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McFarlane SJ, Morgan SE, Carcioppolo N. Lessons learned from the “Goodie Box”: A message design study developed and evaluated in community settings for cervical cancer prevention. Front Oncol 2022; 12:935704. [PMID: 36158662 PMCID: PMC9492837 DOI: 10.3389/fonc.2022.935704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the availability of free pap testing services, Jamaican women have low human papillomavirus (HPV) screening rates; 16% of women in the Kingston Metropolitan Area have been screened within the prior 3 years. This paper discusses the testing of theory-based messages to increase HPV screening uptake in a low-resource setting, using HPV self-test kits designed for this intervention. A total of 163 Jamaican women, aged 30–65 years, who had not had a pap test in at least 3 years, from two low socioeconomic status communities in Kingston, were enrolled and assigned to one of two versions of an HPV self-test kit, either with or without culturally targeted fear appeal messages. The uptake of screening was high across conditions; 95.6% of participants used the HPV self-test and returned their kits. However, surprising variations were observed in self-test acceptability, explained by differing attitudes toward the message conditions. Based on the results, we recommend four key components to increase HPV screening in low-resource settings: 1) focus on perceived threat in message design, 2) avoid written materials due to literacy concerns, 3) use culturally appropriate interpersonal or community-based channels, and 4) consider alternative solutions (such as a self-test) available at no or low cost to address structural barriers.
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Kretzler B, König HH, Brandt L, Weiss HR, Hajek A. Religious Denomination, Religiosity, Religious Attendance, and Cancer Prevention. A Systematic Review. Healthc Policy 2022; 15:45-58. [PMID: 35079226 PMCID: PMC8777031 DOI: 10.2147/rmhp.s341085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/20/2021] [Indexed: 12/24/2022] Open
Abstract
Recent research highlighted the influence of religion among health outcomes. To the best of our knowledge, there is no systematic review that summarizes the evidence on the relationship between religious factors and the utilization of cancer screenings. Therefore, this article aims to list the findings about the influence of religious denominations, the importance of religion in one’s life, and religious practices, such as church attendance on the utilization of cancer screenings. PubMed, PsycInfo and CINAHL were searched using a predefined algorithm in June 2020. We included observational studies that examined the association between religion and cancer screening use and employed appropriate items to quantify these key variables. Study selection, data extraction and quality assessment were performed independently by two reviewers. We detected n=27 studies that fulfilled the inclusion criteria. Hereby, n=16 used data from the United States. Most of the studies that were included in our review found a positive association between religious attendance and cancer screening utilization. There was mixed evidence concerning religious denomination as well as religiosity and use of cancer screenings. The studies suggest that religious factors are related to the utilization of cancer screenings. The findings of this systematic review may be helpful to resolve the underuse of cancer screenings by revealing at-risk-groups.
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Affiliation(s)
- Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Correspondence: Benedikt Kretzler Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20251, GermanyTel +49 40 741 024 161Fax +49 40 741 040 261 Email
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linéa Brandt
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helene Rabea Weiss
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Singal AG, Tiro JA, Murphy CC, Blackwell JM, Kramer JR, Khan A, Liu Y, Zhang S, Phillips JL, Hernaez R. Patient-Reported Barriers Are Associated With Receipt of Hepatocellular Carcinoma Surveillance in a Multicenter Cohort of Patients With Cirrhosis. Clin Gastroenterol Hepatol 2021; 19:987-995.e1. [PMID: 32629122 PMCID: PMC7779689 DOI: 10.1016/j.cgh.2020.06.049] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/04/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND More than 20% of patients with cirrhosis do not receive semi-annual hepatocellular carcinoma (HCC) surveillance as recommended. Few studies have evaluated the effects of patient-level factors on surveillance receipt. METHODS We administered a telephone survey to a large cohort of patients with cirrhosis from 3 health systems (a tertiary care referral center, a safety-net health system, and Veterans Affairs) to characterize patient knowledge, attitudes, and perceived barriers of HCC surveillance. Multinomial logistic regression was performed to identify factors associated with HCC surveillance receipt (semi-annual and annual vs none) during the 12-month period preceding survey administration. RESULTS Of 2871 patients approached, 1020 (35.5%) completed the survey. Patients had high levels of concern about developing HCC and high levels of knowledge about HCC. However, patients had knowledge deficits, including believing surveillance was unnecessary when physical examination and laboratory results were normal. Nearly half of patients reported barriers to surveillance, including costs (28.9%), difficulty scheduling (24.1%), and transportation (17.8%). In the year before the survey, 745 patients (73.1%) received 1 or more surveillance examination; 281 received on-schedule, semi-annual surveillance and 464 received annual surveillance. Semi-annual HCC surveillance (vs none) was significantly associated with receipt of hepatology subspecialty care (odds ratio, 30.1; 95% CI, 17.5-51.8) and inversely associated with patient-reported barriers (odds ratio, 0.62; 95% CI, 0.41-0.94). Patterns of associations comparing annual vs no surveillance were similar although the magnitude of effects were reduced. CONCLUSIONS Patient-reported barriers such as knowledge deficits, costs, difficulty scheduling, and transportation are significantly associated with less frequent receipt of HCC surveillance, indicating a need for patient-centered interventions, such as patient navigation.
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Affiliation(s)
- Amit G Singal
- Department of Internal Medicine, UT Southwestern Medical Center and Parkland Health Hospital System, Dallas, Texas; Harold C. Simmons Cancer Center, UT Southwestern Medical Center, Dallas, Texas; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas.
| | - Jasmin A Tiro
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Caitlin C Murphy
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas
| | | | - Jennifer R Kramer
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Aisha Khan
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Yan Liu
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Song Zhang
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Jessica L Phillips
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Ruben Hernaez
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, Texas
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Julian McFarlane S, Morgan SE, Schlumbrecht M. Acceptability of a multicomponent, community-based, HPV self-test intervention among Jamaican women. Cancer Causes Control 2021; 32:547-554. [PMID: 33660168 DOI: 10.1007/s10552-021-01406-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 02/18/2021] [Indexed: 11/26/2022]
Abstract
Jamaican women do not participate in routine Pap test screening as recommended, despite the availability of free Pap test services at community clinics. This low uptake has been associated with cultural and structural barriers such as limited knowledge and awareness, fear of pain associated with Pap tests, fear of diagnosis, modesty or self-consciousness, medical mistrust, and discontent with healthcare services. This study suggests that a multicomponent, community-based intervention that includes education and self-testing for the virus that causes cervical cancer (i.e., Human Papillomavirus, HPV) might increase screening rates. Community outreach workers were hired and recruited 163 women from two low socioeconomic status communities in Kingston, aged 30 to 65 years, and who had not had a Pap test in at least 3 years, to use an HPV self-test kit. Almost all the women (95.6%) used and returned the kit and reported in structured interviews that it was easy to use and preferable to visiting a doctor. Paired samples t-tests revealed that participants perceived higher threat of cervical cancer, greater susceptibility to cancer, greater sense of self-efficacy, and more positive screening social norms at post-test than at pretest. Among returners, 22% had an oncogenic HPV type detected in their sample. Findings demonstrate high acceptability of the HPV self-test among Jamaican women and, therefore, the potential of HPV self-test tools to increase screening uptake. Community-based approaches to disseminate this tool, such as outreach workers and educational small group sessions, appear to be culturally appropriate and effective in this context.
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Affiliation(s)
- Soroya Julian McFarlane
- Department of Communication Studies, University of Georgia, 602 Caldwell Hall, Athens, GA, 30602, USA.
| | - Susan E Morgan
- Department of Communication Studies, Communication International Building, University of Miami, Room 5051D, Coral Gables, FL, 33124, USA
| | - Matthew Schlumbrecht
- Miller School of Medicine, The University of Miami, 1121 NW 14th St, Suite 345C, Miami, FL, 33136, USA
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Yoon S, Wang K, Luo Y, Lee J, Neese J, Lee H. Cancer Screening Literacy among Vietnamese Population: Does Annual Checkup Improve Cancer Screening Literacy? Asian Pac J Cancer Prev 2021; 22:927-933. [PMID: 33773559 PMCID: PMC8286676 DOI: 10.31557/apjcp.2021.22.3.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Colorectal, breast, and cervical cancers disproportionately impact the Vietnamese population. However, research on cancer prevention among this population was very limited. The purpose of this study is to examine the cancer screening literacy levels for these three types of cancers among rural Vietnamese and investigate correlates of cancer screening literacy. METHODS A sample of 226 Vietnamese men and women aged 25-70 years old was recruited from rural Vietnam and finished a self-administered questionnaire. Andersen's Behavioral Model was used to guide this cross-sectional study to identify modifiable variables. Bivariate analysis was used to explore the relationship between demographic factors and cancer screening literacy levels. Multiple linear regressions were also used to identify significant factors for cancer literacy levels. RESULTS Cancer screening literacy levels of Vietnamese men and women were low regarding all three types of cancers, especially HPV symptom questions. Only about 24% of women answered correctly on "most people with genital HPV have no visible signs/symptoms" and less than 18% answered correctly on "I can transmit HPV to my partner(s) even if I have no HPV symptoms." Findings suggested that having an annual checkup was associated with higher colorectal (β=.15, p <.05), breast (β=.25, p <.001), and cervical (β=.18, p <.01) cancer screening literacy. CONCLUSIONS Public health efforts should focus on encouraging annual checkups in the Vietnamese population. During the annual checkup, health care professionals should educate patients about importance of cancer screening and provide recommendations for regular cancer screenings to reduce cancer health disparities.
