THE RELATIONSHIP BETWEEN FUNCTIONAL LIMITATIONS AND BREAST CANCER SCREENING AMONG OLDER WHITE AND BLACK WOMEN

Purpose: To determine the relationship between breast cancer screening knowledge and intent to receive a mammogram within 6 months in a sample of Mexican-origin women living in El Paso, Texas. Methods: A total of 489 uninsured Mexican-origin women were assigned to treatment or control and completed surveys at pre- and postintervention. Pre-post associations between breast cancer screening knowledge and intent were tested. Results: Participants were on average were 56.7 years of age and spoke primarily Spanish (92.6%). Most of the samples had not had a mammogram in 3 or more years (51.6%) and 14.6% had never had a mammogram. At baseline, the majority intended to be screened for breast cancer within the next 6 months (93.4%). At postintervention, half of the intervention group changed their 6-month intent to be screened for breast cancer from likely to unlikely. Change in intent was associated with a change in knowledge of risk of having a first child by the age of 30 and breast cancer being rare after the age of 70. Discussion: Intent to be screened for breast cancer in Mexican-origin women may be influenced by the type of knowledge. Conclusions: Change in screening knowledge may influence perceived risk that influences intention to be screened.

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Relationship between dementia severity in older women and family caregivers’ preferences for shared decision making about breast cancer screening

Proceedings of IMPRS ◽

10.18060/25923 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Molly Frank ◽

Nicole Fowler

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Shared Decision Making ◽

Family Caregiver ◽

Standard Of Care ◽

Shared Decision ◽

Dementia Severity ◽

The Relationship

Background/Objective: Mammography is one of the most effective ways to diagnose breast cancer early; however, its perceived benefits are complicated by terminal conditions such as dementia. By undergoing mammography, women with dementia risk treatment complications and false-positive results, which can exacerbate psychological distress. The lack of a standard of care confounds the individual roles of the patient, family caregiver, and physician in the decision-making process. This study evaluates the relationship between dementia severity and family caregiver preferences for shared decision making. Methods: Data were gathered from the Decisions about Cancer screening in Alzheimer’s Disease trial, which uses the Dementia Severity Rating Scale (DSRS) and a revised version of the Control Preferences Scale (CPS) to assess family caregiver preferences for decision-making as a dyad (patient and caregiver) and triad (patient, caregiver, and physician). Two multinomial logistic regression models assessed the relationship between DSRS and CPS categories (active, passive, and collaborative), while controlling for the caregivers’ age, gender, education, relationship to patient, self-perceived income, and race. Both models used the “active” group as the baseline; however, Model 1 examined preferences as a dyad and Model 2 as a triad. Results: Model 1 found a statistically significant association between dementia severity and a collaborative approach (p<0.001), and between dementia severity and a passive approach (p=0.014). For every one-unit increase in DSRS score, the odds of being in the collaborative group decreased by 0.083 and the odds of being in the passive group decreased by 0.085. There was no statistically significant association between dementia severity and decision-making preferences in Model 2. Clinical Significance: The association between dementia severity and family caregiver decision-making preferences supports the need for a standard of care regarding breast cancer screening in women with dementia.

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Examining Breast Cancer Screening Behavior Among Southern Black Women After the 2009 US Preventive Services Task Force Mammography Guideline Revisions

Journal of Community Health ◽

10.1007/s10900-019-00697-8 ◽

2019 ◽

Vol 45 (1) ◽

pp. 20-29 ◽

Cited By ~ 2

Author(s):

Deeonna E. Farr ◽

Heather M. Brandt ◽

Swann Arp Adams ◽

Venice E. Haynes ◽

Andrea S. Gibson ◽

...

Keyword(s):

Breast Cancer ◽

Black Women ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Task Force ◽

Preventive Services ◽

Screening Behavior

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Do patient tracking, follow-up, and referral practices contribute to breast cancer disparities in a large urban area?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6120 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6120-6120

Author(s):

Christine B. Weldon ◽

Julia R. Trosman ◽

Danielle Dupuy ◽

Betty Roggenkamp ◽

Julian C. Schink ◽

...

Keyword(s):

