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Schaeffler F, Parry AM, Beck J, Rees M, Schaeffler S, Whittaker T. Comparing Vocal Health and Attitudes to Voice care in Primary Teachers and Voiceover Artists - A Survey Study Using the Health Belief Model. J Voice 2023:S0892-1997(23)00039-5. [PMID: 36941165 DOI: 10.1016/j.jvoice.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES A range of professions experience high demands on their voices and are potentially at risk of developing voice disorders. Teachers have been studied extensively in this respect, while voiceover artists are a growing professional group with unknown levels of voice training, voice problems and voice care attitudes. To better understand profession-specific voice care requirements, we compared voice training, voice care habits and self-reported voice problems of these two professional groups and measured attitudes to voice care, informed by the Health Belief Model (HBM). STUDY DESIGN The study was a cross-sectional survey study with two cohorts. METHODS We surveyed 264 Scottish primary school teachers and 96 UK voiceover artists . Responses were obtained with multiple-choice and free-text questions. Attitudes to voice care were assessed with Likert-type questions that addressed five dimensions of the HBM. RESULTS Most voiceover artists had some level of voice training, compared to a minority of teachers. Low numbers of teachers reported regular voice care, compared to over half of voiceover artists. Higher numbers of teachers reported work-related voice problems. Voiceover artists reported greater awareness for vocal health and perceived potential effects of voice problems on their work as more severe. Voiceover artists also saw voice care as more beneficial. Teachers perceived barriers to voice care as substantially higher and felt less confident about voice care. Teachers with existing voice problems showed increased perceptions of voice problem susceptibility and severity and saw more benefit in voice care. Cronbach's alpha was below 0.7 for about half of the HBM-informed survey subsets, suggesting that reliability could be improved. CONCLUSIONS Both groups reported substantial levels of voice problems, and different attitudes to voice care suggest that the two groups require different approaches to preventative intervention. Future studies will benefit from the inclusion of further attitude dimensions beyond the HBM.
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Affiliation(s)
- Felix Schaeffler
- Clinical Audiology Speech and Language (CASL) Research Centre, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom; Business Innovation Zone (BIZ), Fitvoice CIC, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom; Business Innovation Zone (BIZ), The Voice Distillery Ltd, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom.
| | - Anna M Parry
- Department of Speech, Voice and Swallowing, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Janet Beck
- Clinical Audiology Speech and Language (CASL) Research Centre, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom; Business Innovation Zone (BIZ), Fitvoice CIC, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom
| | - Meagan Rees
- Clinical Audiology Speech and Language (CASL) Research Centre, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom
| | - Sonja Schaeffler
- Clinical Audiology Speech and Language (CASL) Research Centre, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom
| | - Tess Whittaker
- Business Innovation Zone (BIZ), Fitvoice CIC, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom; Business Innovation Zone (BIZ), The Voice Distillery Ltd, Queen Margaret University Edinburgh, Musselburgh, Scotland, United Kingdom
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Nolan TS, Tan A, Williams KP. The ties that bind: Cancer history, communication, and screening intention associations among diverse families. J Med Screen 2021; 28:108-113. [PMID: 32393152 PMCID: PMC8532169 DOI: 10.1177/0969141320920900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Breast and cervical cancers are screen-detectable; yet, challenges exist with ensuring uptake of mammography and Pap smear. Family, a central factor in developing knowledge to carry out health promotion behaviors, may be an asset to improving intention to screen among non-adherent women from underrepresented minority groups. We explored familial cancer; communication; and breast and cervical screening intention among non-adherent Black, Latina, and Arab women in the United States who participated in a randomized controlled trial of the Kin KeeperSM Cancer Prevention Intervention study. The intervention was a culturally-targeted breast and cervical cancer literacy tool for Black, Latina, and Arab women, consisting of two family-focused education sessions on the cancers, their screening guidelines, and risk-reducing health-related behaviors. METHODS For this secondary analysis, we assessed family cancer history, family communication, and screening intention for breast and cervical cancer in age-eligible, non-adherent participants. Descriptive statistics examined sample characteristics of the intervention and control groups. Odds ratios were estimated from logistic regression modeling to assess the intervention and sample characteristic effects on screening intention. RESULTS Of the 516 participants, 123 and 98 were non-adherent to breast and cervical cancer screening, respectively. The intervention (OR = 1.95 for mammography; OR = 1.62 for Pap smear) and highly communicative (OR = 2.57 for mammography; OR = 3.68 for Pap smear) families reported greater screening intention. Family history of cancer only increased screening intention for mammography (OR = 2.25). CONCLUSION Family-focused approaches supporting communication may increase breast and cervical cancer screening intention among non-adherent, underrepresented minority groups.