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Affiliation(s)
| | - Kun Wang
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
| | - Yan Luo
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
| | - Jongwook Lee
- Department of Agricultural Economics and Rural Development, Seoul National University, Building, Seoul, Republic of Korea
| | - Jessica Neese
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
| | - Hee Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
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Hajek A, Kretzler B, König HH. Personality and the use of cancer screenings. A systematic review. PLoS One 2020; 15:e0244655. [PMID: 33370379 PMCID: PMC7769487 DOI: 10.1371/journal.pone.0244655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND No systematic review exists synthesizing studies examining the association between personality factors and use of cancer screenings. Hence, the aim of this systematic review is to provide an overview of empirical findings from observational studies investigating the link between personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism and openness to experience) and use of cancer screenings. METHODS Medline, PsycInfo and CINAHL were searched using predefined search terms. Observational studies examining the link between personality factors and use of cancer screenings using validated tools were included. Study selection, data extraction, and quality assessment were performed by two reviewers. RESULTS In total, n = 11 studies were included in our systematic review. There is mostly inconclusive evidence regarding the link between agreeableness, neuroticism, openness to experience and the use of cancer screenings. Clearer evidence was identified for an association between increased extraversion and an increased use of cancer screenings. Moreover, the majority of studies identified a link between increased conscientiousness and an increased use of cancer screenings. DISCUSSION Studies indicate that personality factors, particularly an increased extraversion and increased conscientiousness, are associated with an increased use of cancer screenings. This knowledge may be beneficial to address individuals at risk for underuse. PROSPERO REGISTRATION NUMBER CRD42020176830.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Marques P, Nunes M, Antunes MDL, Heleno B, Dias S. Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review. Int J Equity Health 2020; 19:160. [PMID: 32917224 PMCID: PMC7488650 DOI: 10.1186/s12939-020-01275-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/02/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe. METHODS Electronic peer-reviewed databases were searched in November 2019 for studies on factors related to the participation of migrants in cervical cancer screening conducted in EU/EFTA countries, using comprehensive search expressions. Retrieved articles were screened and those eligible were selected for data extraction. Quantitative and qualitative studies were included. Factors were classified in barriers and facilitators and were divided into further categories. RESULTS Twenty out of 96 articles were selected and analyzed. Factors associated with participation in cervical cancer screening were classified in categories related to sociodemographic, healthcare-system, psychological, migration, knowledge, language, and cultural factors. Lack of information, lack of female healthcare providers, poor language skills, and emotional responses to the test (especially fear, embarrassment and discomfort) were the most reported barriers to cervical cancer screening. Encouragement from healthcare providers and information available in migrants' languages were frequently stated as facilitators. Results on the role of sociodemographic factors, such as age, education, employment and marital status, are the most conflicting, highlighting the complexity of the issue and the possibility of interactions between factors, resulting in different effects on cervical cancer screening participation among migrant women. Several identified barriers to screening are like those to access to healthcare services in general. CONCLUSIONS Efforts to increase migrant women's participation in CCS must target barriers to access to healthcare services in general but also specific barriers, including cultural differences about sexuality and gender, past traumatic personal experiences, and the gender and competences of healthcare professionals performing CCS. Healthcare services should strengthen resources to meet migrants' needs, including having CCS information translated and culturally adapted, as well as healthcare providers with skills to deal with cultural background. These findings can contribute to improve CCS programs among migrant women, reducing health disparities and enhancing their overall health and well-being.
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Affiliation(s)
- Patrícia Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mariana Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Maria da Luz Antunes
- ESTeSL (Instituto Politécnico de Lisboa), Lisbon, Portugal
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA, Lisbon, Portugal
| | - Bruno Heleno
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
- NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
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Solomon IB, McGraw S, Shen J, Albayrak A, Alterovitz G, Davies M, Del Vecchio Fitz C, Freedman RA, Lopez LN, Sholl LM, Van Allen E, Mortimer J, Fakih M, Pal S, Reckamp KL, Yuan Y, Gray SW. Engaging Patients in Precision Oncology: Development and Usability of a Web-Based Patient-Facing Genomic Sequencing Report. JCO Precis Oncol 2020; 4:1900195. [PMID: 32923887 DOI: 10.1200/po.19.00195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Evidence-based somatic and germline sequencing has transformed cancer care and improves patient outcomes. However, patients' low genetic literacy and misunderstanding of their own genomic results poses a threat to the realization of precision oncology. To optimize patient genomic comprehension, we developed a Web-based, patient-directed, genomic sequencing education and return-of-results tool, HOPE-Genomics. METHODS The HOPE-Genomics prototype included somatic and germline sequencing results, embedded multimedia genomic education, and interactive features (eg, request for genetic counseling). Between January and April 2018, we elicited feedback on tool usability and comprehensiveness through participant surveys, 4 focus groups of patients with cancer and their family members, and 3 provider focus groups (comprising 8 patients, 5 family members, and 19 providers). RESULTS We identified themes in patient/family tool-related responses, including the desire to view a patient-friendly report, a desire to receive multiple types of genomic information (eg, prognostic and uncertain), high acceptability of report content, and interest in tool-enabled access to genetic counseling. Major themes from the clinician focus groups included believing the tool could help patients formulate questions and facilitate patients' communication of results to family members. However, there were diverse responses from all participants in terms of tool implementation (ie, timing and nature of report release). Some participants preferred report release before meeting with the provider, and others preferred it during the appointment. Additionally, some clinicians were concerned about providing prognostic and treatment information through the tool. CONCLUSION There was high acceptability and interest from patients, family members, and providers in a patient-directed genomics report. Future work will determine whether direct-to-patient reporting of genomic results improves patient knowledge, care engagement, and compliance with genomically guided interventions.
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Affiliation(s)
- Ilana B Solomon
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | | | - Jenny Shen
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Gil Alterovitz
- Harvard Medical School, Boston, MA.,Department of Biomedical Informatics, Boston Children's' Hospital, Boston; and Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA
| | - Melanie Davies
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
| | | | - Rachel A Freedman
- Harvard Medical School, Boston, MA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Lisa N Lopez
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Lynette M Sholl
- Harvard Medical School, Boston, MA.,Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Eliezer Van Allen
- Harvard Medical School, Boston, MA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.,The Broad Institute, Cambridge, MA
| | - Joanne Mortimer
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Marwan Fakih
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sumanta Pal
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Karen L Reckamp
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Yuan Yuan
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Stacy W Gray
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
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Relationship between Mammographic Density and Age in the United Arab Emirates Population. JOURNAL OF ONCOLOGY 2019; 2019:7351350. [PMID: 31467543 PMCID: PMC6701291 DOI: 10.1155/2019/7351350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/27/2019] [Accepted: 07/14/2019] [Indexed: 12/12/2022]
Abstract
Objective Higher breast density is a strong, independent risk factor for breast cancer. Breast density varies by age, ethnicity, and geographic area although dense breast tissue has been associated with younger age and premenopausal status. The relationship between breast density and age in women in the United Arab Emirates (UAE) has not been determined. This study evaluated breast density in the UAE population and its relationship with age. Methods Women participating in the national cancer screening program from August 2015 to May 2018 who underwent screening mammography were included. Breast parenchymal density was classified according to the American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) from category a (almost entirely fatty) through d (extremely dense). Subjects were divided into six age groups, and the association between age and breast density was evaluated. Results Of the 4911 women included, 1604 (32.7%), 2149 (43.8%), 1055 (21.5%), and 103 (2.1%) were classified as having categories a–d breast density, respectively. A significant negative correlation was observed between age and breast density category (p < 0.001). Women of mean age 44 ± 7 years had the highest breast density, whereas those of mean age 56 ± 14 years had the lowest breast density. Comparisons of Emirati women with Lebanese and Western women showed that breast density was lower in Emirati women than in the other populations. Conclusions To our knowledge, this is the first study to evaluate the relationship between mammographic breast density and age in UAE women. As in other populations, age was inversely related to breast density, but the proportion of Emirati women with dense breasts was lower than in other populations. Because this study lacked demographic, clinical, and histopathological data, further evaluation is required.
