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Mascara M, Constantinou C. Global Perceptions of Women on Breast Cancer and Barriers to Screening. Curr Oncol Rep 2021; 23:74. [PMID: 33937940 DOI: 10.1007/s11912-021-01069-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Breast cancer (BC) is a public health dilemma across the globe and a leading cause of mortality for women. Approximately 2.1 million newly diagnosed female BC cases occurred in 2018, comprising nearly 1 in 4 cancer cases among women. When BC is recognized in its early stages, successful treatment results can be achieved. Therefore, screening for BC is of paramount significance and routine screening mammography has been shown to be effective in reducing mortality from BC. Despite being considered a global health issue, national screening programmes are offered only in developed countries and BC is still often diagnosed in advanced stages. RECENT FINDINGS Disparities in screening exist not only between different countries but also between local and immigrant populations within a particular country. Low screening is attributed to low public awareness as well as numerous social, psychological, and geographical barriers to screening. This review addresses (a) the differences in BC awareness and screening across the globe, (b) the most important barriers and facilitators to screening, and (c) the potential role of health education programmes to increase BC awareness and promote BC screening programmes with the ultimate goal to achieve earlier stage diagnosis of BC.
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Affiliation(s)
- Mariah Mascara
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus.
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Orji CC, Kanu C, Adelodun AI, Brown CM. Factors that Influence Mammography Use for Breast Cancer Screening among African American Women. J Natl Med Assoc 2020; 112:578-592. [PMID: 32641257 DOI: 10.1016/j.jnma.2020.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/03/2019] [Accepted: 05/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this study was to assess factors that influence use of mammography screening among African American women, with a focus on social and cultural influences using Andersen's behavioral model (ABM), and to assess the methodological quality of the included studies. METHODS A literature review was conducted using PubMed, CINAHL, PSYCINFO, and Web of Science. Search terms included a combination of the following words using Boolean operators: breast cancer screening, mammography, repeat mammography, and African American. Studies that met the following criteria were included in the review: 1) examined factors associated with mammography screening, 2) included African American women as a majority, 3) published in a peer-reviewed English language journal between 2005 and 2017, and 4) conducted in the United States. Literature reviews, commentaries and non-research studies were excluded. Cited references from identified studies were examined for additional, relevant articles. Associated factors were grouped into predisposing, enabling, and need factor domains of ABM. The reviewed studies were rated using a methodological quality score (MQS) ranging from 0 to 20, with higher scores indicating higher methodological quality. RESULTS Twenty-four studies met the inclusion criteria. Fifteen factors that affect breast cancer screening in African American women were identified: predisposing (age, education, knowledge, beliefs, mistrust, religiosity, fears and fatalism), enabling (health insurance, access to care, income, health utilization), and need (physician recommendation, family/personal history, pain/discomfort, family responsibilities) factors. The most common factor was insurance status, although cultural issues (e.g., mistrust) were evident. Most of the identified factors are modifiable. The mean MQS was 12.2, indicating that the studies were slightly above average in quality. CONCLUSIONS Financial and cultural issues were important hindrances to breast cancer screening in African American women. These findings highlight the importance of affordable health care for preventive health services as well as the relevance of culturally embedded issues to health, while the MQS accentuates the need for more rigorous research articles. Breast cancer screening interventions in this population should attend to barriers identified in this review.
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Affiliation(s)
- Chinelo C Orji
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA.
| | - Chisom Kanu
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA
| | | | - Carolyn M Brown
- Health Outcomes & Pharmacy Practice, University of Texas, Austin, TX, USA
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Hardy K, Bugella NE. Making Breast Cancer (Black) History: Results of a Church-Based Primary Prevention Study. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:251-259. [PMID: 30907267 DOI: 10.1080/19371918.2019.1580658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Breast cancer rates for African American women are lower than that of their White peers, yet their mortality rate is disproportionately higher. This study sought to address the disparity through a community-based primary prevention study targeting African American women in the Black church utilizing the public health model of primary, secondary, and tertiary prevention. The study centered on the meaningful intersection of race, gender, and faith as key factors in increasing breast health knowledge and breast cancer risk factors. The results reveal that African American women respond positively to intervention models centered on salient aspects of their identity.