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Affiliation(s)
- Timiya S Nolan
- Martha S. Pitzer Center for Women, Children & Youth, College of Nursing, The 2647Ohio State University, Columbus, OH, USA
| | - Alai Tan
- Martha S. Pitzer Center for Women, Children & Youth, College of Nursing, The 2647Ohio State University, Columbus, OH, USA
| | - Karen Patricia Williams
- Martha S. Pitzer Center for Women, Children & Youth, College of Nursing, The 2647Ohio State University, Columbus, OH, USA
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Farr DE, Brandt HM, Friedman DB, Adams SA, Armstead CA, Fulton JK, Bull DM. False-positive mammography and mammography screening intentions among black women: the influence of emotions and coping strategies. ETHNICITY & HEALTH 2020; 25:580-597. [PMID: 30676782 DOI: 10.1080/13557858.2019.1571563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
Introduction: Abnormal mammograms confirmed as benign are known as false-positive mammography (FPM) results. Research indicates that a history of FPM results may be linked to diagnostic delays in Black women, yet much of the research on FPM has focused on White women.Objectives: The purpose of this study was to examine: 1) The influence of FPM on breast cancer (BrCa) screening beliefs and intentions among Black women and 2) Whether emotional states, personality traits or coping behaviors altered the previously described relationships.Design: BrCa-free, Black women, aged 40 and older who completed screening mammograms in 2016 were recruited for a case-control study from 2016 to 2017. Women with FPM results were cases, and women with normal results served as matched controls. Print surveys assessing demographics, personality traits, emotions, BrCa screening history, BrCa beliefs, and africentric coping behaviors were mailed to participants. The final sample consisted of 118 respondents (55 cases, 63 controls). Ordinary least squares (OLS) models were constructed. Personality traits and emotions were tested as mediators and coping behaviors as moderators of the relationship between FPM results and BrCa beliefs.Results: FPM status was associated with a higher perception of barriers to mammography, and an elevated perception of barriers was associated with lower intentions to complete mammography. Collective coping behaviors functioned as a moderator and were associated with a decreased perception of mammography barriers in women with FPM results.Conclusions: FPM status had a detrimental impact on mammography intention indirectly through the perception of mammography barriers, but the use of africentric coping behaviors moderated the relationship between FPM status and perceived barriers to mammography. Culturally specific research focused on Black women is needed to explore influences on BrCa screening beliefs and mammography completion in this population.
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Affiliation(s)
- Deeonna E Farr
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
| | - Heather M Brandt
- Department of Health Promotion, Education, and Behavior, South Carolina Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, South Carolina Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Swann Arp Adams
- Department of Epidemiology and Biostatistics, South Carolina Statewide Cancer Prevention and Control Program, College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Cheryl A Armstead
- Department of Psychology, University of South Carolina Health Equity Laboratory, South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
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Che Mohamed N, Moey SF, Lim BC. Validity and Reliability of Health Belief Model Questionnaire for Promoting Breast Self-examination and Screening Mammogram for Early Cancer Detection. Asian Pac J Cancer Prev 2019; 20:2865-2873. [PMID: 31554389 PMCID: PMC6976832 DOI: 10.31557/apjcp.2019.20.9.2865] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM) with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study. Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram, perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and mammogram screening in health care practice and research.
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Affiliation(s)
- Norfariha Che Mohamed
- Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia.
| | - Soo-Foon Moey
- Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia.
| | - Bee Chiu Lim
- Clinical Research Centre, Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
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Borrayo EA, Rosales M, Gonzalez P. Entertainment-Education Narrative Versus Nonnarrative Interventions to Educate and Motivate Latinas to Engage in Mammography Screening. HEALTH EDUCATION & BEHAVIOR 2016; 44:394-402. [PMID: 27553361 DOI: 10.1177/1090198116665624] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The evidence is limited comparing the effects of entertainment-education (E-E) narrative versus nonnarrative interventions to educate and motivate Latinas to engage in mammography screening. AIMS This study compared an E-E narrative intervention to two nonnarrative interventions' effects among Latinas on breast cancer knowledge and motivation, as measured by changes in self-efficacy, behavioral norms, and behavioral intentions to engage in mammography screening. METHOD A sample of 141 Spanish-speaking Latinas was randomly assigned to one of three arms: an E-E narrative video, a nonnarrative educational video, and printed educational materials. Using a repeated measures design, the influence of the E-E narrative on pretest to posttest measures was assessed and compared to the influence of the other two interventions. RESULTS The E-E narrative and nonnarrative interventions significantly increased Latinas' breast cancer knowledge, mammography self-efficacy, and behavioral norms from pretest to posttest. However, the E-E narrative participants' pretest to posttest difference in mammography self-efficacy was significantly higher when compared to the difference of the other two interventions. The effect of the E-E narrative intervention on self-efficacy and behavioral norms was moderated by the participants' absorption in the story and identification with the story characters. CONCLUSION E-E narrative and nonnarrative interventions significantly educated and motivated Latinas to engage in mammography screening. The effects on mammography self-efficacy, an important precursor to behavior change, can be more strongly influenced by E-E narratives. DISCUSSION Although E-E narrative and nonnarrative interventions were effective, the need still exists to assess if they can ultimately influence lifesaving breast cancer screening behaviors.
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Affiliation(s)
| | - Monica Rosales
- 2 Los Angeles County Department of Public Health, Los Angeles, CA, USA
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Abstract
Despite increases in mammography rates among Latinas, screening rates remain lower than in non-Latina Whites and Latinas typically present with breast cancer at a later stage. Trained lay community workers (promotores) have been successfully used to increase screening mammography intention in Latinas. Little is known, however, about the potential mechanisms of these interventions, such as increased breast cancer knowledge (knowledge) and social interactions concerning mammography practices (social engagement). This prospective pre-post study examined this gap in the literature by (1) documenting changes in knowledge and social engagement after receipt of a promotores-based intervention; and (2) establishing if post-intervention knowledge and social engagement predicted mammography intention, after adjusting for socio-demographic and lifetime mammography history. There were significant increases in knowledge and social engagement about mammography. Finally, post-intervention social engagement was a significant predictor of mammography intention. Future promotores-based interventions should focus on enhancing social engagement to improve mammography intention and use.
