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Chen WH, Brandford A, Bloom R, Han G, Horel S, Sanchez M, Lichorad A, Bolin J. Factors Associated with Abnormal Mammogram Results Among Low-Income Uninsured Populations in Medically Underserved And Rural Texas Regions. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:613-623. [PMID: 39391788 PMCID: PMC11462426 DOI: 10.1089/whr.2024.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 10/12/2024]
Abstract
Background This study investigated the potential associations between neighborhood characteristics, rurality, ethnicity/race, and breast cancer screening outcomes in designated Health Professional Shortage Areas in Central Texas. Limited access to preventive medical care can impact screening rates and outcomes. Previous research on the effects of factors such as rurality, neighborhood socioeconomic status, and education level on cancer prevention behaviors has yielded inconsistent results. Materials and Methods We analyzed data from a state-funded breast and cervical cancer screening programs for disadvantaged and medically underserved individuals. A mixed-effects logistic regression model was used to assess the impact of residency characteristics (rurality, educational attainment, unemployment, and poverty) on abnormal breast cancer screening outcomes, with individual level (age, ethnicity, race, and education) as control variables. Results During the studied time, there were 1,139 women screened and 134 abnormal mammograms found. Residency characteristics were not significantly associated with abnormal mammography outcomes at 0.05. However, individual factors are strongly associated with abnormal screening results. Non-Hispanic or Latino white women had increased odds of abnormal clinical outcomes compared with Hispanic or Latino women (OR = 2.03, CI 1.25-3.28; p = 0.004). Additionally, women residing in counties with more than 30% of the population completing college had increased odds of abnormal mammogram outcomes compared with counties with less than 15% college attainment (OR = 2.89, CI 0.99-8.38; p = 0.051). Conclusions This study found a significant correlation between area-level educational characteristics and abnormal mammography outcomes. Future research should explore the contextual risk factors influencing breast cancer occurrence and develop targeted interventions for this population.
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Affiliation(s)
- Wen Hsin Chen
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Arica Brandford
- Houston Methodist Research Institute, Texas A&M University, Houston, Texas, USA
| | - Rosaleen Bloom
- School of Nursing, Texas A&M University, College Station, Texas, USA
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Scott Horel
- School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Marivel Sanchez
- School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Anna Lichorad
- School of Medicine, Texas A&M University, College Station, Texas, USA
| | - Jane Bolin
- Houston Methodist Research Institute, Texas A&M University, Houston, Texas, USA
- School of Nursing, Texas A&M University, College Station, Texas, USA
- School of Public Health, Texas A&M University, College Station, Texas, USA
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Ahadinezhad B, Khosravizadeh O, Rafiei S, Habibi N, Karimkhani Z, Maleki A. What is the uptake rate of breast self-examination in Iranian women? Estimation based on systematic review and meta-analysis. BMC Womens Health 2023; 23:538. [PMID: 37848904 PMCID: PMC10580562 DOI: 10.1186/s12905-023-02688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Breast self-examination is a simple, painless, confidential and inexpensive screening method for early diagnosis that does not require specialized tools and equipment. In this study, we have estimated the pooled percentage of breast self-examination (BSE) in Iranian women. METHODS All the published literatures between 2012 and 2022 have been reviewed. Searches were performed in PubMed, Web of Science, ProQuest, Science Direct, Google Scholar, Scientific Information and Magiran databases. The effect size was the pooled percentage of breast self-examination (BSE). In order to check the heterogeneity, the estimation of the I2 index and extraction of the Galbraith plot were used, and the drivers of heterogeneity have been identified through meta-regression and estimates were made based on subgroups. All the analysis was done in STATA 15. RESULTS From the initial 294 records, 38 were included in the final analysis in which 9960 women have been studied. The heterogeneity of the studies was high based on the variation in OR (I2 = 98.4%, heterogeneity X2 = 2278.21 (d.f. = 37), p < 0.01). The pooled rate of BSE based on fixed and random methods was obtained as 15.46 (95% CI: 14.83 to 16.09) and 24.74 (95% CI: 19.62 to 29.86) percent, respectively. The highest pooled percentage BSE (39.41%, 95% CI: 30.98 to 47.83) was obtained from studies that investigated the action phase in the Trans theoretical model. The pooled percentage obtained from the studies conducted in the central regions of Iran was higher than other cities (27.47%, 95% CI: 17.38 to 37.55). CONCLUSION The result from our analysis determined that performing breast self-examination in Iranian women is low. Health policy makers can increase the rate of breast self-examination in Iran by implementing basic educational programs in schools and encouraging and justifying women in social health centers.
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Affiliation(s)
- Bahman Ahadinezhad
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Khosravizadeh
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sima Rafiei
- Department of Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | | | - Aisa Maleki
- Department of Health Services Management, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
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Social Disparities in Post-diagnosis Health Behaviors of Iranian Breast Cancer Survivors: The Mediating Role of Psychosocial Factors as Potential Buffering Agents. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.104760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Breast cancer (BC) is surging as a public health issue in Iran and engagement in positive health behaviors improves the odds of survival and reduces the risk of concomitant comorbidities in BC survivors. Objectives: The primary purpose of this study was to investigate the impact of socioeconomic inequalities on leisure-time physical activity (LTPA) and fruit and vegetable (F & V) consumption among Iranian BC survivors. Another objective of this study was to examine the role of psychosocial factors, such as stress, self-efficacy, and social support as mediators between socioeconomic status (SES) and these health behaviors. Few studies have investigated social disparities in the health behaviors of cancer survivors. Likewise, the mediating role of psychosocial factors in the SES-health behavior gradient has rarely been explored in the cancer context. Psychosocial factors might have positive implications for socioeconomically disadvantaged survivors. Methods: Cross-sectional data were obtained from 196 patients with BC by a telephone-administrated questionnaire. The Behavioral Risk Factor Surveillance System (BRFSS) 2013 was partially employed to measure exercise and F & V consumption. Cross-sectional analyses (correlation and logistic regression) were conducted to assess the relationship between SES, psychosocial factors, and health behaviors (P < 0.05). Results: Regarding LTPA and F & V consumption, more than half of the survivors complied with the recommended levels, consecutively. Both education and family income exhibited a positive association with LTPA and F & V consumption. Furthermore, self-efficacy and social support showed a positive relationship with LTPA and F & V consumption. Conclusions: The SES impacted health behaviors directly and via intermediary psychosocial factors. The results can inform future studies and interventions; psychosocial factors could buffer the effects of social inequalities on health behaviors. A key policy priority should, therefore, be planning and implementing psychosocial empowerment interventions to promote exercise and a healthy diet among impoverished cancer survivors.
