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Consedine NS, Tuck NL, Ragin CR, Spencer BA. Beyond the black box: a systematic review of breast, prostate, colorectal, and cervical screening among native and immigrant African-descent Caribbean populations. J Immigr Minor Health 2015; 17:905-24. [PMID: 24522436 DOI: 10.1007/s10903-014-9991-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cancer screening disparities between black and white groupings are well-documented. Less is known regarding African-descent subpopulations despite elevated risk, distinct cultural backgrounds, and increasing numbers of Caribbean migrants. A systematic search of Medline, Web of Science, PubMed and SCOPUS databases (1980-2012) identified 53 studies reporting rates of breast, prostate, cervical, and colorectal screening behavior among immigrant and non-immigrant Caribbean groups. Few studies were conducted within the Caribbean itself; most work is US-based, and the majority stem from Brooklyn, New York. In general, African-descent Caribbean populations screen for breast, prostate, colorectal, and cervical cancers less frequently than US-born African-Americans and at lower rates than recommendations and guidelines. Haitian immigrants, in particular, screen at very low frequencies. Both immigrant and non-immigrant African-descent Caribbean groups participate in screening less frequently than recommended. Studying screening among specific Caribbean groups of African-descent may yield data that both clarifies health disparities between US-born African-Americans and whites and illuminates the specific subpopulations at risk in these growing immigrant communities.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland, New Zealand,
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Yang TC, Chen IC, Noah AJ. Examining the complexity and variation of health care system distrust across neighborhoods: Implications for preventive health care. RESEARCH IN THE SOCIOLOGY OF HEALTH CARE 2015; 33:43-66. [PMID: 26435564 PMCID: PMC4592143 DOI: 10.1108/s0275-495920150000033003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Recently, the institutional performance model has been used to explain the increased distrust of health care system by arguing that distrust is a function of individuals' perceptions on the quality of life in neighborhood and social institutions. We examined (1) whether individuals assess two dimensions of distrust consistently, (2) if the multilevel institutional performance model explains the variation of distrust, and (3) how distrust patterns affect preventive health care behaviors. METHODOLOGY Using data from 9,497 respondents in 914 census tracts (neighborhoods) in Philadelphia, we examined the patterns of how individuals evaluate the competence and values distrust using the Multilevel Latent Class Analysis (MLCA), and then investigated how neighborhood environment factors are associated with distrust patterns. Finally, we used regression to examine the relationships between distrust patterns and preventive health care. FINDINGS The MLCA identified four distrust patterns: Believers, Doubters, Competence Skeptics, and Values Skeptics. We found that 55 % of the individuals evaluated competence and values distrust coherently, with Believers reporting low levels and Doubters having high levels of distrust. Competence and Values Skeptics assessed distrust inconsistently. Believers were the least likely to reside in socioeconomically disadvantaged and racially segregated neighborhoods than other patterns. In contrast to Doubters, Believers were more likely to use preventive health care, even after controlling for other socioeconomic factors including insurance coverage. PRACTICAL IMPLICATIONS Our findings suggest that distrust patterns are function of neighborhood conditions and distrust patterns are associated with preventive health care. This study provides important policy implications for health care and future interventions.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, Center for Social and Demographic Analysis, University at Albany, State University of New York, 315 Arts and Sciences Building, 1400 Washington Avenue, Albany, NY 12222,
| | - I-Chien Chen
- Department of Sociology, Michigan State University, 316 Berkey Hall, East Lansing, MI 48824, USA,
| | - Aggie J. Noah
- Department of Sociology, Population Research Institute, Penn State University, 612 Oswald Tower, University Park, PA 16802, USA,
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Yang TC, Matthews SA, Anderson RT. Prostate cancer screening and health care system distrust in Philadelphia. J Aging Health 2013; 25:737-57. [PMID: 23775208 PMCID: PMC3761213 DOI: 10.1177/0898264313490199] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aim to examine whether distrust of health care system (hereafter distrust) is associated with prostate cancer screening and whether different dimensions of distrust demonstrate similar relationships with prostate cancer screening. METHOD With data on 1,784 men aged 45 to 75 from the Philadelphia metropolitan area, we first applied factor analysis to generate factor scores capturing two distrust subscales: competence and values. We then implemented logistic regressions to estimate the relationships between distrust and prostate cancer screening, controlling for covariates related to demographics (e.g., race and age), socioeconomic status (e.g., poverty status and education), health care resources (e.g., insurance status), and health status (i.e., self-rated health). RESULTS Without considering any other covariates, both competence and values distrust were negatively associated to the receipt of prostate cancer screening. After accounting for other covariates shown above, values distrust remained negatively associated with the odds of receiving prostate cancer screening (OR = 0.89, 95% CI [0.81, 0.98]) but competence distrust was not a significant predictor. CONCLUSIONS Values distrust was independently associated with prostate cancer screening. Macro-level change in the health care system may influence men's health behaviors. Our findings suggested that efforts to make the health care system more transparent and enhanced communications between men and health providers may facilitate prostate cancer screening.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, Center for Social & Demographic Analysis, University at Albany, State University of New York, USA.