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Betsch C, Böhm R, Airhihenbuwa CO, Butler R, Chapman GB, Haase N, Herrmann B, Igarashi T, Kitayama S, Korn L, Nurm ÜK, Rohrmann B, Rothman AJ, Shavitt S, Updegraff JA, Uskul AK. Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication. Med Decis Making 2016; 36:811-33. [DOI: 10.1177/0272989x15600434] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 07/17/2015] [Indexed: 11/16/2022]
Abstract
This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient’s cultural characteristics and the respective message will increase the communication’s effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients’ cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research.
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Affiliation(s)
- Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Robert Böhm
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Collins O. Airhihenbuwa
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Robb Butler
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Gretchen B. Chapman
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Niels Haase
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Benedikt Herrmann
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Tasuku Igarashi
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Shinobu Kitayama
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Lars Korn
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Ülla-Karin Nurm
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Bernd Rohrmann
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Alexander J. Rothman
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Sharon Shavitt
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - John A. Updegraff
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
| | - Ayse K. Uskul
- Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany (CB, LK)
- School of Business and Economics, RWTH Aachen University, Aachen, Germany (RB)
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA (COA)
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark (RB)
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC)
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Lee CJ, Zhao X, Pena-y-Lillo M. Theorizing the Pathways From Seeking and Scanning to Mammography Screening. HEALTH COMMUNICATION 2016; 31:117-28. [PMID: 26086195 DOI: 10.1080/10410236.2014.942769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study combines insights from existing theories in mass communication and health communication, and builds an integrated model accounting for the mechanisms by which an individual's acquisition of mammogram-related media information becomes associated with intentions to obtain a mammogram. Our model was largely supported by a survey with a nationally representative sample of American females between the ages of 40 and 70 years. As expected, seeking and scanning mammogram-related information from the media were both positively associated with reflective integration of media health information, which in turn was positively related to behavioral attitudes and perceived normative pressures. Attitudes and normative pressures were then positively linked to the intention to get a mammogram. Based on these findings, we offer some suggestions for future research in this area.
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Affiliation(s)
- Chul-Joo Lee
- a Department of Communication , Seoul National University
| | - Xiaoquan Zhao
- b Department of Communication , George Mason University
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Molina Y, Ornelas IJ, Doty SL, Bishop S, Beresford SAA, Coronado GD. Family/friend recommendations and mammography intentions: the roles of perceived mammography norms and support. HEALTH EDUCATION RESEARCH 2015; 30:797-809. [PMID: 26324395 PMCID: PMC4654755 DOI: 10.1093/her/cyv040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 08/06/2015] [Indexed: 05/07/2023]
Abstract
Identifying factors that increase mammography use among Latinas is an important public health priority. Latinas are more likely to report mammography intentions and use, if a family member or friend recommends that they get a mammogram. Little is known about the mechanisms underlying the relationship between social interactions and mammography intentions. Theory suggests that family/friend recommendations increase perceived mammography norms (others believe a woman should obtain a mammogram) and support (others will help her obtain a mammogram), which in turn increase mammography intentions and use. We tested these hypotheses with data from the ¡Fortaleza Latina! study, a randomized controlled trial including 539 Latinas in Washington State. Women whose family/friend recommended they get a mammogram within the last year were more likely to report mammography intentions, norms and support. Perceived mammography norms mediated the relationship between family/friend recommendations and intentions, Mediated Effect = 0.38, 95%CI [0.20, 0.61], but not support, Mediated Effect = 0.002, 95%CI [-0.07, 0.07]. Our findings suggest perceived mammography norms are a potential mechanism underlying the effect of family/friend recommendations on mammography use among Latinas. Our findings make an important contribution to theory about the associations of social interactions, perceptions and health behaviors.
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Affiliation(s)
- Yamile Molina
- Community Health Sciences Division, University of Illinois-Chicago, Chicago, IL 60607, USA, Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA,
| | - India J Ornelas
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA, Department of Health Services, University of Washington, Seattle, WA 98122, USA
| | - Sarah L Doty
- Sea Mar community Health Centers, Seattle, WA 98108, USA
| | - Sonia Bishop
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Shirley A A Beresford
- Sea Mar community Health Centers, Seattle, WA 98108, USA, Department of Epidemiology, University of Washington, Seattle, WA 98122, USA and
| | - Gloria D Coronado
- Kaiser Permanente Research Center for Health Research, Portland, OR 97227, USA
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Taymoori P, Berry T, Roshani D. Differences in health beliefs across stage of adoption of mammography in Iranian women. Cancer Nurs 2015; 37:208-17. [PMID: 23624601 DOI: 10.1097/ncc.0b013e31829194bc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. OBJECTIVES The aims of this study were to (a) examine the relationships between related beliefs and (b) to determine to what extent women in stages of mammography adoption differ in their agreement of individual perceived health beliefs. METHODS A sample of 686 Iranian women completed a questionnaire including selected constructs of the Health Belief Model and stages of mammography adoption. RESULTS Proportions of participants who were in the preadoption and adoption stages were 75% and 17.8%, respectively. Precontemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than did those in other adoption stages. In terms of specific items, women in the relapse and maintenance stages endorsed greatest agreement for the barrier items "not knowing how to get a mammogram" and "forget to schedule," respectively. Common barriers for women in preadoption stages were being painful, taking much time, and embarrassing. CONCLUSION Iranian women are less likely than other Asian women to be in the maintenance and action stages. Identifying the associations between perceived related beliefs items and stages of mammography adoption may provide detailed information to allow for future research and guide the development of interventions not only for Iranian women but also for similar cultural and immigrant groups that have been neglected to date in the breast cancer literature. IMPLICATIONS FOR PRACTICE Examining the interactions between perceived related beliefs items and other beliefs such as perceived control and self-efficacy to having a mammography is warranted.
