Predictors Of Screening Behavior Research Articles

The Significant Predictors for Breast, Cervical, Colorectal, or Oral Cancer Screening Intention and Behavior in Taiwan.

Cancer screening can improve outcomes in patients with cancer. Accordingly, under the direction of the National Health Insurance program, the Taiwan government conducts screenings for breast cancer, cervical cancer, oral cancer, and colorectal cancer. The aim of this study was to identify the primary predictors of cancer screening intention and behavior at 1 and 6 months after patients are provided information and an invitation by telephone to attend cancer screenings. In this prospective longitudinal study, 339 participants meeting the screening criteria were recruited. At baseline, telephone interviews were used to collect information on demographic characteristics, exercise and smoking habits, family cancer history, screening beliefs, and screening intention. Screening behavior was followed up at 1 and 6 months after the telephone interviews. At baseline, 87.02% of the participants intended to undergo screening, and 31.86% and 63.42% had undergone screening after 1 and 6 months, respectively. The predictors of screening intention were awareness of the screening policy, willingness to learn about screening, and believing in the health benefits of screening. The predictor of screening behavior after 1 month was screening intention at baseline, and the predictors of behavior after 6 months were screening intention, marital status, and belief that cancer is a hereditary disease. Adults with screening intention tended to undergo cancer screenings. The use of strategies based on screening intention, beliefs, and information can be used to improve participation in cancer screening in Taiwan.

Ethnic Differences Among Black Men in Prostate Cancer Knowledge and Screening: a Mixed-Methods Study.

Black men are disproportionately affected by prostate cancer (PCa) incidence and mortality. Limited research has been reported on the ethnic differences among Black men in regard to family history, knowledge, and screening habits. Thus, this study was conducted to understand and compare knowledge levels and family history of the three main Black subgroups (African Americans, Caribbean immigrants, and African immigrants) in the USA and to assess the influence of knowledge on past screening behavior and intentionality for screening in the future for PCa. A concurrent mixed-methods design was used with participants (N = 396) recruited from different parts of the country. The grounded theory method of analysis was used for qualitative data and a logistic regression was used to explain the relationship between screening intentionality and PCa knowledge and family history. Qualitative results indicated that subjective PCa knowledge between the three subgroups was relatively similar but differed based on whether a person knew a family member or friend who had been affected by the disease. Themes focused on risk, PCa education, screening, and impact on sexuality. Quantitatively, result revealed that there are ethnic differences in knowledge across the three subgroups. Additionally, regression results revealed that family history is a stronger predictor of screening behavior and intentionality than knowledge. This study was able to unveil a deeper understanding on the role of family history and knowledge on PCa among Black subgroups.

PDG67 PREDICTORS OF CHRONIC MEDICATION NONADHERENCE IN CANCER SURVIVORS: A SYSTEMATIC LITERATURE REVIEW

The prevalence of cancer survivorship is increasing. Compared to patients without a history of cancer, cancer survivors are more likely to develop chronic conditions and have poorer health outcomes overall. Nonadherence to chronic medications may further contribute to these outcomes. Cancer survivors face a variety of barriers to medication adherence, including financial and attitudinal. Patient characteristics may be associated with nonadherence. While most literature on cancer survivorship has been focused on patterns and predictors of screening behaviors, the goal of this study was to examine factors associated with chronic medication nonadherence in cancer survivors. A systematic literature search of MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science through July 2019 was performed to identify case-control and cohort studies evaluating factors contributing to nonadherence to chronic disease medications amongst survivors of adult cancer. Studies examining adherence to cancer-related medications, vaccines, or non-pharmacological treatments or whose populations were survivors of pediatric cancer or patients with active cancer were excluded. Of 1,422 records found through database searching, 190 abstracts were screened. Fifty-seven full-text articles were assessed by two independent reviewers, yielding 16 full-text articles in the final qualitative analysis. Studies most commonly included breast cancer survivors (n = 12), using self-reported adherence data (n = 9). Studies examined demographics, health, and cost-related characteristics associated with nonadherence. Few (n = 7) studies investigated the impact of patient attitudes on medication nonadherence; some (n=2) mentioned patient perceptions of their cancer prognosis. Existing studies on predictors of nonadherence to chronic medications in cancer survivors are varied in their data sources, patient populations, and predictors investigated. Publicly-available real-world data like the Medical Expenditure Panel Survey (MEPS), may provide insight into factors affecting adherence. Future studies focused on findings from MEPS may inform future interventions aimed at improving adherence in cancer survivors.

Knowledge of, and beliefs about, access to screening facilities and cervical cancer screening behaviors among low-income women in New Jersey.