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Consedine NS, Tuck NL, Fiori KL. Attachment and health care utilization among middle-aged and older African-descent men: dismissiveness predicts less frequent digital rectal examination and prostate-specific antigen screening. Am J Mens Health 2013; 7:382-93. [PMID: 23355546 DOI: 10.1177/1557988312474838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although health care utilization occurs in interpersonal contexts, little is known regarding how interpersonal preferences or styles among patients may be relevant. A small body of work has identified links between attachment-a dispositional style of relating to others-and patterns of health care use. The current report examined how attachment characteristics predicted the frequency of digital rectal exam and prostate-specific antigen testing in a sample of African-descent men. Four hundred and fourteen African-descent men aged 45 to 70 years completed measures of prostate screening and attachment, together with measures of traditional predictors of screening (demographics, insurance, family history, physician variables, knowledge, perceived risk, and accessibility). Consistent with predictions, dismissiveness-the most common relational style among older men-predicted less frequent prostate-specific antigen testing and digital rectal examination. However, attachment security-a comfort with intimate relationships-also predicted lower screening frequency. Identifying the interpersonal characteristics predicting screening may help identify men at risk of suboptimal health care use and guide the development of interventions suited to the normative relational preferences of current cohorts of older, African-descent men.
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Consedine NS. The demographic, system, and psychosocial origins of mammographic screening disparities: prediction of initiation versus maintenance screening among immigrant and non-immigrant women. J Immigr Minor Health 2012; 14:570-82. [PMID: 21904869 DOI: 10.1007/s10903-011-9524-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Disparities in breast screening are well documented. Less clear are differences within groups of immigrant and non-immigrant minority women or differences in adherence to mammography guidelines over time. A sample of 1,364 immigrant and non-immigrant women (African American, English Caribbean, Haitian, Dominican, Eastern European, and European American) were recruited using a stratified cluster-sampling plan. In addition to measuring established predictors of screening, women reported mammography frequency in the last 10 years and were (per ACS guidelines at the time) categorized as never, sub-optimal (<1 screen/year), or adherent (1+ screens/year) screeners. Multinomial logistic regression showed that while ethnicity infrequently predicted the never versus sub-optimal comparison, English Caribbean, Haitian, and Eastern European women were less likely to screen systematically over time. Demographics did not predict the never versus sub-optimal distinction; only regular physician, annual exam, physician recommendation, and cancer worry showed effects. However, the adherent categorization was predicted by demographics, was less likely among women without insurance, a regular physician, or an annual exam, and more likely among women reporting certain patterns of emotion (low embarrassment and greater worry). Because regular screening is crucial to breast health, there is a clear need to consider patterns of screening among immigrant and non-immigrant women as well as whether the variables predicting the initiation of screening are distinct from those predicting systematic screening over time.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
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Consedine NS, Reddig MK, Ladwig I, Broadbent EA. Gender and ethnic differences in colorectal cancer screening embarrassment and physician gender preferences. Oncol Nurs Forum 2012; 38:E409-17. [PMID: 22037340 DOI: 10.1188/11.onf.e409-e417] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine colorectal cancer (CRC) screening embarrassment among men and women from three ethnic groups and the associated physician gender preference by patient gender and ethnicity. DESIGN Cross-sectional, purposive sampling. SETTING Urban community in Brooklyn, NY. SAMPLE A purpose-derived, convenience sample of 245 European American, African American, and immigrant Jamaican men and women (aged 45-70 years) living in Brooklyn, NY. METHODS Participants provided demographics and completed a comprehensive measure of CRC screening embarrassment. MAIN RESEARCH VARIABLES Participant gender and ethnicity, physician gender, and CRC screening embarrassment regarding feces or the rectum and unwanted physical intimacy. FINDINGS As predicted, men and women both reported reduced fecal and rectal embarrassment and intimacy concern regarding same-gender physicians. As expected, Jamaicans reported greater embarrassment regarding feces or the rectum compared to European Americans and African Americans; however, in contrast to expectations, women reported less embarrassment than men. Interactions indicated that rectal and fecal embarrassment was particularly high among Jamaican men. CONCLUSIONS Men and women have a preference for same-gender physicians, and embarrassment regarding feces and the rectum shows the most consistent ethnic and gender variation. IMPLICATIONS FOR NURSING Discussing embarrassment and its causes, as well as providing an opportunity to choose a same-gender physician, may be promising strategies to reduce or manage embarrassment and increase CRC screening attendance.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, New Zealand.