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Affiliation(s)
- Parvaneh Taymoori
- Author Affiliations: Kurdistan Research Center for Social Determinants of Health, School of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Taymooi); Department of Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada (Dr Berry); and Kurdistan Research Center for Social Determinants of Health, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Roshani)
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11
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Bazargan M, Lucas-Wright A, Jones L, Vargas R, Vadgama JV, Evers-Manly S, Maxwell AE. Understanding Perceived Benefit of Early Cancer Detection: Community-Partnered Research with African American Women in South Los Angeles. J Womens Health (Larchmt) 2015; 24:755-61. [PMID: 26131760 DOI: 10.1089/jwh.2014.5049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND African American women have lower 5-year cancer survival rates than non-Latino White women. Differences in perceived benefits of early cancer detection among racial/ethnic groups may affect cancer-screening behaviors. This study assessed correlates of perceived benefits of early breast, cervical and colorectal cancer detection among 513 African American women. METHODS Using a community-partnered participatory research approach, we conducted a survey on cancer screening, risk behaviors, and related knowledge and attitudes among African American parishioners at 11 churches in South Los Angeles, a neighborhood that experiences one of the highest cancer mortality rates in California. RESULTS African American women who participated in this study were more likely to believe that chances for survival are very good or good after early detection of breast cancer (74%) than after early detection of colorectal (51%) and cervical cancer (52%). Multivariate analyses show that perceived benefit of early cancer detection is associated with higher cancer knowledge and having discussed one's cancer risk with a doctor. CONCLUSIONS Given that 5-year survival rates for early stage breast, cervical, and colorectal cancer range from 84% to 93%, our data suggest that a substantial proportion of African American women in South Los Angeles are not aware of the benefits of early detection, particularly of colorectal and cervical cancers. Programs that increase cancer knowledge and encourage a discussion of individual's cancer risk with a doctor may be able to increase perceived benefit of early detection, a construct that has been shown to be associated with cancer screening in some studies.
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Affiliation(s)
- Mohsen Bazargan
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,3 David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California
| | - Anna Lucas-Wright
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,2 Healthy African American Families , Los Angeles, California
| | - Loretta Jones
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California.,2 Healthy African American Families , Los Angeles, California
| | - Roberto Vargas
- 3 David Geffen School of Medicine, University of California Los Angeles , Los Angeles, California
| | - Jaydutt V Vadgama
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California
| | - Shirley Evers-Manly
- 1 Charles R. Drew University of Medicine and Science , Los Angeles, California
| | - Annette E Maxwell
- 4 Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles , Los Angeles, California
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12
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Jerome-D'Emilia B, Suplee PD. Mammogram Use and Self-Efficacy in an Urban Minority Population. Public Health Nurs 2014; 32:287-97. [DOI: 10.1111/phn.12162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Bonnie Jerome-D'Emilia
- School of Nursing - Camden; Rutgers, The State University of New Jersey; Camden New Jersey
| | - Patricia Dunphy Suplee
- School of Nursing - Camden; Rutgers, The State University of New Jersey; Camden New Jersey
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13
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Feldman DB, Sills JR. Hope and cardiovascular health-promoting behaviour: Education alone is not enough. Psychol Health 2013; 28:727-45. [DOI: 10.1080/08870446.2012.754025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Rivers D, August EM, Sehovic I, Lee Green B, Quinn GP. A systematic review of the factors influencing African Americans' participation in cancer clinical trials. Contemp Clin Trials 2013; 35:13-32. [PMID: 23557729 DOI: 10.1016/j.cct.2013.03.007] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/08/2013] [Accepted: 03/22/2013] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This systematic review was conducted to synthesize the existing evidence regarding key considerations influencing African Americans' participation in cancer clinical trials (CCTs). METHODS The PubMed and PsycINFO databases were searched to identify peer-reviewed publications during the last decade (2002-2011) that met our inclusionary criteria. Our search utilized Boolean combinations of the following terms: "clinical trial"; "cancer"; "neoplasm"; "African American"; "Black"; "caregiver"; "decision making"; "recruitment"; "companion"; "family"; "significant other"; and "social support". RESULTS A total of 267 articles were identified in the database searches. Of these articles, a total of 31 were determined to meet the inclusion criteria and were retained for review. Key issues that emerged as impediments to a successful recruitment of African Americans to CCTs included negative attitudes towards clinical trials, low levels of knowledge and awareness regarding CCTs, religious beliefs, and structural barriers, such as transportation, childcare, and access to health care. Recommendations from physicians, family members, and friends may promote CCT participation. Multimedia, and culturally-appropriate recruitment approaches may also be effective in soliciting participation among African Americans. CONCLUSION Existing research underscores the importance of social support from family and friends, cultural appropriateness and sensitivity from physicians and in the design of the CCT, and enhanced education among African Americans in decision-making processes. As African Americans are underrepresented in CCTs, targeted strategies to enhance recruitment efforts and improve cancer treatment outcomes are essential.
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15
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The link between women's body image disturbances and body-focused cancer screening behaviors: a critical review of the literature and a new integrated model for women. Body Image 2013; 10:149-62. [PMID: 23265838 DOI: 10.1016/j.bodyim.2012.11.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 11/07/2012] [Accepted: 11/20/2012] [Indexed: 11/20/2022]
Abstract
A large body of literature demonstrates the association between body image disturbances and health compromising behaviors among women (e.g., pathological eating, substance use, inappropriate exercise). However, given that disturbed body image is a pervasive problem, it is likely inversely related to health maintenance behaviors. Cancer screenings for breast, skin, and cervical cancer represent an important type of health maintenance behavior, yet adherence rates are low. Given the body-focused nature of these screenings, body image may be a salient predictor. This paper reviews the literature on the relationship between body image disturbances and cancer screening behaviors among women culminating in the proposal of a theoretical model. This model posits that body shame and body avoidance predict performance of cancer screenings and that variables drawn from the cancer literature, including risk perception, health anxiety, subjective norms, and self-efficacy, may moderate this relationship. Clinical implications and suggestions for research are discussed.