Racial/ethnic disparities in cancer outcomes have been well documented. Access to Pap testing may account for some of the variation in the racial and socioeconomic differences in cervical cancer outcomes. Literature exploring perceived access to care as it relates to women of color and low-income women is lacking. The goal of the study was to evaluate and characterize the relationship between what respondents believe about access to free/low-cost screening facilities and screening behaviors among low-income women in New Jersey. We used multivariate logistic regression to investigate belief about access to affordable screening on cancer screening behaviors using data from a cross-sectional study of low-income women in New Jersey (n = 430). Having had a Pap test in the past 3years was inversely associated with age (OR 0.94, 95% CI 0.92-0.97) and was positively associated with having had insurance in the previous 2years (OR 32.48. 95% CI 1.04-5.91), higher perceived risk of cervical cancer (OR 2.59, 95% CI 1.29-5.66), and knowing where to go to get a check-up that includes a cancer test (OR 1.97, 95% CI 1.11-3.49). These results suggest that insurance status continues to be a predictor of screening behavior but also that perceived risk awareness of where to go to get cancer screenings in general may influence the likelihood of utilizing screening, which can be important in developing targeted prevention strategies.

Predictive Power of PEN-3 Model Constructs in Breast Cancer Screening Behaviors among Teachers: A Cross- Sectional Study in Central Iran.

Identifying the factors influencing screening is necessary to promote early detection of breast cancer. This study aims to determine the predictive power of PEN-3 model structures in breast cancer screening behaviors among teachers of Isfahan city in Iran. This cross-sectional study was conducted on 192 female teachers in Isfahan selected by the multi-stage random sampling method. A questionnaire based on PEN-3 model was used for data collection. Statistical analysis was conducted using SPSS version 20 (multiple linear regression analysis, independent t-test, Pearson correlation coefficient), and p<0.05 was considered statistically significant. The mean score of behavior, perceptual, enabling and nurturer factors in early detection of breast cancer was 36.5±30.5, 74.6±8.9, 65.5±19.9 and 68.1±20.7, respectively. The mean score of behavior in early detection of breast cancer in women with individual and familial history of breast disease was significantly higher than that of those who did not have such history. Perceptual and nurturer factors as the best predictors of screening behaviors were associated with screening behaviors. The study results indicate that nurturer and perceptual factors were the best predictors of breast cancer screening behaviors among teachers. Therefore, attention to these constructs in developing educational interventions is highly recommended.

Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University.

Many universities seek to improve the health and wellbeing of their faculty and staff through employer wellness programs but racial/ethnic disparities in health care use may still persist. The purpose of this research was to identify racial/ethnic disparities in the use of preventive health services at a Midwestern university. A record review was conducted of self-reported health data from University employees, examining the use of primary care and common screening procedures collected in a Personal Health Assessment conducted by the University's wellness program. Results show that there were significant racial/ethnic differences in the use of primary care and participation in screening. Notably, Asian employees in this sample were less likely to have a primary care provider and participate in routine cancer screenings. The observed racial/ethnic differences in screening behavior were mediated by the use of primary care. Together, these data show that despite equal access to care, racial and ethnic disparities in screening persist and that having a primary care provider is an important predictor of screening behavior. Results suggest that health communications designed to increase screening among specific racial/ethnic minority groups should target primary care use.

Abstract P1-17-03: Impact of a culturally syntonic door-to-door breast cancer early detection intervention

Abstract Introduction. Disparities in the detection of breast cancer persist despite efforts to reach underserved populations and increase mammography utilization. Black and Hispanic women are more likely to be diagnosed at a later stage compared to White women. Lack of health insurance and limited awareness of breast cancer are significant predictors of screening behaviors; other reasons remain poorly understood and warrant further research. Our study presents highlights of the Women’s Breast Health Initiative Florida Affiliate (WBHI) intervention and key findings related to its impact. Methods. The intervention targeted single-family home neighborhoods with high incidence of late-stage breast cancer, median income at 200% of the poverty level, and access to affordable health clinics. Neighborhood mobile mammography or transportation to local facilities was provided, followed by navigation to assure proper follow up. Eligible women were uninsured, ≥40 years of age and were qualified for an annual screening mammogram. During 2011-2012Intervention Days45Educational Materials21,079Volunteers*2,025Women Interviewed5,441Eligible Women643Appointments Scheduled581Screening Days15Screening Mammograms Completed409*culturally relevant &amp; trained Descriptive and inferential statistical methods were used to analyze participant data divided into 3 groups based on neighborhood racial demographics: "Black" or "Hispanic" data groups had ≥75% Black or Hispanic residents respectively, while the "Other" did not have a predominant race. Post-visit phone surveys of 1,871 participants were conducted within 30 days. Results. The intervention significantly increased screening rates amongst eligible women from 22% to 64%, had a 0.24% breast cancer diagnosis rate and motivated 59% of the women to propagate awareness. Health insurance coverage rates did not differ significantly between the 3 groups. Notably, amongst the insured, those from "Hispanic" neighborhoods had the highest recent mammogram rate while, amongst the uninsured, those from "Black" neighborhoods had the highest. Neighborhood culture and prior mammogram history impacted the efficacy of the intervention. Among the "Hispanic" and "Other" groups, women with no prior mammograms were less receptive to receiving one compared to those who had prior mammograms. This phenomenon was not observed in the "Black" group. Women’s responses and perceived benefit to the educational package differed according to the neighborhood race and ethnicity: "Black""Hispanic""Other"Benefited70%85%88%Spread the Word54%57%65% Discussion. WBHI reached the goal of increasing screening rates in this underserved population, thus showing that this type of intervention can be effective. Educational packages presented in a face-to-face format within a door-to-door context were found useful by most women. Our findings highlight disparities beyond a woman’s access to breast healthcare and education by showing that neighborhood culture impacts response to outreach intervention and breast healthcare. This generates the hypothesis that given equal access to care, disparities in using screening mammography will remain. Educational methods further tailored to racial and ethnic characteristics may play a significant role in closing disparity gaps. Citation Format: Carmen J Calfa, Julie G Wilkinson, Mindy M Williams, James M Pann, Angela Yehl, Stephanie E Hoogenbergen, Andrea D Ivory. Impact of a culturally syntonic door-to-door breast cancer early detection intervention [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-17-03.