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Consedine NS. Are we worrying about the right men and are the right men feeling worried? Conscious but not unconscious prostate anxiety predicts screening among men from three ethnic groups. Am J Mens Health 2011; 6:37-50. [PMID: 21862565 DOI: 10.1177/1557988311415513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Anxieties regarding cancer and screening have been consistently linked in prostate screening behavior with cancer-related anxieties generally thought to be higher among minority men. To date, however, the literature linking cancer anxieties to screening among diverse men remains predicated on self-reported anxiety. Research has yet to consider how "accurate" the reporting of anxiety may be among distinct groups of men or the possibility that anxiety may influence prostate cancer (PC) screening behavior through conscious and nonconscious channels; the current study tested for discrepancies between self-report and Stroop-ascertained general- and prostate-specific anxiety and their links to screening among 180 U.S.-born African American, U.S.-born European American, and immigrant Jamaican men. Men provided self-report information regarding trait and prostate-related anxiety and completed an emotional Stroop task. Mixed model ANOVAs showed that while U.S.-born African Americans had few discrepancies between self-report and Stroop-ascertained anxiety, Jamaicans reported greater PC anxiety than indicated by Stroop performance, while the opposite was true among U.S.-born Europeans. As expected, self-reported (but not Stroop-ascertained) PC anxiety predicted screening in multivariate analysis. Although men from different age and ethnic groups varied in the discrepancy between self-reported and Stroop-ascertained PC anxiety, the influence of avoidance-producing emotions appears to operate predominantly through conscious channels.
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Consedine NS, Ladwig I, Reddig MK, Broadbent EA. The many faeces of colorectal cancer screening embarrassment: preliminary psychometric development and links to screening outcome. Br J Health Psychol 2011; 16:559-79. [PMID: 21722276 DOI: 10.1348/135910710x530942] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Although embarrassment may be among the most easily modified discrete emotional barriers to patients seeking health care or testing, work in the area of colorectal cancer (CRC) has been restricted by the absence of suitable instrumentation. The current report describes the development and validation of a self-report instrument assessing two specific aspects of CRC screening embarrassment and their links to screening outcomes. DESIGN Convenience sampling was used to recruit 245 European American, African-American, and immigrant Caribbean community-dwelling men and women (aged 45-75 years) living in Brooklyn, New York. METHODS Participants completed the measure of CRC screening embarrassment, an array of convergent and divergent validity measures including dispositional embarrassment, general medical embarrassment, neuroticism, trait emotion, social desirability, previous treatment avoidance because of embarrassment, relevant health characteristics, and a brief CRC screening history. RESULTS As expected, CRC screening embarrassment was not unidimensional and had two reliable and distinct components, one concentrated on faecal/rectal embarrassment and the other on embarrassment arising from unwanted intimacy during examinations. In addition to demonstrating patterns of convergent and divergent validity consistent with their separation, multivariate analyses indicated that faecal/rectal embarrassment (but not intimacy concerns) predicted CRC screening frequency. CONCLUSIONS The current report extends current understanding by identifying the specific sources of embarrassment that may contribute to patients' avoidance of CRC screening. Directions for future study and implications for clinical practice and interventions are discussed.
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Affiliation(s)
- Nathan S Consedine
- Psychological Medicine, Faculty of Medical and Health Sciences, Auckland, University of Auckland, New Zealand.
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Kiviniemi MT, Hay JL, James AS, Lipkus IM, Meissner HI, Stefanek M, Studts JL, Bridges JFP, Close DR, Erwin DO, Jones RM, Kaiser K, Kash KM, Kelly KM, Craddock Lee SJ, Purnell JQ, Siminoff LA, Vadaparampil ST, Wang C. Decision making about cancer screening: an assessment of the state of the science and a suggested research agenda from the ASPO Behavioral Oncology and Cancer Communication Special Interest Group. Cancer Epidemiol Biomarkers Prev 2009; 18:3133-7. [PMID: 19900944 PMCID: PMC2810193 DOI: 10.1158/1055-9965.epi-18-11-aspo] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Marc T Kiviniemi
- Department of Health Behavior, University at Buffalo, Buffalo, New York 14222, USA.
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Consedine NS, Skamai A. Sociocultural considerations in aging men's health: implications and recommendations for the clinician. JOURNAL OF MEN'S HEALTH 2009. [DOI: 10.1016/j.jomh.2009.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ragin C, Taioli E. The Second International African-Caribbean Cancer Consortium for the study of viral, genetic and environmental cancer risk factors. Infect Agent Cancer 2009; 4 Suppl 1:S1. [PMID: 19208200 PMCID: PMC2638454 DOI: 10.1186/1750-9378-4-s1-s1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Camille Ragin
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA, USA
- The University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Epidemiology and Biostatistics, Downstate School of Public Health, State University of New York, USA
| | - Emanuela Taioli
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA, USA
- The University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Epidemiology and Biostatistics, Downstate School of Public Health, State University of New York, USA
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