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16
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Katapodi MC, Northouse LL, Schafenacker AM, Duquette D, Duffy SA, Ronis DL, Anderson B, Janz NK, McLosky J, Milliron KJ, Merajver SD, Duong LM, Copeland G. Using a state cancer registry to recruit young breast cancer survivors and high-risk relatives: protocol of a randomized trial testing the efficacy of a targeted versus a tailored intervention to increase breast cancer screening. BMC Cancer 2013; 13:97. [PMID: 23448100 PMCID: PMC3599993 DOI: 10.1186/1471-2407-13-97] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 02/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background The Michigan Prevention Research Center, the University of Michigan Schools of Nursing, Public Health, and Medicine, and the Michigan Department of Community Health propose a multidisciplinary academic-clinical practice three-year project to increase breast cancer screening among young breast cancer survivors and their cancer-free female relatives at greatest risk for breast cancer. Methods/design The study has three specific aims: 1) Identify and survey 3,000 young breast cancer survivors (diagnosed at 20–45 years old) regarding their breast cancer screening utilization. 2) Identify and survey survivors’ high-risk relatives regarding their breast cancer screening utilization. 3) Test two versions (Targeted vs. Enhanced Tailored) of an intervention to increase breast cancer screening among survivors and relatives. Following approval by human subjects review boards, 3,000 young breast cancer survivors will be identified through the Michigan Cancer Registry and mailed an invitation letter and a baseline survey. The baseline survey will obtain information on the survivors’: a) current breast cancer screening status and use of genetic counseling; b) perceived barriers and facilitators to screening; c) family health history. Based on the family history information provided by survivors, we will identify up to two high-risk relatives per survivor. Young breast cancer survivors will be mailed consent forms and baseline surveys to distribute to their selected high-risk relatives. Relatives’ baseline survey will obtain information on their: a) current breast cancer screening status and use of genetic counseling; and b) perceived barriers and facilitators to screening. Young breast cancer survivors and high-risk relatives will be randomized as a family unit to receive two versions of an intervention aiming to increase breast cancer screening and use of cancer genetic services. A follow-up survey will be mailed 9 months after the intervention to survivors and high-risk relatives to evaluate the efficacy of each intervention version on: a) use of breast cancer screening and genetic counseling; b) perceived barriers and facilitators to screening; c) self-efficacy in utilizing cancer genetic and screening services; d) family support related to screening; e) knowledge of breast cancer genetics; and f) satisfaction with the intervention. Discussion The study will enhance efforts of the state of Michigan surrounding cancer prevention, control, and public health genomics. Trial registration NCT01612338
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Affiliation(s)
- Maria C Katapodi
- University of Michigan School of Nursing, 400 N, Ingalls Building, Room 2158, Ann Arbor, MI 48109, USA.
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17
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Lee S, Yoon H, Chen L, Juon HS. Culturally appropriate photonovel development and process evaluation for hepatitis B prevention in Chinese, Korean, and Vietnamese American communities. HEALTH EDUCATION & BEHAVIOR 2013; 40:694-703. [PMID: 23372031 DOI: 10.1177/1090198112474003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Asian Americans have disproportionately high prevalence of chronic hepatitis B virus infection in the United States and yet have low hepatitis B screening and vaccination rates. We developed three photonovels specifically designed for Chinese, Korean, and Vietnamese Americans and evaluated their cultural relevance and effectiveness in increasing self-efficacy and intention to have a hepatitis B screening. Photonovels' storylines were drawn from focus group themes, and lay people from each community played actors/actresses in community settings. Photonovels were pilot tested, revised, and distributed in a hepatitis B intervention. A two-page process evaluation questionnaire was mailed to 441 participants after one month. Descriptive analysis and multiple logistic regressions were conducted to assess the overall evaluation of the photonovel and to assess factors associated with self-efficacy and intention to have hepatitis B screening. Eighty-four percent of participants responded to the process evaluation. The majority of participants either strongly agreed or agreed that the cancer information in the photonovel was helpful, the story was written by someone who knows the community, and the information was easy to understand. Overall, more than 80% of them thought this photonovel was a good teaching tool. Favorable evaluation of the photonovel was associated with both having intention and self-efficacy to have a hepatitis B screening in the next 5 months. When stratified by level of education and income, the associations were stronger among the lower income and education groups. Culturally appropriate photonovels are useful tools to promote hepatitis B screening among Asian Americans, especially among those of lower socioeconomic status.
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Affiliation(s)
- Sunmin Lee
- 1University of Maryland School of Public Health, College Park, MD, USA
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Kagawa Singer M. Applying the concept of culture to reduce health disparities through health behavior research. Prev Med 2012; 55:356-61. [PMID: 22391576 DOI: 10.1016/j.ypmed.2012.02.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 02/20/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
Culture is often cited as an underlying cause of the undue burden of disease borne by communities of color along the entire life cycle. However, culture is rarely defined or appropriately measured. Scientifically, culture is a complex, integrated, and dynamic conceptual framework that is incongruent with the way it is operationalized in health behavior theories: as a unidimensional, static, and immutable character element of a homogeneous population group. This paper lays out this contradiction and proposes a more scientifically grounded approach to the use of culture. The premise is that if the concept of culture were better operationalized, results from studies of diverse population groups would produce findings that are more scientifically valid and relevant to the community. Practitioners could then use these findings to develop more effective strategies to reduce health disparities and improve the health of all population groups. Six steps are proposed to increase our ability to achieve greater clarity on what culture is and to identify how it impacts health behavior and ultimately health outcomes, enabling researchers to build a stronger science of cultural diversity.