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Affiliation(s)
- Kimberly Hardy
- a School of Social Work , Fayetteville State University , Fayetteville , North Carolina , USA
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Fang CY, Tseng M. Ethnic density and cancer: A review of the evidence. Cancer 2018; 124:1877-1903. [PMID: 29411868 PMCID: PMC5920546 DOI: 10.1002/cncr.31177] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 10/24/2017] [Accepted: 11/13/2017] [Indexed: 01/04/2023]
Abstract
Accumulating data suggest that factors in the social environment may be associated with cancer-related outcomes. Ethnic density, defined as the proportion of racial/ethnic minority individuals residing in a given geographic area, is 1 of the most frequently studied social environment factors, but studies on ethnic density and cancer have yielded inconsistent findings. Thus, the objective of the current review was to summarize the extant data on ethnic density and cancer-related outcomes (cancer risk, stage at diagnosis, and mortality) with the aim of identifying pathways by which ethnic density may contribute to outcomes across populations. In general, the findings indicated an association between ethnic density and increased risk for cancers of infectious origin (eg, liver, cervical) but lower risk for breast and colorectal cancers, particularly among Hispanic and Asian Americans. Hispanic ethnic density was associated with greater odds of late-stage cancer diagnosis, whereas black ethnic density was associated with greater mortality. In addition, this review highlights several methodological and conceptual issues surrounding the measurement of ethnic neighborhoods and their available resources. Clarifying the role of neighborhood ethnic density is critical to developing a greater understanding of the health risks and benefits accompanying these environments and how they may affect racial and ethnic disparities in cancer-related outcomes. Cancer 2018;124:1877-903. © 2018 American Cancer Society.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Marilyn Tseng
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
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Cadet TJ, Burke SL, Stewart K, Howard T, Schonberg M. Cultural and emotional determinants of cervical cancer screening among older Hispanic women. Health Care Women Int 2017; 38:1289-1312. [PMID: 28825525 DOI: 10.1080/07399332.2017.1364740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.
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Affiliation(s)
- Tamara J Cadet
- a Simmons College School of Social Work , Boston , Massachusetts , USA.,b Harvard School of Dental Medicine Department of Oral Health Policy and Epidemiology , Boston , Massachusetts , USA
| | - Shanna L Burke
- c Florida International University , Robert Stempel College of Public Health and Social Work , Miami , Florida, USA
| | | | - Tenial Howard
- a Simmons College School of Social Work , Boston , Massachusetts , USA
| | - Mara Schonberg
- e Harvard Medical School , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA
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Davis C, Darby K, Moore M, Cadet T, Brown G. Breast care screening for underserved African American women: Community-based participatory approach. J Psychosoc Oncol 2016; 35:90-105. [PMID: 27662263 DOI: 10.1080/07347332.2016.1217965] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Traditional health promotion models often do not take into account the importance of shared cultural backgrounds, beliefs, and experiences unique to underserved African American women when designing community-based cancer screening and prevention programs. Thus, the purpose of this study was the development, implementation, and evaluation of a community-based participatory research (CBPR) program designed to increase breast cancer screening awareness in an underserved African American population by providing culturally appropriate social support and information. The study includes 357 African American women who participated in the program and completed the 6-month follow-up questionnaire. The program consisted of a 45-minute play, using community members and storytelling to honor and incorporate five different cultural experiences (skits) with breast care and cancer. Overall, findings indicate that the educational intervention was effective. In addition, these findings are consistent with the literature that suggests that educational interventions that include knowledge to alleviate concerns, dispel myths, and create awareness can increase breast cancer screening participation rates. Furthermore, these findings confirm the importance of CBPR in health promotion activities in reducing health and cancer disparities.
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Affiliation(s)
- Cindy Davis
- a Faculty of Arts and Business , University of the Sunshine Coast , Sippy Downs , Queensland , Australia
| | - Kathleen Darby
- b Middle Tennessee State University , Murfreesboro , TN , USA
| | - Matthew Moore
- c College of Social Work , University of Tennessee , Knoxville , TN , USA
| | - Tamara Cadet
- d Simmons College of Social Work , Boston , MA , USA
| | - Gwendolynn Brown
- e Urban Health Education & Support Services Foundation , Memphis , TN , USA
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Kwok C, Ogunsiji O, Lee CF. Validation of the Breast Cancer Screening Beliefs Questionnaire among African Australian women. BMC Public Health 2016; 16:117. [PMID: 26846341 PMCID: PMC4743245 DOI: 10.1186/s12889-016-2793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/27/2016] [Indexed: 11/11/2022] Open
Abstract
Background The Breast Cancer Screening Beliefs Questionnaire (BCSBQ) has been designed as a culturally appropriate instrument for assessing women’s beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices. While it has proved to be a reliable instrument when applied to women of Chinese, Arabic and Korean origin living in Australia, its psychometric properties among women from African backgrounds have not been tested. The aim of this study is to examine the psychometric properties of the BCSBQ among African Australian women. Methods The BCSBQ was administered to 284 African Australian women who were recruited from a number of African community organizations and churches. Factor analysis was conducted to study the factor structure. Construct validity was examined using Cuzick’s non-parametric test while Cronbach alpha was used to assess internal consistency reliability. Results Exploratory factor analysis results demonstrated that the African-Australian BCSBQ can be conceptualized as a 4-factor model. The third factor, viz. “barriers to mammography”, was split into two separate factors namely, “psychological” and “practical” barriers. The results indicated that the African-Australian BCSBQ had both satisfactory validity and internal consistency. The Cronbach’s alpha of the three subscales ranged between 0.84-0.92. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-ups and perceived barriers to mammographic screening. Conclusions Our study provided evidence to support the psychometric properties of the BCSBQ.in African Australian women. The study moreover demonstrated that the use of the instrument can help health professionals to understand the beliefs, knowledge and attitudes to breast cancer among African Australian women and also the factors that impact on their breast cancer screening practices.
