seven community health representatives serving Comanche women participated in a "Talking Circle," an indigenous method of making decisions and conducting group process among American Indian people. FINDINGS Themes were Barriers to Information, Barriers to Screening, Economic Barriers, Barriers to Follow-up, and Protecting Our Women. DISCUSSION This study provided insight into barriers to breast health for women in the Comanche Nation. These findings contribute to a foundation for enhancements needed to make breast health education and interventions culturally appropriate. These findings also add to the cultural knowledge of nurses for use in the practice area to improve understanding and communication with American Indian patients.
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Katz ML, Kauffman RM, Tatum CM, Paskett ED. Influence of church attendance and spirituality in a randomized controlled trial to increase mammography use among a low-income, tri-racial, rural community. JOURNAL OF RELIGION AND HEALTH 2008; 47:227-36. [PMID: 19105013 PMCID: PMC3895452 DOI: 10.1007/s10943-008-9159-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 01/02/2008] [Indexed: 05/21/2023]
Abstract
Background The influence of church attendance and spirituality on mammography use was studied among Native American, White, and African American women living in a rural county. Methods A randomized trial was conducted to increase mammography use. Women (n = 851) were randomly assigned to receive either an educational program delivered by a lay health advisor or a physician letter and brochure about cervical cancer screening (control group). Church attendance and spirituality were measured at baseline and mammography use was evaluated 12 months after enrollment using medical record review. Results Almost two-thirds of the women reported that they attended church at least once a week, and less than 4% were classified as having low spirituality. Church attendance (P = 0.299) or spirituality (P = 0.401) did not have a significant impact on mammography use. Conclusions Church attendance and spirituality did not impact mammography use.
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Affiliation(s)
- Mira L. Katz
- The College of Public Health, The Ohio State University, A-352 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA
- The Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Ross M. Kauffman
- The College of Public Health, The Ohio State University, A-352 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Cathy M. Tatum
- The Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Electra D. Paskett
- The College of Public Health, The Ohio State University, A-352 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA
- The Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
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