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Affiliation(s)
- Marjorie Kagawa Singer
- UCLA School of Public Health and Department of Asian American Studies, Los Angeles, CA, USA.
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19
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Holt CL, Litaker MS, Scarinci IC, Debnam KJ, McDavid C, McNeal SF, Eloubeidi MA, Crowther M, Bolland J, Martin MY. Spiritually based intervention to increase colorectal cancer screening among African Americans: screening and theory-based outcomes from a randomized trial. HEALTH EDUCATION & BEHAVIOR 2012; 40:458-68. [PMID: 23033548 DOI: 10.1177/1090198112459651] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Colorectal cancer screening has clear benefits in terms of mortality reduction; however, it is still underutilized and especially among medically underserved populations, including African Americans, who also suffer a disproportionate colorectal cancer burden. This study consisted of a theory-driven (health belief model) spiritually based intervention aimed at increasing screening among African Americans through a community health advisor-led educational series in 16 churches. Using a randomized design, churches were assigned to receive either the spiritually based intervention or a nonspiritual comparison, which was the same in every way except that it did not contain spiritual/religious content and themes. Trained and certified peer community health advisors in each church led a series of two group educational sessions on colorectal cancer and screening. Study enrollees completed a baseline, 1-month, and 12-month follow-up survey at their churches. The interventions had significant pre-post impact on awareness of all four screening modalities, and self-report receipt of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. There were no significant study group differences in study outcomes, with the exception of fecal occult blood test utilization, whereas those in the nonspiritual intervention reported significantly greater pre-post change. Both of these community-engaged, theory-driven, culturally relevant approaches to increasing colorectal cancer awareness and screening appeared to have an impact on study outcomes. Although adding spiritual/religious themes to the intervention was appealing to the audience, it may not result in increased intervention efficacy.
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Affiliation(s)
- Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA.
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20
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Jensen JD, King AJ, Carcioppolo N, Davis L. Why are Tailored Messages More Effective? A Multiple Mediation Analysis of a Breast Cancer Screening Intervention. THE JOURNAL OF COMMUNICATION 2012; 62:851-868. [PMID: 26405350 PMCID: PMC4578294 DOI: 10.1111/j.1460-2466.2012.01668.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Past research has found that tailoring increases the persuasive effectiveness of a message. However, the observed effect has been small and the explanatory mechanism remains unknown. To address these shortcomings, a tailoring software program was created that personalized breast cancer screening pamphlets according to risk, health belief model constructs, and visual preference. Women aged 40 and older (N = 119) participated in a 2 (tailored vs. stock message) × 2 (charts/graphs vs. illustrated visuals) × 3 (nested replications of the visuals) experiment. Participants provided with tailored illustrated pamphlets expressed greater breast cancer screening intentions than those provided with other pamphlets. In a test of 10 different mediators, perceived message relevance was found to fully mediate the tailoring × visual interaction.
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Affiliation(s)
- Jakob D Jensen
- (University of Illinois, 2007) is an Assistant Professor at the University of Utah jointly appointed in the Departments of Communication and Health Promotion & Education
| | - Andy J King
- Doctoral candidate in the Brian Lamb School of Communication at Purdue University
| | - Nicholas Carcioppolo
- Assistant Professor in the Department of Communication at Missouri State University
| | - LaShara Davis
- Post-doctoral fellow in the Department of Internal Medicine at Washington University
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21
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Wang JHY, Schwartz MD, Luta G, Maxwell AE, Mandelblatt JS. Intervention tailoring for Chinese American women: comparing the effects of two videos on knowledge, attitudes and intentions to obtain a mammogram. HEALTH EDUCATION RESEARCH 2012; 27:523-36. [PMID: 22327806 PMCID: PMC3337423 DOI: 10.1093/her/cys007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study utilized data from an ongoing randomized controlled trial to compare a culturally tailored video promoting positive attitudes toward mammography among Chinese immigrant women to a linguistically appropriate generic video and print media. Intervention development was guided by the Health Belief Model. Five hundred and ninety-two immigrant Chinese Americans from the metropolitan Washington, DC, and New York City areas completed telephone interviews before and after intervention. Changes in knowledge, Eastern views of health care (fatalism and self-care), health beliefs (perceived susceptibility, severity, benefits and barriers) and screening intentions were measured. Results showed that both videos improved screening knowledge, modified Eastern views of health care, reduced perceived barriers and increased screening intentions relative to print media (all P < 0.05). The generic video increased screening intention twice as much as the cultural video, although subgroup analysis showed the increase was only significant in women aged 50-64 years. Only Eastern views of health care were negatively associated with screening intentions after adjusting for all baseline covariates. These data suggest that a theoretically guided linguistically appropriate video that targets women from various ethnic groups is as efficacious in modifying attitudes toward mammography screening as a video that is exclusively tailored for Chinese immigrant women.
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Affiliation(s)
- Judy Huei-yu Wang
- Department of Oncology and Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA.