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Yeung MPS, Chan EYY, Wong SYS, Yip BHK, Cheung PSY. Hong Kong female’s breast cancer awareness measure: Cross-sectional survey. World J Clin Oncol 2019; 10:98-109. [PMID: 30815376 PMCID: PMC6390121 DOI: 10.5306/wjco.v10.i2.98] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/05/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In women worldwide, breast cancer is the most common cancer. Breast cancer accounted for 26.6% of all new cancers in females diagnosed in 2015 in Hong Kong.
AIM To examine women’s awareness, perception, knowledge, and screening practice of breast cancer in Hong Kong.
METHODS We carried out a population-based survey using random telephone interviews to women aged 18 or above using the United Kingdom Cancer Research Breast Cancer Awareness Measure (United Kingdom CAM). The data was analysed using proportions, chi-square test (χ2-test) and adjusted odds ratios (ORs).
RESULTS A total of 1000 participants completed the CAM questionnaire from 1,731 responses (response rate = 57.8%) from September to October 2017. One in five and one in four respondents recalled ≥ 3 early warning signs and ≥ 2 risk factors of breast cancer respectively. The majority (62.6%) reported they were not confident that they would notice a change in their breasts. Among the respondents, 16.8% would have regular mammography at least every two years. In general, 4 in 10 women had tried practices on preventing breast cancer. Respondents with better result in recalling breast cancer signs and symptoms were more likely to seek immediate medical help when noticed a change in their breasts (χ2-test P = 0.038), and more likely had tried prevention practice (χ2-test P < 0.001). Respondents received higher education (secondary school or above) had higher breast cancer awareness (OR = 2.83, CI: 1.61-4.97), more frequent screening (OR = 2.64, CI: 1.63-4.26) and more had tried prevention practices (OR = 2.80, CI: 1.96-4.02) when compared to those with lower education. Those in age groups 31-45 and 46-60 had higher percentages in performing breast self-exam and mammography when compared to the 18-30 and 61 or above age groups.
CONCLUSION Population-wide public health initiatives should emphasize on prevention and early detection of breast cancer in women, with targeted strategy for those with low education level and advance in age.
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Affiliation(s)
- May Pui Shan Yeung
- Division of Global Health and Humanitarian Medicine, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Emily Ying Yang Chan
- Division of Global Health and Humanitarian Medicine, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Samuel Yeung Shan Wong
- Division of Family Medicine and Primary Healthcare, the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Benjamin Hon Kei Yip
- Division of Family Medicine and Primary Healthcare, the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
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Marzouq Muhanna A, Floyd MJ. A qualitative study to determine Kuwaiti Women's knowledge of breast cancer and barriers deterring attendance at mammography screening. Radiography (Lond) 2019; 25:65-71. [PMID: 30599833 DOI: 10.1016/j.radi.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/14/2018] [Accepted: 10/20/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Although a Mammography Screening Service (MSS) has been established in Kuwait since 2014, the attendance rate for eligible women is only 4.2% in comparison to 72.1% attendance in the United Kingdom (UK) mammography screening service. The aim of this study was to determine Kuwaiti women's knowledge of breast cancer (BC), their attitudes toward BCS and the reasons for not attending Mammography Screening (MS). METHODS A pragmatic qualitative methodology was used which included the use of two focus groups conducted at two women only social organisations in Kuwait with a total of 23 women. One focus group was conducted at a social and cultural organisation; the second focus group took place at a social organisation whose primary role is the improvement of literacy though the use of religious scripture. Thematic analysis was applied to the recorded verbal transcripts from each focus group. RESULTS Thematic analysis revealed four major themes, accompanied by a series of subthemes (1) knowledge and awareness of BC health, (2) knowledge of MS (3) personal factors, (4) medical provision and social environment. CONCLUSION Findings suggest that participant's knowledge of BC and the decision to attend MS is influenced by a series of factors both personal and external. An increase in the awareness of BC, MS and the process of accessing MSS will enhance the uptake of MS among Kuwaiti women. Furthermore, doctors and health care providers will need to play a significant role in encouraging women to self-refer.
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Affiliation(s)
| | - M J Floyd
- Cardiff University, Heath Park Campus, CF14 4ER, UK
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12
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Ferdous M, Lee S, Goopy S, Yang H, Rumana N, Abedin T, Turin TC. Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review. BMC WOMENS HEALTH 2018; 18:165. [PMID: 30305056 PMCID: PMC6180489 DOI: 10.1186/s12905-018-0654-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 09/26/2018] [Indexed: 01/10/2023]
Abstract
Background The objective of this scoping study is to review the published literature and summarize findings related to barriers experienced by immigrant women in Canada while accessing cervical cancer screening. Methods Electronic databases of peer-reviewed articles and grey literature were searched using comprehensive sets of keywords, without restricting the time period or language. Articles were selected based on the following criteria: (a) the study population consisted of Canadian immigrant women and healthcare providers and other stakeholders serving immigrant women, (b) the research focused on the barriers to accessing cervical cancer screening, and (c) the study was conducted in Canada. Results Extracted data were grouped and analyzed, resulting in barriers comprised of six themes: economic barriers, cultural barriers, language barriers, healthcare system-related barriers, knowledge-related barriers, and individual-level barriers. Lack of education, low income, preference for a female physician, lack of knowledge, lack of effective communication, and embarrassment were some of the most common barriers mentioned. Conclusions Immigrant access to health services, including cervical cancer screening, is a complex issue concerning a wide range of barriers. Our findings offer insights into barriers to cervical cancer screening in immigrant communities in Canada that can be used to assist policymakers, healthcare providers, and researchers enhance the health and well-being of these populations by mitigating barriers and improving screening. Electronic supplementary material The online version of this article (10.1186/s12905-018-0654-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mahzabin Ferdous
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012F, Health Sciences Center, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Sonya Lee
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012F, Health Sciences Center, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Suzanne Goopy
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Nahid Rumana
- Sleep Center, Foothills Medical Center, University of Calgary, Calgary, AB, Canada
| | - Tasnima Abedin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012F, Health Sciences Center, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012F, Health Sciences Center, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
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Gornick MC, Kurian AW, An LC, Fagerlin A, Jagsi R, Katz SJ, Hawley ST. Knowledge regarding and patterns of genetic testing in patients newly diagnosed with breast cancer participating in the iCanDecide trial. Cancer 2018; 124:4000-4009. [DOI: 10.1002/cncr.31731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/22/2018] [Accepted: 07/13/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Michele C. Gornick
- Department of Internal MedicineUniversity of Michigan Medical School Ann Arbor Michigan
| | - Allison W. Kurian
- Department of MedicineStanford University Stanford California
- Department of Health Research and PolicyStanford University Stanford California
| | - Lawrence C. An
- Department of Internal MedicineUniversity of Michigan Medical School Ann Arbor Michigan
| | - Angela Fagerlin
- Department of Population Health SciencesUniversity of Utah School of Medicine Salt Lake City Utah
| | - Reshma Jagsi
- Department of Radiation OncologyUniversity of Michigan Medical School Ann Arbor Michigan
| | - Steven J. Katz
- Department of Internal MedicineUniversity of Michigan Medical School Ann Arbor Michigan
| | - Sarah T. Hawley
- Department of Internal MedicineUniversity of Michigan Medical School Ann Arbor Michigan
- Ann Arbor VA Center for Clinical Management Research Ann Arbor Michigan
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Kisiangani J, Baliddawa J, Marinda P, Mabeya H, Choge JK, Adino EO, Khayeka-Wandabwa C. Determinants of breast cancer early detection for cues to expanded control and care: the lived experiences among women from Western Kenya. BMC WOMENS HEALTH 2018; 18:81. [PMID: 29859095 PMCID: PMC5984781 DOI: 10.1186/s12905-018-0571-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/18/2018] [Indexed: 01/24/2023]
Abstract
Background Estimately, 70–80% of cancer cases are diagnosed in late stages in Kenya with breast cancer being a common cause of mortality among women where late diagnosis is the major ubiquitous concern. Numerous studies have focused on epidemiological and health policy dynamics essentially underestimating the determining factors that shape people’s choices and cues to health care service uptake. The study sought to evaluate the knowledge, attitude and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies. Methods Eight focus groups (6–10 members per group) and four key informant interviews were conducted among adult participants from rural and urban settings. Sessions were audio-recorded and transcribed. A thematic analysis of the data was based on the concepts of the health belief model. Data analysis was conducted using NVIVO10. Results Most women perceived breast cancer as a fatal disease and conveyed fear of having early screening. Rural women preferred self-prescribed medications and the use of alternative medicine for long periods before presenting for professional care on suspicion that the lump is cancerous. Accessibility to equipped health facilities, lack of information to establish effective follow-up treatment and low-income status were underscored as their major health seeking behavior barriers whereas, urban women identified marital status as their main barrier. Key informant interviews revealed that health communication programs emphasized more on communicable diseases. This could in part explain why there is a high rate of misconception and suspicion about breast cancer among rural and urban women in the study setting. Conclusions Creating breast cancer awareness alongside clear guidelines on accessing screening and treatment infrastructure is critical. It was evident, a diagnosis of breast cancer or lump brings unexpected confrontation with mortality; fear, pain, cultural barriers, emotional and financial distress. Without clear referral channels to enable those with suspicious lumps or early stage disease to get prompt diagnosis and treatment, then well-meaning awareness will not necessarily contribute to reducing morbidity and mortality. Electronic supplementary material The online version of this article (10.1186/s12905-018-0571-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joyce Kisiangani
- The Aquaya Institute, Nairobi, 00505, Kenya.,School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Joyce Baliddawa
- School of Public Health, Department of Epidemiology and disease control, Moi University, P.O. Box 3900, Eldoret, Kenya
| | - Pamela Marinda
- Department of Food Science and Nutrition, School of Agricultural Sciences, The University of Zambia, Lusaka, Zambia
| | - Hillary Mabeya
- Gynocare Fistula Centre, Eldoret Hospital Lane, P.O. BOX 2326-30100, Eldoret, Kenya
| | - Joseph K Choge
- University of Kabianga, P.O. Box 2030-20200, Kericho, Kenya
| | | | - Christopher Khayeka-Wandabwa
- School of Pharmaceutical Science and Technology (SPST), Health Science Platform, Tianjin University, 92 Weijin road, Nankai District, Tianjin, 300072, People's Republic of China. .,African Population and Health Research Center (APHRC), P .O. Box 10787-00100, Nairobi, Kenya.