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Rezaeimanesh M, Solhi M, Azar FEF, Sajjadi H, Rafiey H, Nejad FN, Gharehghani MAM, Najafi M, Hosseini SM, Karimi SE. Determinants of mammography screening in Tehranian women in 2018 based on the health belief model: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:119. [PMID: 34084866 PMCID: PMC8150056 DOI: 10.4103/jehp.jehp_339_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Breast cancer is the most common type of cancer among women. Mammography is the most sensitive and important method for screening and early diagnosis of breast cancer. Considering the importance of using mammography in breast cancer screening, this study was performed to evaluate mammographic determinants. MATERIALS AND METHODS In the cross-sectional study, we surveyed 985 women over 40 years in Tehran concerning demographic characteristics: age, socioeconomic status, a problem in the breast, alcohol use, drug use, and health belief model. Logistic regression was used to identify determinant factors associated with mammography performance. RESULTS The results of this study showed that 42.1% (95% confidence interval [CI]: 38, 45) participant performed mammography at least once during their lifetime. Age (odds ratio [OR] = 4.252; 95% CI = 2.041-8.857); housing situation (OR = 1.706; 95% CI = 1.178-2.469); having breast problems (OR = 5.224; 95% CI = 3.501-7.795); socioeconomic status (OR = 1.855; 95% CI = 1.035-3.325); family income level (OR = 1.998; 95% CI = 1.028-3.884); alcohol consumption (OR = 2.676; 95% CI = 1.344-5.328); smoking (OR = 2.824; 95% CI = 1.418-5.623); self-efficacy (OR = 1.935; 95% CI = 1.242-3.015); perceived barriers (OR = 2.017; 95% CI = 1.348-3.019); self-care (OR = 4.901; 95% CI = 3.152-7.620); perceived susceptibility (OR = 1.971; 95% CI = 1.271-3.057) and perceived severity (OR = 1.830; 95% CI = 1.170-2.860) were mammography behaviors determinants. CONCLUSION The findings indicated that the rate of mammography screening among Tehranian women is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the priority for health-care providers. Furthermore, the identification of these factors can help to design an appropriate educational intervention that focuses on the benefits of mammography screening.
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Affiliation(s)
- Masoumeh Rezaeimanesh
- PhD Candidate of Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Homeira Sajjadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hassan Rafiey
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhad Nosrati Nejad
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | | | - Sayedeh Mahboobeh Hosseini
- Clinical Research Development Unit, Ayatollah Kashani Hospital, Shahrekord University of Medical Science, Shahrekord, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Panahi R, Namdar P, Siboni FS, Fallah S, Anbari M, Dehghankar L, Yekefallah L, Shafaei M. Association between health literacy and adopting preventive behaviors of breast cancer in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:241. [PMID: 33209933 PMCID: PMC7652072 DOI: 10.4103/jehp.jehp_313_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Health literacy plays an important role in adopting preventive behaviors. Considering the relatively high prevalence of breast cancer in women, this study aimed to assess the association between health literacy and adopting the preventive behavior of breast cancer in Iran. METHODS This was a descriptive, cross-sectional study, in which 375 female students at Imam Khomeini International University in Qazvin in the academic year of 2018-2019 were selected through a stratified random sampling method. Demographic and background questionnaire, the standard questionnaire of Health Literacy for Iranian Adults in addition to another questionnaire for measuring breast cancer preventive behaviors, were used for collecting data. Data were analyzed using SPSS 22 using descriptive statistics and logistic regression. RESULTS The mean of the breast cancer preventive behaviors and health literacy were 8.92 ± 1.82 out of 16 and 70.80 ± 12.49 out of 100. Regression results showed that there was a statistically significant association between the adoption of breast cancer preventive behaviors and physical activity (P < 0.001) and health literacy (P < 0.018). Accordingly, the chance for adopting the preventive behaviors in good level among students with rare and without physical activity was 0.105 and 0.100 times, respectively, more than students who had been doing physical activity on a daily basis. Moreover, the same chance among students with adequate and very adequate health literacy was 1.802 and 2.169 times more than students with inadequate health literacy. CONCLUSION The results indicated that students with lower levels of health literacy and less physical activity had shown less tendency to adopt preventive behaviors of breast cancer. Therefore, special attention should be paid to health literacy (HL), particularly physical activity, application of health information, and assessment in students when designing educational programs to prevent breast cancer.
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Affiliation(s)
- Rahman Panahi
- Department of Health Education and Health Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Peyman Namdar
- Department of Emergency Medicine, Emergency Medicine Specialist, Metabolic Disease Research Center, Qazvin University of Medical Science, Qazvin, Iran
| | - Fatemeh Samiei Siboni
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Somayeh Fallah
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Anbari
- Department of Occupational Health, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Dehghankar
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Leili Yekefallah
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahya Shafaei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
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