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22
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Taymoori P, Berry T, Farhadifar F. Predicting mammography stage of adoption among Iranian women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2012; 1:13. [PMID: 23555116 PMCID: PMC3577413 DOI: 10.4103/2277-9531.98571] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. The purposes of this study were to (1) identify the associations between individual characteristics, related health beliefs, and stages of mammography behavior and (2) examine the socio-demographic factors and the health beliefs that predicate stages of mammography behavior. DESIGN All health care centers were considered as clusters and 30 women were randomly selected from each of them. A sample of 689 Iranian women completed a questionnaire. MATERIALS AND METHODS The questionnaire used was based on Champion's revised Health Belief Model Scale (CHBMS). One-way analysis of covariance (ANCOVA) was used to assess differences in the outcome variables (perceived severity, susceptibility, benefits, and barriers) across the stages. Multinomial logistic regression was conducted to test multivariate relationships. RESULTS THE PERCENTAGE OF PARTICIPANTS IN EACH STAGE WAS: 40.1% in pre-contemplation, 34.7 in contemplation, 7.5% in relapse, 12% in action, and 5.7% in maintenance stage of mammography adoption. Older women were most likely to be in the pre-contemplation stage and action stage, and the youngest women were most likely to be in the relapse stage. Differences across stages of change were found for related beliefs for all participants except those in the relapse stage. CONCLUSION Iranian women are less likely to be in maintenance and action stages than ot er Asian women and this study identifies constructs that may be targeted in interventions.
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Affiliation(s)
- Parvaneh Taymoori
- Research Center for Environment Health and Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Pasdaran Street, Sanandaj, Iran
- Address for correspondence: Prof. Parvaneh Taymoori, Research Center for Environment Health and Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Pasdaran Street, P.O. Box 66177 13391, Sanandaj, Iran. E-mail:
| | - Tanya Berry
- Department of Faculty of Physical Education and Recreation, University of Alberta, E4-88 Van Vliet Centre, Edmonton, Alberta T6G 2H9, Canada
| | - Fariba Farhadifar
- Department of Gynecology, Kurdistan University of Medical Sciences, Pasdaran Street, Sanandaj, Iran
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Health Beliefs and Illness Perceptions as Related to Mammography Uptake in Randomly Selected Women in Greece. J Clin Psychol Med Settings 2011; 19:147-64. [DOI: 10.1007/s10880-011-9272-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pasick RJ, Barker JC, Otero-Sabogal R, Burke NJ, Joseph G, Guerra C. Intention, subjective norms, and cancer screening in the context of relational culture. HEALTH EDUCATION & BEHAVIOR 2010; 36:91S-110S. [PMID: 19805793 DOI: 10.1177/1090198109338919] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research targeting disparities in breast cancer detection has mainly utilized theories that do not account for social context and culture. Most mammography promotion studies have used a conceptual framework centered in the cognitive constructs of intention (commonly regarded as the most important determinant of screening behavior), self-efficacy, perceived benefit, perceived susceptibility, and/or subjective norms. The meaning and applicability of these constructs in diverse communities are unknown. The purpose of this study is to inductively explore the social context of Filipina and Latina women (the sociocultural forces that shape people's day-to-day experiences and that directly and indirectly affect health and behavior) to better understand mammography screening behavior. One powerful aspect of social context that emerged from the findings was relational culture, the processes of interdependence and interconnectedness among individuals and groups and the prioritization of these connections above virtually all else. The authors examine the appropriateness of subjective norms and intentions in the context of relational culture and identify inconsistencies that suggest varied meanings from those intended by behavioral theorists.
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Affiliation(s)
- Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94158-9001, USA.
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Pasick RJ, Burke NJ, Barker JC, Joseph G, Bird JA, Otero-Sabogal R, Tuason N, Stewart SL, Rakowski W, Clark MA, Washington PK, Guerra C. Behavioral theory in a diverse society: like a compass on Mars. HEALTH EDUCATION & BEHAVIOR 2010; 36:11S-35S. [PMID: 19805789 DOI: 10.1177/1090198109338917] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The behavioral theory constructs most often used to study mammography utilization-perceived benefit, perceived susceptibility, self-efficacy, intention, and subjective norms-have neither been developed nor sufficiently tested among diverse racial/ethnic subgroups. The authors explored these constructs and their underlying assumptions relating to the social context of Filipina and Latina women. The mixed-methods study included testing construct measures in the multilingual surveys of a concurrent intervention study of 1,463 women from five ethnic groups. An intensive inductive investigation then targeted Latina and Filipina women to elucidate connections between social context and individual screening behavior. In-depth interviews were conducted with 11 key informant scholars, 13 community gatekeepers, and 29 lay women, and a supplemental study videotaped and interviewed 9 mother-daughter dyads. Three social context domains emerged: relational culture, social capital, and transculturation and transmigration. The meaning and appropriateness of the five behavioral constructs were analyzed in relation to these domains. In contradistinction to tenets of behavioral theory, the authors found that social context can influence behavior directly, circumventing or attenuating the influence of individual beliefs; contextual influences, synthesized from multiple perspectives, can operate at an unconscious level not accessible to the individual; and contextual influences are dynamic, contingent on distal and proximal forces coming together in a given moment and are thus not consistent with an exclusive focus at the individual level. This article describes the study methods, summarizes main findings, and preview the detailed results presented in the other articles in this issue.
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Affiliation(s)
- Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94158-9001, USA.