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15
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Akinlotan MA, Weston C, Bolin JN. Individual- and county-level predictors of cervical cancer screening: a multi-level analysis. Public Health 2018; 160:116-124. [PMID: 29803186 DOI: 10.1016/j.puhe.2018.03.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/08/2018] [Accepted: 03/21/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Despite the gains in cervical cancer screening, there remain persistent socio-economic, geographical, racial, and ethnic disparities. This study examines the combined effect of individual- and county-level characteristics on the use of cervical cancer screening tests such as Papanicolaou (Pap) tests in Texas. STUDY DESIGN Cross-sectional study. METHODS Individual-level information was obtained from 2014-2015 Texas Behavioral Risk Factor Surveillance System (BRFSS). Using the county of residence of the study population, the BRFSS data were linked to the American Community Survey (2010-2014) and the Area Health Resources File (2015). Women aged between 21 and 65 years, with no history of hysterectomy, and residing in 47 counties in Texas were included in the study (n = 4276). Multi-level logistic regression was used to assess the independent influences of individual- and county-level covariates on receipt of a Pap test in the past 3 years. RESULTS The odds of timely Pap testing were lower among women aged greater than 50 years, single women, and those with low education and income (<$25,000). Black women who reside in counties with higher percentages of Hispanics (quartile 4) were less likely to be screened compared with black women living in counties with a low Hispanic population (adjusted odds ratio [OR] = 0.08 [95% confidence interval [CI]: 0.02-0.37]). County-level socio-economic status, although associated with timely screening in bivariate analysis, was not a significant predictor of screening after controlling for individual characteristics. CONCLUSIONS There are significant disparities in the uptake of cervical cancer screening across Texas counties. Individual-level socio-economic disparities as well as the number of obstetric-gynecologic physicians in a county are predictors of these disparities.
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Affiliation(s)
- M A Akinlotan
- Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX 77843 - 1266, USA.
| | - C Weston
- College of Nursing, Texas A&M University, 8447 Riverside Parkway, Bryan, TX 77807-1359, USA
| | - J N Bolin
- Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX 77843 - 1266, USA
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Akinlotan M, Bolin JN, Helduser J, Ojinnaka C, Lichorad A, McClellan D. Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women. J Community Health 2018; 42:770-778. [PMID: 28155005 PMCID: PMC5494033 DOI: 10.1007/s10900-017-0316-9] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00–2.43), language barriers (OR 4.72, 95% CI 2.62–8.50), and male physicians (OR 2.16, 95% CI 1.32–3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16–3.44) and Blacks (OR 2.06, 95% CI 1.15–3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.
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Affiliation(s)
- Marvellous Akinlotan
- Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA.
| | - Jane N Bolin
- Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA
| | - Janet Helduser
- Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA
| | - Chinedum Ojinnaka
- Department of Health Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Anna Lichorad
- Department of Clinical Translational Medicine, College of Medicine, Texas A&M Health Science Center, 2900 E. 29th Street, Bryan, TX, 77802, USA
| | - David McClellan
- Department of Clinical Translational Medicine, College of Medicine, Texas A&M Health Science Center, 2900 E. 29th Street, Bryan, TX, 77802, USA
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17
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Shepherd L, Walbey C, Lovell B. Assessing the effectiveness of a knowledge-based intervention to tackle barriers to cervical screening: A pilot study. Psychooncology 2018; 27:1065-1067. [DOI: 10.1002/pon.4523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/24/2017] [Accepted: 08/01/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Lee Shepherd
- Department of Psychology; Northumbria University; Newcastle upon Tyne UK
| | - Cherokee Walbey
- Department of Psychology; Northumbria University; Newcastle upon Tyne UK
| | - Brian Lovell
- Department of Psychology; Northumbria University; Newcastle upon Tyne UK
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18
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Lee H, Ghebre R, Le C, Jang YJ, Sharratt M, Yee D. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2017; 5:e154. [PMID: 29113961 PMCID: PMC5698632 DOI: 10.2196/mhealth.7091] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 07/08/2017] [Accepted: 07/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background Despite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes. Objective This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community. Methods Using a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed. Results The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group. Conclusions A mobile phone app–based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women. A flexible, easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit populations that bear disproportionate cancer burdens. Trial Registration Clinicaltrials.gov NCT01972048; https://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29)
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Affiliation(s)
- Hee Lee
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology and Women's Health, School of Medicine, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Chap Le
- Division of Biostatistics, School of Public Health, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Yoo Jeong Jang
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Monica Sharratt
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Douglas Yee
- Division of Hematology, Oncology and Transplantation, School of Medicine and Pharmacology, University of Minnesota, Twin Cities, Minneapolis, MN, United States
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19
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Hajek A, Bock JO, König HH. The role of general psychosocial factors for the use of cancer screening-Findings of a population-based observational study among older adults in Germany. Cancer Med 2017; 6:3025-3039. [PMID: 29030910 PMCID: PMC5727314 DOI: 10.1002/cam4.1226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 11/24/2022] Open
Abstract
Within the framework of the health‐belief model, some studies exist investigating the association between illness‐specific psychosocial factors and the use of cancer screenings. However, studies investigating the association between general psychosocial factors and the use of cancer screenings are missing. Thus, this study aimed at examining the association between well‐established general psychosocial factors and the use of cancer screenings. Data were gathered from a large, population‐based sample of community‐dwelling individuals aged 40 and above in Germany (n = 7673; in 2014). Loneliness, cognitive well‐being, affective well‐being (negative and positive affect), optimism, self‐efficacy, self‐esteem, self‐regulation, perceived autonomy, perceived stress, and perceived social exclusion were used as general psychosocial factors. Furthermore, individuals were asked whether they regularly underwent early cancer screening in the past years (yes; no). A total of 65.6% of the individuals used cancer screening. Adjusting for sociodemographic factors, self‐rated health, morbidity and lifestyle factors, multiple logistic regressions revealed that the use of cancer screening is positively associated with decreased loneliness, cognitive well‐being, optimism, self‐efficacy, self‐esteem, self‐regulation, perceived autonomy, decreased perceived stress, decreased perceived social exclusion, and positive affect, while it is not associated with negative affect. This study stresses the strong association between general psychosocial factors and the use of cancer screening. This knowledge might be fruitful to address individuals at risk for underuse.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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20
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Mark KP, Crosby RA, Vanderpool RC. Psychosocial Correlates of Ever Having a Pap Test and Abnormal Pap Results in a Sample of Rural Appalachian Women. J Rural Health 2017; 34:148-154. [PMID: 28872699 DOI: 10.1111/jrh.12265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/02/2017] [Accepted: 07/19/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Despite known prevention and screening efforts, there are higher invasive cervical cancer rates in Appalachia than in other areas of the United States and higher mortality rates in the Appalachian region of Kentucky compared to Appalachian regions of other states. PURPOSE The primary purpose of this study was to investigate the association of psychosocial factors relevant to cervical cancer and the outcome of ever having a Pap test in a rural sample of women. The secondary purpose was to determine whether any of the same psychosocial factors were also associated with ever having an abnormal Pap test result among women with a self-reported history of having one or more Pap tests in their lifetime. METHODS Data were collected in fall of 2013 from 393 women in 8 economically distressed counties of rural Appalachian Kentucky. Women completed an interviewer-administered survey assessing sociodemographic and health information as well as beliefs about cervical cancer. FINDINGS Multivariate logistic regression results indicated that low income and greater perceived local fatalism were significant predictors of never having a Pap test. Lack of personal control over prevention, and peer and family influences were significant predictors of ever having an abnormal Pap test result. CONCLUSIONS Educational efforts targeted in rural Appalachia would be supported by encouraging the benefits of early and consistent screening, altering the established norms of community fatalism and lack of personal control over prevention, and creating targeted messages through public campaigns that convince rural Appalachian women that cervical cancer is highly preventable and screenable.