Ethnic differences in the use of regular mammography: the multiethnic cohort

Women's regular use of mammography over a 6 year interval was examined among women aged 45-75 in the Hawaii and Los Angeles Multiethnic Cohort (MEC). The analyses included 81,722 African American, Japanese, Latina, Native Hawaiian, and White females using self-reported mammography history from 1993 to 1998. Ninety-one percent of MEC women reported ever having a mammogram, however only 36% reported regular annual and 48% reported regular biennial mammography over the interval. Mammography was lowest among women who were obese, had a high school education or less, or who were aged 70 and over. Regular mammography use during follow-up was low compared to prior studies reporting on recent mammography. African American, Latina, and Native Hawaiian women had significantly lower annual and biennial mammography use compared to White women even after controlling for age, education, family history, body mass index and hormone therapy indicating that gaps exist in mammography that remain unexplained by known predictors of screening behavior.

Screening participation in individuals with a family history of colorectal cancer: a review

Literature regarding screening behaviour in individuals with a family history of colorectal cancer was reviewed, in order to determine the prevalence of screening in this population and identify factors associated with screening participation. Four electronic databases were searched from 1994. Thirty papers met the inclusion criteria, including 3 community surveys, 13 studies on first-degree relatives of colorectal cancer patients, and 14 studies on genetic services for colorectal cancer risk assessment. Individuals with a family history of colorectal cancer, who have not received risk assessment, frequently have never had any form of screening for colorectal cancer. Uptake of endoscopic screening when offered to individuals identified as being at increased risk was generally high (often >60% participation). Having a medical recommendation to screen, a stronger family history and perceiving fewer barriers to screening were identified as predictors of screening behaviour. Existing data suggest that use of screening tests in individuals with a family history of colorectal cancer is variable, and our understanding of factors associated with screening behaviour is limited. A number of methodological problems in research to date were identified, and further research is needed in order to inform interventions to support sustained screening participation in this population.

Asian American Subgroup Differences in Sources of Health Information and Predictors of Screening Behavior

This study examined Asian subgroup differences in sources of health information and cancer screening, comparison of Asians and Whites in screening, and the association between health information and screening behavior. A nationally representative sample of 6,722 adults in the US, including those who speak, Chinese, Vietnamese and Korean was selected. Questionnaire items developed by the Commonwealth Fund included demographic variables, health status, cancer screening, health care experiences, health information sources, and use of an interpreter in the patient-provider interaction. There were differences between subgroups in source of health information. Indians from India were more likely to use the World Wide Web than Chinese, Koreans, and Filipinos. There were differences in ease of reading or understanding instructions on the prescription bottle, information booklets provided by physicians, and in difficulty speaking with a physician. There were differences in getting a general physical and a pap test between Asian ethnic subgroups and between Asians and Whites. Certain sources of health information were positively correlated with specific screening tests. Development of particular sources of health information relevant to specific Asian subgroups and for specific screening tests may enhance their decision making prior to and in conjunction with receiving medical care services.

Postpartum depression screening by family nurse practitioners

The purpose of the study was to identify whether and how nurse practitioners (NPs) screen for postpartum depression, as well as to identify factors affecting such screening. Self-report data were gathered from 159 questionnaires completed by a convenience sample of family NPs (FNPs) in Illinois and Wisconsin during July 2002. Despite the fact that 84% of FNP respondents saw at least one postpartum woman yearly, 42% never screened for postpartum depression in any way. The subjects' confidence in their knowledge of how to use a screening tool was the single best predictor of screening behavior (r= .487). NPs tend to follow clinical practice guidelines, but no guidelines exist to address postpartum depression specifically. Screening for postpartum depression is not universal, making it likely that prevailing estimates of the incidence of this disease are low. If the number of NPs who screen for postpartum depression could be increased, many postpartum patients and families could be positively affected. Advanced practice nursing education should adequately prepare graduates to screen at-risk patients. The development of graduate curricula including thorough units on postpartum depression, as well as formulation of clinical practice guidelines for postpartum depression, could make great strides toward more and better screening, prompt diagnosis, and treatment.