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Affiliation(s)
- Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Olayide Ogunsiji
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Chun Fan Lee
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore.
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Maramaldi P, Cadet TJ, Menon U. Cancer screening barriers for community-based older Hispanics and Caucasians. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2012; 55:537-559. [PMID: 22852995 DOI: 10.1080/01634372.2012.683237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Despite advances in screening and early detection, ethnic minority populations, ages 65 and older, are less likely than Caucasians to participate in cancer screening services. Empirical research indicates that older ethnic minorities have cultural values that influence their behaviors. Addressing culturally relevant communication to better understand those values may increase participation in cancer screening. The study reported is a secondary analysis of qualitative data gathered from focus groups. Utilizing an interdisciplinary analytical lens, we compared older Hispanic and Caucasian's cultural values and their screening behaviors. Suggested psychosocial interventions are discussed to assist providers in their ongoing efforts to promote cancer screening.
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Affiliation(s)
- Peter Maramaldi
- Simmons College School of Social Work, Boston, MA 02115, USA
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Hay J, Harris JN, Waters EA, Clayton MF, Ellington L, Abernethy AD, Prayor-Patterson H. Personal communication in primary and secondary cancer prevention: evolving discussions, emerging challenges. JOURNAL OF HEALTH COMMUNICATION 2009; 14 Suppl 1:18-29. [PMID: 19449265 DOI: 10.1080/10810730902806828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Over the past several years, the science of cancer communication has been recognized as integral to the dissemination of cancer prevention and control strategies in both the general population as well as higher-risk groups. In this article we draw upon current literature and small group discussion in the 2008 Society for Behavioral Medicine Cancer Special Interest Group Pre-Conference Workshop on Cancer Communication to identify current findings, critical challenges, and future opportunities regarding personal communication of primary and secondary prevention of cancer. We organize our article with six critical questions: (1) What are the most important directions of research in this area? (2) Does personal cancer communication work through rational processes, or are affective and nonrational processes also involved? (3) Are our efforts adequate to reach underserved populations? (4) Are naturalistic communicative contexts given adequate consideration? (5) Has the field been adequately informed by social psychological and communication theories? (6) What are the best outcomes to document communication effectiveness? Our goals are to initiate thought and collaborative efforts among communication, public health, and behavioral science experts, as well as to establish research priorities at the interface of communication and cancer prevention and control sciences.
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Affiliation(s)
- Jennifer Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., Seventh Floor, New York, NY 10022, USA.
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Allicock M, Sandelowski M, DeVellis B, Campbell M. Variations in meanings of the personal core value "health". PATIENT EDUCATION AND COUNSELING 2008; 73:347-353. [PMID: 18752917 PMCID: PMC2633415 DOI: 10.1016/j.pec.2008.07.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 06/26/2008] [Accepted: 07/10/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Preventive health behavior patterns and practices are influenced by many factors. Knowledge about a person's core values may improve the ability to predict decisions related to behaviors such as healthy eating. METHODS In this cross-case comparison study, we illuminate the meanings ascribed to the core value "health" in relationship to fruit and vegetable intake for colorectal cancer survivors and for persons with no cancer history. RESULTS We found that both survivors and non-survivors gave three accounts of how the value "health" influenced having a healthy diet. These were: (1) good health was necessary to fulfill/attain other values; (2) health was a manifestation of God's will; and (3) good health was not possible unless one values responsibility. CONCLUSION Understanding a person's core values provides insight about how values may act as motivators for behavior change. PRACTICE IMPLICATIONS Practitioners using motivational interviewing techniques should include a values clarification exercise to improve their assessment of how values influence behaviors.
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