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Affiliation(s)
- Kristen P Mark
- Department of Kinesiology & Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Richard A Crosby
- Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky
| | - Robin C Vanderpool
- Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky
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21
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Hope KA, Moss E, Redman CWE, Sherman SM. Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence. Prev Med 2017; 101:60-66. [PMID: 28502577 DOI: 10.1016/j.ypmed.2017.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/28/2017] [Accepted: 05/07/2017] [Indexed: 10/19/2022]
Abstract
Cervical cancer is the fourth most common cancer in women worldwide (WHO, 2016). In many developed countries the incidence of cervical cancer has been significantly reduced by the introduction of organised screening programmes however, in the UK, a fall in screening coverage is becoming a cause for concern. Much research attention has been afforded to younger women but age stratified mortality and incidence data suggest that older women's screening attendance is also worthy of study. This paper provides a review of current evidence concerning the psycho-social influences that older women experience when deciding whether to attend cervical screening. Few studies have focussed on older women and there are significant methodological issues with those that have included them in their samples. Findings from these studies indicate several barriers which may deter older women from screening, such as embarrassment and logistical issues. Drivers to screening include reassurance and a sense of obligation. Physical, social and emotional changes that occur as women age may also have an impact on attendance. This review concludes that there is a clear need for better understanding of the perceptions of older women specifically with regard to cervical cancer and screening. Future research should inform the design of targeted interventions and provision of information to enable informed decision-making regarding cervical screening among older women.
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Affiliation(s)
- Kirsty A Hope
- School of Psychology, Keele University, Keele, Staffs ST5 5BG, UK
| | - Esther Moss
- Department of Gynaecological Oncology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Charles W E Redman
- Department of Obstetrics and Gynaecology, Royal Stoke University Hospital, Stoke-on-Trent ST4 6QG, UK
| | - Susan M Sherman
- School of Psychology, Keele University, Keele, Staffs ST5 5BG, UK.
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22
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Rivers SE, Salovey P, Pizarro DA, Pizarro J, Schneider TR. Message Framing and Pap Test Utilization among Women Attending a Community Health Clinic. J Health Psychol 2016; 10:65-77. [PMID: 15576501 DOI: 10.1177/1359105305048556] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In a randomized experiment, women ( N = 441) watched either a loss- or gain-framed video emphasizing the prevention or detection functions of the Pap test to test the hypothesis that loss- and gain-framed messages differentially influence health behaviors depending on the risk involved in performing the behavior. As predicted, loss-framed messages emphasizing the costs of not detecting cervical cancer early (a risky behavior) and gain-framed messages emphasizing the benefits of preventing cervical cancer (a less risky behavior) were most persuasive in motivating women to obtain a Pap test.
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Affiliation(s)
- Susan E Rivers
- Department of Psychology, Yale University, New Haven, Connecticut 06520-8205, USA
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Lee EWJ, Shin M, Kawaja A, Ho SS. The Augmented Cognitive Mediation Model: Examining Antecedents of Factual and Structural Breast Cancer Knowledge Among Singaporean Women. JOURNAL OF HEALTH COMMUNICATION 2016; 21:583-592. [PMID: 27128006 DOI: 10.1080/10810730.2015.1114053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women's breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.
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Affiliation(s)
- Edmund W J Lee
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Mincheol Shin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Ariffin Kawaja
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Shirley S Ho
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
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Christian T, Guell C. Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados. Women Health 2015; 55:566-79. [PMID: 25833319 DOI: 10.1080/03630242.2015.1022816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to explore Barbadian women's attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants' consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women's overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.
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Affiliation(s)
- Trudy Christian
- a Public Health Group, Faculty of Medical Sciences , University of the West Indies , Cave Hill Campus, Bridgetown , Barbados
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25
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Freedman RA, Kouri EM, West DW, Keating NL. Racial/ethnic disparities in knowledge about one's breast cancer characteristics. Cancer 2015; 121:724-32. [PMID: 25624186 PMCID: PMC4946569 DOI: 10.1002/cncr.28977] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 07/17/2014] [Accepted: 07/25/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND Understanding tumor characteristics is likely important, but little is known about breast cancer patients' knowledge of their own disease. The authors assessed women's knowledge about their tumor characteristics, whether racial/ethnic disparities in knowledge exist, and whether education and health literacy influence associations. METHODS A population-based cohort of women in Northern California with stage 0 through III breast cancers diagnosed from 2010 to 2011 (participation rate 68.5%) was surveyed. Among 500 respondents (222 non-Hispanic white women, 142 non-Hispanic black women, and 136 Hispanic women), racial/ethnic differences in knowledge about tumor characteristics (estrogen receptor [ER] status, human epidermal growth factor receptor 2 [HER2] status, stage, grade) and correctness of tumor information (with California Cancer Registry data for confirmation) were examined. Multivariate logistic regression was used to assess the probability of: 1) knowing tumor stage, receptor status, and grade; and 2) correctly answering questions about tumor information by race/ethnicity. The impact of education and health literacy on findings was examined in sequential models. RESULTS Overall, 32% to 82% of women reported knowing each of the 4 tumor characteristics of interest, and 20% to 58% correctly reported these characteristics. After adjustment, black and Hispanic women were less likely than white women to know and have correct responses for stage, ER status, and HER2 status (all P<.05). Education and health literacy were significantly associated with knowing and having correct information about some characteristics, but these variables did not eliminate most of the racial/ethnic differences observed. CONCLUSIONS Patient's knowledge about their own breast cancer was generally poor, particularly for minority women. Further study of how this knowledge may impact receipt of care and outcomes is warranted.
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Affiliation(s)
- Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Eldeek B, Alahmadi J, Al-Attas M, Sait K, Anfinan N, Aljahdali E, Ajaj H, Sait H. Knowledge, perception, and attitudes about cancer and its treatment among healthy relatives of cancer patients: single institution hospital-based study in Saudi Arabia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:772-780. [PMID: 24715252 DOI: 10.1007/s13187-014-0653-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients who attended an outpatient cancer clinic with their relatives who suffer from cancers. The participants recruited in this cross-sectional, interview-based study were 846 (557 female and 289 male subjects) healthy relatives of cancer patients from the outpatient cancer clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Most of the participants answered that they believed the causes of cancer were genetic (44.90 %), followed by environmental factors (30.10 %), diet (26.90 %), other causes (26.90 %), envy (26.90 %), and black magic (17.60 %). Most of the healthy participants believed that doctors should tell patients the full truth about the diagnosis (83.57 %). More than half of the healthy population stated that cancer patients should accept all types of treatment (chemotherapy and/or radiotherapy and/or surgery), with more male subjects having this position than females (P = 0.014). Most of the participants believed that cancer cannot be caught from another person who suffered from cancer (67.50 %). Most of the participants believed that cancer education was sufficient (66.70 %), with a significant difference between male and female respondents (P = 0.004). With regard to why cancer patients hide their disease, most of the participants in the age group <25 years believed that the causes were fear of loss of health insurance (56.20 %), followed by job loss (34.40 %), and then social stigma (9.40 %); in the age group between 25 and 45 years, the causes were fear of loss of health insurance (76.50 %), followed by social stigma (14.70 %), and then job loss (8.80 %); while in the age group >45 years, the reasons were job loss (47.10 %), followed by health insurance loss (41.20 %), and then social stigma (11.80 %), with a significant difference between groups (P = 0.034). This study demonstrated that still a large number of healthy participants had deficient perceptions and poor attitudes about important issues concerning cancers such as different mode of treatments, alternative treatment, biological causes, and prognosis, particularly among male respondents. Prevention education strategies should be considered, including targeted approaches that aim to reduce disparities in cancer perception among the general population.