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Washington PK, Burke NJ, Joseph G, Guerra C, Pasick RJ. Adult daughters' influence on mothers' health-related decision making: an expansion of the subjective norms construct. HEALTH EDUCATION & BEHAVIOR 2009; 36:129S-44S. [PMID: 19805795 PMCID: PMC2945283 DOI: 10.1177/1090198109338904] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study of mother-adult daughter communication uses qualitative methods to explore the appropriateness of including adult daughters as referents in the measurement of subjective norms (a behavioral theory construct) related to the use of mammography and other health-related tests and services. The methods were chosen to approximate as closely as possible the mother-adult daughter relationship in the context of daily life. This inductive approach contrasts with the deductive origins of the construct. A sample of nine Mexican and Filipina immigrant and U.S.-born mothers and their adult daughters was recruited. Data were collected in two phases: (a) videotaped observations of mother-daughter dyads discussing health-related topics and (b) follow-up interviews designed to obtain an emic (insider) perspective of the videotaped interaction. Results show that adult daughters influence their mothers' ability to navigate the health care system and contribute to health-related decision making and behavior, suggesting that it may be appropriate to include adult daughters in the assessment of subjective norms.
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Joseph G, Burke NJ, Tuason N, Barker JC, Pasick RJ. Perceived susceptibility to illness and perceived benefits of preventive care: an exploration of behavioral theory constructs in a transcultural context. HEALTH EDUCATION & BEHAVIOR 2009; 36:71S-90S. [PMID: 19805792 PMCID: PMC2941192 DOI: 10.1177/1090198109338915] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes how the social context of transculturation (cultural change processes) and transmigration (migration in which relationships are sustained across national boundaries) can directly influence use of mammography screening. The authors conducted semistructured interviews with Latino and Filipino academics and social service providers and with U.S.-born and immigrant Latinas and Filipinas to explore direct and indirect influences of social context on health behavior (Behavioral Constructs and Culture in Cancer Screening study). Iterative analyses identified themes of the transcultural domain: colonialism, immigration, discrimination, and therapeutic engagement. In this domain, the authors examine two key behavioral theory constructs, perceptions of susceptibility to illness and perceptions of benefits of preventive medical care. The findings raise concerns about interventions to promote mammography screening primarily based on provision of scientific information. The authors conclude that social context affects behavior directly rather than exclusively through beliefs as behavioral theory implies and that understanding contextual influences, such as transculturation, points to different forms of intervention.
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Affiliation(s)
- Galen Joseph
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, CA 94143, USA.
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Zapka J, Cranos C. Behavioral theory in the context of applied cancer screening research. HEALTH EDUCATION & BEHAVIOR 2009; 36:161S-6S; discussion 167S-71S. [PMID: 19830886 PMCID: PMC3482984 DOI: 10.1177/1090198109340512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The U.S. health care system is indeed challenged to provide effective, equitable, and efficient care for its citizens (Aday, Begley, Lairson, & Balkrishnan, 2004 ). The past decades have witnessed profound concern about the quality of care Americans receive, the equality of care across racial ethnic communities, and the escalating costs of private and public coverage. These concerns apply to the cancer care continuum, including screening. This commentary reflects on the methods, findings, and implications of the articles from the Behavioral Constructs and Culture in Cancer Screening (3Cs) in this Health Education & Behavior supplement. This commentary considers several important themes for consideration in applied screening research, including the (a) focus on population diversity in a cultural context, (b) domains of social context and their importance, and (c) contributions of an interdisciplinary team and mixed methods to research productivity. Although the articles focus on breast cancer screening, the methods, observations, and recommendations are relevant to other screening tests.
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Affiliation(s)
- Jane Zapka
- Medical University of South Carolina, Charleston, SC 29425, USA.
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Burke NJ, Bird JA, Clark MA, Rakowski W, Guerra C, Barker JC, Pasick RJ. Social and cultural meanings of self-efficacy. HEALTH EDUCATION & BEHAVIOR 2009; 36:111S-28S. [PMID: 19805794 PMCID: PMC2921833 DOI: 10.1177/1090198109338916] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article describes the influences of social context on women's health behavior through illustration of the powerful influences of social capital (the benefits and challenges that accrue from participation in social networks and groups) on experiences and perceptions of self-efficacy. The authors conducted inductive interviews with Latino and Filipino academics and social service providers and with U.S.-born and immigrant Latinas and Filipinas to explore direct and indirect influences of social context on health behaviors such as mammography screening. Iterative thematic analysis identified themes (meanings of efficacy, spheres of efficacy, constraints on efficacy, sources of social capital, and differential access to and quality of social capital) that link the domain of social capital with the behavioral construct perceived self-efficacy. The authors conclude that social capital addresses aspects of social context absent in the current self-efficacy construct and that these aspects have important implications for scholars' and practitioners' understandings of health behavior and intervention development.
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Affiliation(s)
- Nancy J Burke
- Helen Diller Family Comprehensive Cancer Center and Department of Anthropology, History, and Social Medicine, University of California, San Francisco, CA, USA.
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Abstract
This article reviews the contribution and potential of widely used health behavior theories in research designed to understand and redress the disproportionate burden of breast cancer borne by diverse race/ethnic, immigrant, and low-income groups associated with unequal use of mammography. We review the strengths and limitations of widely used theories and the extent to which theory contributes to the understanding of screening disparities and informs effective intervention. The dominant focus of most theories on individual cognition is critically assessed as the abstraction of behavior from its social context. Proposed alternatives emphasize multilevel ecological approaches and the use of anthropologic theory and methods for more culturally grounded understandings of screening behavior. Common and alternative treatments of fatalism exemplify this approach, and descriptive and intervention research exemplars further highlight the integration of screening behavior and sociocultural context.
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Affiliation(s)
- Rena J Pasick
- Comprehensive Cancer Center, University of California, San Francisco, CA 94143-0981, USA.
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