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Affiliation(s)
- Bassem Eldeek
- Community Medicine in the Medical Education Department, King Abdulaziz University, Jeddah, Saudi Arabia
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Elobaid YE, Aw TC, Grivna M, Nagelkerke N. Breast cancer screening awareness, knowledge, and practice among arab women in the United Arab Emirates: a cross-sectional survey. PLoS One 2014; 9:e105783. [PMID: 25265385 PMCID: PMC4179300 DOI: 10.1371/journal.pone.0105783] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/27/2014] [Indexed: 12/15/2022] Open
Abstract
Background Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy. Low participation in screening programs has been attributable to many factors including lack of knowledge. The aim of this study was to assess breast cancer screening knowledge, attitudes and practices among women of screening age (≥40 years old) in the city of Al Ain, United Arab Emirates (UAE). Methods A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure (CAM). Four out of twelve cultural and religious community centers in Al Ain city were randomly selected. Two hundred and forty seven women were interviewed. Chi Square test and regression analysis were used to analyze the data. Results Despite the increase in the uptake of screening modalities in our study group, a lack of knowledge about breast cancer screening is still evident. Almost half (44.8%) of women who never had a Clinical Breast Exam (CBE) and 44.1% of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques. Nearly one third of the participants interpreted the presence of a breast lump incorrectly and, moreover, expressed fewer worries about the nature of the lump than would normally be expected. Conclusions The National screening program needs to be improved and directed towards more efficient and targeted utilization of resources. Healthcare professionals play a major role in alerting women to the importance of periodic screening.
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Affiliation(s)
- Yusra E. Elobaid
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
| | - Tar Ching Aw
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Michal Grivna
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nico Nagelkerke
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Cancer awareness and socio-economic position: results from a population-based study in Denmark. BMC Cancer 2014; 14:581. [PMID: 25108301 PMCID: PMC4138385 DOI: 10.1186/1471-2407-14-581] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 08/01/2014] [Indexed: 11/10/2022] Open
Abstract
Background Differences in cancer awareness between individuals may explain variations in healthcare seeking behaviour and ultimately also variations in cancer survival. It is therefore important to examine cancer awareness and to investigate possible differences in cancer awareness among specific population subgroups. The aim of this study is to assess awareness of cancer symptoms, risk factors and perceived 5-year survival from bowel, breast, ovarian, and lung cancer in a Danish population sample and to analyse the association between these factors and socio-economic position indicators. Methods A population-based telephone survey was carried out among 1,000 respondents aged 30–49 years and 2,000 respondents aged 50 years and older using the Awareness and Beliefs about Cancer measure. Information on socio-economic position was obtained by data linkage through Statistics Denmark. Prevalence ratios were used to determine the association between socio-economic position and cancer awareness. Results A strong socio-economic gradient in cancer awareness was found. People with a low educational level and a low household income were more likely to have a lower awareness of cancer symptoms, cancer risk factors and the growing risk of cancer with age. Furthermore, men and people outside the labour force tended to be less aware of these factors than women and people within the labour force. However, women were more likely than men to lack awareness of the relationship between age and cancer risk. No clear associations were found between socio-economic position and lack of awareness of 5-year survival from bowel, breast, ovarian, and lung cancers. Conclusions As cancer awareness has shown to be positively associated with cancer-related behaviour, e.g. healthcare seeking, consideration must be given to tackle inequalities in cancer awareness and to address this issue in future public health strategies, which should be targeted at and tailored to the intended recipient groups.
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Abstract
Although cervical cancer rates in the United States have declined sharply in recent decades, certain groups of women remain at elevated risk, including middle-aged and older women in central Appalachia. Cross-sectional baseline data from a community-based randomized controlled trial were examined to identify barriers to cervical cancer screening. Questionnaires assessing barriers were administered to 345 Appalachian women aged 40-64, years when Papanicolaou (Pap) testing declines and cervical cancer rates increase. Consistent with the PRECEDE/PROCEED framework, participants identified barriers included predisposing, enabling, and reinforcing factors. Descriptive and bivariate analyses are reported, identifying (a) the most frequently endorsed barriers to screening, and (b) significant associations of barriers with sociodemographic characteristics in the sample. Recommendations are provided to decrease these barriers and, ultimately, improve rates of Pap tests among this traditionally underserved and disproportionately affected group.
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Lee HY, Ju E, Vang PD, Lundquist M. Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter [corrected]? J Womens Health (Larchmt) 2013; 19:1877-84. [PMID: 20831437 DOI: 10.1089/jwh.2009.1783] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ethnic minorities are frequently considered as one homogeneous group in research, and this trend is particularly true for Asian Americans. This article seeks to uncover the intragroup differences in cancer screening behavior among subgroups of Asian American women by disaggregating them into six subgroups. The subgroups were compared with non-Latina white women to examine differences in breast and cancer screening rates and relevant factors associated with receiving these screenings. METHODS Three-year merged data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS) were used to investigate the subgroup differences. Samples for the current study were restricted to non-Latina white and Asian American women whose age was ≥ 18 years (n = 58,000) for cervical cancer screening and ≥ 40 years (n = 43,518) for breast cancer screening at the time of the interview. RESULTS Results showed marked differences in cancer screening rates among Asian American subgroups and between cancer types. Cervical cancer screening rates were noticeably higher than breast cancer screening rates in all groups. The Korean group consistently showed the lowest rates of both cancer screenings. Japanese ranked the highest (79.5%) in breast cancer screening but the second lowest (79.7%) in cervical cancer screening. Enabling factors, such as having private health insurance and a usual source of care, were found to be the strongest predictors of receiving both breast and cervical cancer screening. Screenings for both types of cancer increased if a woman was married or was born in the United States. CONCLUSIONS The findings of this study illustrate the heterogeneity that exists among Asian American subgroups in their cancer screening behaviors. Further development of culturally relevant and ethnic-specific cancer prevention strategies and policies that address the subgroup differences within the larger racial/ethnic population are needed. Public health outreach and cancer education should be prioritized to the Asian American women who are more recent arrivals in the United States and have minimal access to healthcare.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, Saint Paul, Minnesota 55108, USA.
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Suh B, Shin DW, Kim SY, Park JH, Chang WY, Lim SP, Yim CY, Cho BL, Park EC, Park JH. Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea. BMC Cancer 2012. [PMID: 23181637 PMCID: PMC3517745 DOI: 10.1186/1471-2407-12-557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND While knowledge and risk perception have been associated with screening for second primary cancer (SPC), there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected) is associated with subsequent completion of all appropriate SPC screening in cancer survivors. METHODS Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. RESULTS Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36-3.33), after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. CONCLUSIONS The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.
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Affiliation(s)
- Beomseok Suh
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea
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Abstract
BACKGROUND South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. OBJECTIVE : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. METHODS Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. RESULTS Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. CONCLUSIONS Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. IMPLICATIONS FOR PRACTICE Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.
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Takahashi M, Kai I, Muto T. Discrepancies Between Public Perceptions and Epidemiological Facts Regarding Cancer Prognosis and Incidence in Japan: An Internet Survey. Jpn J Clin Oncol 2012; 42:919-26. [DOI: 10.1093/jjco/hys125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Whitaker KL, Simon AE, Beeken RJ, Wardle J. Do the British public recognise differences in survival between three common cancers? Br J Cancer 2012; 106:1907-9. [PMID: 22555400 PMCID: PMC3388561 DOI: 10.1038/bjc.2012.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The recognition that cancer is not a single entity, rather that different cancers have different causes and trajectories, has been a key development in the scientific understanding of cancer. However, little is known about the British public's awareness of differences between cancers. This study examined differences in perceived survivability for three common cancers with widely disparate survival rates (breast, colorectal and lung). METHOD In a population-based survey, using home interviews (N=2018), respondents answered a quantitative (numeric) question on 5-year survival and a qualitative (non-numeric) question on curability, for each of the three cancers. RESULTS British adults correctly recognised that 5-year survival for breast cancer was higher than for colorectal cancer (CRC), which in turn was recognised to be higher than for lung cancer. Similarly, curability was perceived to be higher for breast than CRC, and both were perceived to be more curable than lung cancer. Awareness of survival differences did not vary by sex, age or socioeconomic status. In terms of absolute values, there was a tendency to underestimate breast cancer survival and overestimate lung cancer survival. CONCLUSION The British public appear to be aware that not all cancers are equally fatal.
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Affiliation(s)
- K L Whitaker
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UK
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Kessler TA. Increasing mammography and cervical cancer knowledge and screening behaviors with an educational program. Oncol Nurs Forum 2012; 39:61-8. [PMID: 22201656 DOI: 10.1188/12.onf.61-68] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the effectiveness of using an educational program based on self-efficacy to increase knowledge and create behavior change regarding recommended mammography and Papanicolaou (Pap) test screening guidelines. DESIGN Pretest and post-test, prospective. SETTING An urban county in northern Indiana. SAMPLE 56 women who attended one of four educational programs and 47 women who responded 15 months later. METHODS The one-hour educational programs based on self-efficacy included vicarious experiences and verbal persuasion regarding breast and cervical screening practices. Two programs were offered to local church groups as part of a health fair, and two were offered through health promotion initiatives sponsored by private businesses. MAIN RESEARCH VARIABLES Demographics, knowledge of breast and cervical cancer, and screening behaviors. FINDINGS Knowledge of risk and screening guidelines increased significantly immediately following the educational program (p < 0.001) and did not decrease significantly 15 months later (p = 0.57). Family history and history of human papillomavirus and sexually transmitted diseases were the top known risk factors for breast and cervical cancers, respectively. Participant-reported rates of screening behaviors increased 15 months later for mammography (100%) and Pap test (84%). CONCLUSIONS Educational interventions based on self-efficacy increased knowledge of breast and cervical health and helped increase the rate of mammography and Pap tests. IMPLICATIONS FOR NURSING Preparing women with strategies to complete a mammogram and Pap test is an important approach to enhancing self-efficacy and increasing screening behaviors.
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Tracy JK, Lydecker AD, Ireland L. Barriers to cervical cancer screening among lesbians. J Womens Health (Larchmt) 2012; 19:229-37. [PMID: 20095905 DOI: 10.1089/jwh.2009.1393] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate cervical cancer screening practices and barriers to screening in a sample of lesbians. METHODS Cross-sectional survey data were collected from 225 self-identified lesbians who completed an online questionnaire. RESULTS Of the respondents, 71% reported receiving a Pap screening test in the past 24 months (routine screeners), and 29% reported receiving a Pap screening test >24 months ago or never (nonroutine screeners). Routine screeners were more likely to be older (p < 0.01), white (p = 0.04), and college graduates (p < 0.01) than nonroutine screeners. Nonroutine screeners were more likely to delay seeking healthcare because of fear of discrimination (p < 0.01) and were less likely than routine screeners to disclose orientation to their primary care physician (p < 0.01). After adjusting for age, race, and education, nonroutine screeners perceived fewer benefits from (p < 0.01) and more barriers (p < 0.01) to Pap screening tests and were less knowledgeable about screening guidelines (p < 0.01) than routine screeners, but there was no difference in perceived susceptibility (p = 0.68), perceived seriousness (p = 0.68), or risk factor knowledge (p = 0.35) of cervical cancer. CONCLUSIONS Many lesbians do not screen for cervical cancer at recommended rates. Nonroutine screeners perceive fewer benefits, more barriers, and more discrimination and are less knowledgeable about screening guidelines than routine screeners.
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Affiliation(s)
- J Kathleen Tracy
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
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Jackowska M, von Wagner C, Wardle J, Juszczyk D, Luszczynska A, Waller J. Cervical screening among migrant women: a qualitative study of Polish, Slovak and Romanian women in London, UK. ACTA ACUST UNITED AC 2012; 38:229-38. [PMID: 22219504 PMCID: PMC3970719 DOI: 10.1136/jfprhc-2011-100144] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore awareness of and participation in cervical screening services in women from Poland, Slovakia and Romania living in London, UK. METHODS Three qualitative studies were carried out in London in 2008-2009: an interview study of professionals working with Central and Eastern European migrants (n=11); a focus group study including three Polish, one Slovak and one Romanian focus group; and an interview study of Polish (n=11), Slovak (n=7) and Romanian (n=2) women. RESULTS Awareness of the cervical screening programme was good, but understanding of the purpose of screening was sometimes limited. Some women were fully engaged with the UK screening programme; others used screening both in the UK and their countries of origin; and a third group only had screening in their home countries. Women welcomed the fact that screening is free and that reminders are sent, but some were concerned about the screening interval and the age of the first invitation. CONCLUSIONS Migrant women from Poland, Slovakia and Romania living in London vary in their level of participation in the National Health Service Cervical Screening Programme. More needs to be done to address concerns regarding screening services, and to ensure that language is not a barrier to participation.
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Affiliation(s)
- Marta Jackowska
- Department of Epidemiology and Public Health, University College London, UK
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Han KH, Jo S. Does Culture Matter?: A Cross-National Investigation of Women's Responses to Cancer Prevention Campaigns. Health Care Women Int 2012; 33:75-94. [DOI: 10.1080/07399332.2011.630117] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Australian women's perceptions of breast cancer risk factors and the risk of developing breast cancer. Womens Health Issues 2011; 21:353-60. [PMID: 21565527 DOI: 10.1016/j.whi.2011.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 02/02/2011] [Accepted: 02/03/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND Numerous studies have shown that the majority of women overestimate both their own risk and the populations' risk of developing breast cancer. A number of factors have been found to correlate with perceived risk. METHODS This paper reports on a telephone survey of a nationally representative sample of approximately 3,000 Australian women aged 30 to 69 years, conducted in 2007, and compares the findings with those of a similar survey conducted in 2003. RESULTS There was a clear tendency for respondents to overestimate the proportion of women who will develop breast cancer during their lifetime. Approximately half the respondents perceived themselves as being at the same risk of developing breast cancer as other women their age; older respondents were more likely to perceive themselves to be at a lower than average risk. Family history was recognized as a risk factor for breast cancer, although there was evident confusion in relation to risk from paternal family history. It was also evident that the association between age and risk status is poorly understood, and misconceptions of breast cancer risk factors identified in the previous survey persisted in 2007. CONCLUSION Overall, these results suggest that there remains an educational challenge if we seek to increase the accuracy of women's perceptions of their risk for developing breast cancer, primarily in relation to the significance of age and family history as breast cancer risk factors.
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Gallagher KM, Updegraff JA, Rothman AJ, Sims L. Perceived susceptibility to breast cancer moderates the effect of gain- and loss-framed messages on use of screening mammography. Health Psychol 2011; 30:145-52. [PMID: 21401248 PMCID: PMC4679369 DOI: 10.1037/a0022264] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined the role of three distinct beliefs about risk (risks associated with screening, construal of the function of screening as health-affirming or illness-detecting, and perceived susceptibility to breast cancer) in moderating women's responses to framed messages that promote mammography. DESIGN Three hundred fifty-five women recruited from an inner city hospital, nonadherent to guidelines for receiving annual screening mammograms,were randomly assigned to view a gain- or loss-framed video message about the importance of mammography. MAIN OUTCOME MEASURE Mammography screening was self-reported at a 3-month follow-up. RESULTS Only perceived susceptibility to breast cancer significantly moderated the effect of message framing on screening. Women with average and higher levels of perceived susceptibility for breast cancer were significantly more likely to report screening after viewing a loss-framed message compared to a gain-framed message. No effects of framing on reported screening were observed for women with lower levels of perceived susceptibility. CONCLUSION The study identifies a key role for perceived susceptibility in shaping responses to framed messages that promote cancer screenings.
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Shin DW, Kim YW, Oh JH, Kim SW, Chung KW, Lee WY, Lee JE, Lee WC, Guallar E, Cho J. Knowledge, attitudes, risk perception, and cancer screening behaviors among cancer survivors. Cancer 2011; 117:3850-9. [PMID: 21319155 DOI: 10.1002/cncr.25951] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 11/27/2010] [Accepted: 12/20/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND Knowledge, attitudes, and risk perception in relation to second primary cancer (SPC) screening and their impact on screening practices in cancer survivors are largely unknown. METHODS A total of 326 cancer survivors who had completed primary treatment for cancer >1 year previously were recruited from 6 oncology care outpatient clinics in the Republic of Korea. Survivors' knowledge, attitudes, perceived risk, and screening practices were assessed along with sociodemographic, behavioral, and clinical characteristics. Multivariate logistic regression was used to examine behavioral factors associated with the completion of all appropriate SPC screening according to national guidelines. RESULTS Approximately 37.7% of survivors had undergone all appropriate SPC screening tests. Survivors were found to have a high perceived risk of SPC, high perceived benefits of screening, and positive attitudes toward cancer screening. However, they had limited knowledge regarding SPC screening tests and few had received a recommendation from a physician to undergo SPC screening. Although there was no association found between perceived risk and positive attitudes with screening behavior, higher knowledge was noted to be significantly associated with the completion of all appropriate SPC screening (adjusted odds ratio, 1.81; 95% confidence interval, 1.03-3.33). CONCLUSIONS In the current study, cancer survivors were found to have limited knowledge regarding second cancer screening tests, which may have resulted in lower rates of completion of screening practices in this population.
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Affiliation(s)
- Dong Wook Shin
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Byrne MM, Davila EP, Zhao W, Parker D, Hooper MW, Caban-Martinez A, Dietz N, Huang Y, Messiah A, Lee DJ. Cancer screening behaviors among smokers and non-smokers. Cancer Epidemiol 2010; 34:611-7. [PMID: 20655820 DOI: 10.1016/j.canep.2010.06.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 06/22/2010] [Accepted: 06/23/2010] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We explored whether smoking is associated with cancer screening behaviors. METHODS We used data from the 2007 Florida Behavioral Risk Factor Surveillance System and the Florida Tobacco Callback Survey to examine screening behaviors related to four cancer types (breast, cervical, prostate, and colorectal). Using multiple logistic regression analyses, we examined the association between smoking status and health screening behaviors. RESULTS For 10 of the 11 cancer screening variables, being a current smoker was significantly associated with being less likely to ever have been screened and also less likely to be compliant with screening guidelines. For breast and cervical cancer, level of nicotine dependence was also significantly related to compliance with screening recommendations; women with higher levels of dependence were less likely to be compliant. CONCLUSIONS Our results support the notion that individuals' actions related to their health are consistent across different types of behaviors. We found that smokers were less likely to engage in cancer screening behaviors. In addition, among smokers, individuals with greater nicotine dependence had lower compliance with some screening tests. Physicians should ensure that their patients who smoke are receiving appropriate and adequate screening for cancer.
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Affiliation(s)
- Margaret M Byrne
- Department of Epidemiology and Public Health, University of Miami, Miami, FL 33136, USA.
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Chang SCH, Woo JST, Gorzalka BB, Brotto LA. A questionnaire study of cervical cancer screening beliefs and practices of Chinese and Caucasian mother-daughter pairs living in Canada. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:254-62. [PMID: 20500970 DOI: 10.1016/s1701-2163(16)34452-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Papanicolaou (Pap) testing rates among Chinese women remain low compared with their Caucasian counterparts despite extensive efforts to raise awareness of the importance of regular screening. We examined three potential predictors of Pap testing behaviour in Chinese women: acculturation, cervical cancer screening belief accuracy, and intergenerational transmission. METHODS Caucasian (n = 78) and Chinese (n = 93) female university students and their mothers completed questionnaires concerning acculturation, Pap testing beliefs, and behaviours. RESULTS Ethnic group comparisons revealed that Chinese daughters and mothers had lower Pap testing rates and less accurate beliefs regarding cervical cancer screening. Among women who had had at least one Pap test, there was no ethnic difference in the proportion of women who adhered to the recommended screening frequency. Among the Chinese women, lower heritage acculturation was correlated with higher cancer screening belief accuracy in both the daughters and their mothers. Maternal Pap testing behaviour was predicted by level of cancer screening belief accuracy, whereas daughters' Pap testing behaviour was predicted by previous experience of sexual intercourse and heritage acculturation. No intergenerational transmission of Pap testing beliefs or behaviours was found. CONCLUSION The accuracy of cancer screening beliefs, level of acculturation and experience of sexual intercourse may be predictors of Pap testing behaviour in Chinese women. Contrary to our prediction, we found no support for intergenerational transmission, suggesting that Pap testing beliefs and behaviours of Chinese women are independent of the beliefs and behaviours of their mothers.
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Affiliation(s)
- Sabrina C H Chang
- Department of Psychology, University of British Columbia, Vancouver BC
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Lee HY, Vang S. Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy. J Community Health 2010; 35:302-14. [PMID: 20140486 DOI: 10.1007/s10900-010-9228-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, Saint Paul, MN 55108, USA.
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Evaluating the Health Belief Model: A critical review of studies predicting mammographic and pap screening. SOCIAL THEORY & HEALTH 2010. [DOI: 10.1057/sth.2009.23] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Naito M, O'Callaghan FV, Morrissey S. Understanding women's mammography intentions: a theory-based investigation. Women Health 2009; 49:101-18. [PMID: 19533505 DOI: 10.1080/03630240902915119] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study compared the utility of two models (the Theory of Planned Behavior and Protection Motivation Theory) in identifying factors associated with intentions to undertake screening mammography, before and after an intervention. The comparison was made between the unique components of the two models. The effect of including implementation intentions was also investigated. Two hundred and fifty-one women aged 37 to 69 years completed questionnaires at baseline and following the delivery of a standard (control) or a protection motivation theory-based informational intervention. Hierarchical multiple regressions indicated that theory of planned behavior variables were associated with mammography intentions. Results also showed that inclusion of implementation intention in the model significantly increased the association with mammography intentions. The findings suggest that future interventions aiming to increase screening mammography participation should focus on the theory of planned behavior variables and that implementation intention should also be targeted.
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Affiliation(s)
- Mikako Naito
- School of Psychology, Griffith University, Gold Coast, Queensland, Australia
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Walsh JC. The impact of knowledge, perceived barriers and perceptions of risk on attendance for a routine cervical smear. EUR J CONTRACEP REPR 2009; 11:291-6. [PMID: 17484195 DOI: 10.1080/13625180600841827] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Cervical cancer is one of the most preventable malignant tumours, and 90% of cases can be identified and treated in its early stages in a simple outpatient procedure. In spite of this, many new cases of cervical cancer are diagnosed each year. The present study examines the impact of knowledge, perceived risk, past experience and perceived barriers on attendance for a routine cervical smear test. METHODS The study is based on a sample of over 1,000 women from the Irish Cervical Screening Programme (ICSP) database who were sent a letter of invitation to attend for a smear test. RESULTS The results show that women have relatively poor levels of knowledge about cervical cancer and screening. Significant barriers to attendance included: the perception of having a cervical smear test as time consuming (P < 0.01), causing greater distress (P < 0.01) and being more afraid of the test (P < 0.05). Women who attended for a smear perceived themselves at greater risk of cervical cancer than non-attenders. CONCLUSIONS Barriers to attendance should be addressed in programmes that focus on the benefits outweighing the costs of attending for a cervical smear test.
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Affiliation(s)
- Jane C Walsh
- Department of Psychology, National University of Ireland, Galway, Ireland.
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Lester WT, Ashburner JM, Grant RW, Chueh HC, Barry MJ, Atlas SJ. Mammography FastTrack: an intervention to facilitate reminders for breast cancer screening across a heterogeneous multi-clinic primary care network. J Am Med Inform Assoc 2009; 16:187-95. [PMID: 19074304 PMCID: PMC2649321 DOI: 10.1197/jamia.m2813] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Accepted: 11/30/2008] [Indexed: 11/10/2022] Open
Abstract
Health care information technology can be a means to improve quality and efficiency in the primary care setting. However, merely applying technology without addressing how it fits into provider workflow and existing systems is unlikely to achieve improvement goals. Improving quality of primary care, such as cancer screening rates, requires addressing barriers at system, provider, and patient levels. The authors report the development, implementation, and preliminary use of a new breast cancer screening outreach program in a large multicenter primary care network. This installation paired population-based surveillance with customized information delivery based on a validated model linking patients to providers and practices. In the first six months, 86% of physicians and all case managers voluntarily participated in the program. Providers intervened in 83% of the mammogram-overdue population by initiating mailed reminders or deferring contact. Overall, 63% of patients were successfully contacted. Systematic population-based efforts are promising tools to improve preventative care.
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Affiliation(s)
- William T Lester
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, 7th Floor, Boston, Massachusetts 02114, USA.
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Sanderson SC, Waller J, Jarvis MJ, Humphries SE, Wardle J. Awareness of lifestyle risk factors for cancer and heart disease among adults in the UK. PATIENT EDUCATION AND COUNSELING 2009; 74:221-227. [PMID: 19059747 DOI: 10.1016/j.pec.2008.08.003] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Revised: 07/05/2008] [Accepted: 08/06/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To examine and compare awareness of lifestyle risk factors for cancer and heart disease in a single UK representative sample. METHODS Two open-ended questions about cancer and heart disease risk factors were included in a population-based survey of 1747 adults. Responses were coded for four lifestyles with established links to both diseases: smoking, eating an unhealthy diet, drinking excessive alcohol and physical inactivity. RESULTS Awareness of lifestyle risk factors was low for both diseases, although higher for heart disease than cancer. The average number identified by respondents was 2.1 (heart disease) and 1.4 (cancer). The strongest predictor was education (both p<0.001). Awareness that physical inactivity is a cancer risk factor was particularly low at 7%. CONCLUSION These findings suggest that public awareness of the impact of lifestyle on commonly feared diseases, especially cancer, is low. PRACTICE IMPLICATIONS Unhealthy lifestyles make a significant contribution to ill health and mortality. Increased public awareness of the links between lifestyles and commonly feared diseases might help people understand the potential health consequences of their actions and encourage them to make much-needed lifestyle changes. Efforts are needed to improve public health messages about how lifestyle risk factors impact on the chances of developing these important diseases.
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Affiliation(s)
- Saskia C Sanderson
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, NY 10029, United States.
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Chen JY, Diamant AL, Thind A, Maly RC. Determinants of breast cancer knowledge among newly diagnosed, low-income, medically underserved women with breast cancer. Cancer 2008; 112:1153-61. [DOI: 10.1002/cncr.23262] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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