Breast Cancer ◽

Black Women ◽

Cancer Screening ◽

Breast Cancer Screening ◽

White Women ◽

Public Hospitals ◽

Care Plan ◽

Patient Tracking ◽

Referral Practices

6120 Background: Chicago Black women are 62% more likely to die from breast (BC) cancer than White women. Previous data from 39 Chicago hospitals suggested significant quality deficits in breast cancer screening and treatment (Chicago Breast Cancer Quality Consortium, 2010). Patient tracking, follow up and referral practices may influence quality of care for minority women (Mojica et al, Cancer Control, 2007). Our goal is to evaluate tracking, follow up and referral practices during screening, diagnosis and treatment of BC at Chicago hospitals servicing Black women. Methods: Using the framework approach of qualitative research, we conducted interviews with providers of BC screening and care from 20 Chicago institutions with Black patients averaging 50% of patient base (15 community, 3 academic and 2 public hospitals). Informants included surgeons, medical oncologists, radiologists, mammography technicians, internists, nurses, administrators, and patient navigators. Interviews were transcribed, and thematic and statistical analyses were performed (simple frequencies and Fisher's exact test). Results: Six of the 20 sites (30%) follow up with patients who did not show for a scheduled mammography visit. Five of these sites (83%, 5/6) have a low “no-show” rate (below 20%), compared to 4 sites (29%, 4/14) with low “no-show” rates among the 14 sites without follow-up (p=0.05). Seven of the 20 sites (25%) direct diagnosed patients to their next step in care by providing referrals and guidance, while other 13 sites rely on a primary care physician or leave the patient without a clear care plan. BC patients at 6 of the 7 sites directing care (83%, 5/6) are referred to a mid- or high-volume surgeon (3+ BC surgeries / month), compared to patients from only 1 of the 13 sites not directing care (p=0.001). Nine of the 20 sites track diagnosed BC patients through their care. Five of them (56%, 5/9) also track survivors, compared to none (0%, 0/11) of the 11 sites who do not track patients (p=0.008). Conclusions: Poor tracking, follow up and referral practices for breast cancer screening and treatment are associated with suboptimal care and may contribute to outcome disparities for Black women in Chicago.

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Using an integrated social-behavioral text message approach to improve screening mammography in African American women.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.240 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 240-240

Author(s):

Amina Dhahri ◽

Paapa Nyanin ◽

Shana Ntiri

Keyword(s):

Breast Cancer ◽

Black Women ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Text Messaging ◽

Text Message ◽

Screening Mammography ◽

Text Messages ◽

Patient Centered ◽

Self Advocacy

240 Background: The rate of breast cancer among Black and White women is nearly equivalent but the death rate is 40% higher for Blacks. This disparity is often attributed to lower screening mammography rates in Black women. The effectiveness of text messages on increasing screening mammography among Black women is not well known. Importantly, the themes that are most effective at promoting behavioral changes in Black women’s breast cancer screening practices through text message interventions have not been explored. An integrated social-behavioral approach was used to identify themes associated with Black women’s response to two types of text messaging: reminder and educational texts. Methods: A qualitative study was conducted in Metropolitan Baltimore with two focus groups among Black breast cancer survivors. Participants completed a demographic survey and indicated text messaging practices and preferences for future breast screening texts via survey. Participants provided feedback on a series of 17 educational and reminder text messages. Focus groups were digitally recorded and transcribed for analysis. Text message preferences were analyzed using a content analysis approach. Multiple themes were identified, discussed and recorded. Results: 17 participants had an average age of 60. All participants reported cell phone ownership and 82% of participants reported texting. 46% reported an interest in reminder text messages and 54% reported an interest in educational text messages. Four main themes were derived from participants’ responses the text message series: 1) access to cancer care surveillance, 2) social network support, 3) patient-centered approach, and 4) self-advocacy. Text messages that included themes of self-advocacy, social network support, and patient-centered approach generated positive responses and the text messages that included access to cancer care surveillance were perceived as demotivating. Educational text messages were perceived to be more motivating than reminder text messages. Conclusions: Breast cancer screening behaviors are affected by various demographic, social-behavioral, and socioeconomic factors. The findings from this study suggest that developing an educational text message content that incorporates social and behavioral themes focusing on the patient may be more beneficial to improve breast cancer screening rates in this population.

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Moderate psychological distress as a barrier to breast cancer screening among women

Journal of Hospital Administration ◽

10.5430/jha.v9n4p1 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1

Author(s):

Umar Yusuf Kabir ◽

Angela Askew ◽

Yu Jiang ◽

Soumitra S. Bhuyan ◽

Emmanuel Ezekekwu ◽

...

Keyword(s):

Breast Cancer ◽

Psychological Distress ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Behavioral Model ◽

Health Services Use ◽

Interview Survey ◽

Study Population ◽

Logistic Regressions ◽

The Relationship

Objective: To examine the relationship between Breast Cancer Screening (BCS) and Moderate Psychological Distress (MPD). Also, to assess the effect of aggregating women with No Psychological Distress (NPD) and MPD into one group, as done in prior studies when evaluating the relationship between BCS and Psychological Distress (PD).Methods: The study population comprised of 34,565 women aged 50-74 years who participated in the National Health Interview Survey from 2013 to 2017. The Kessler-6 PD index score (0-24) was dichotomized (0-12: NPD; > 13: Severe Psychological Distress SPD) and trichotomized (0-5: NPD; 5-12: MPD; > 13 SPD). Two multivariate logistic regressions were conducted for the dichotomous and trichotomous PD categories. Andersen’s Behavioral Model of Health Services Use guided the choice of covariates. Data analysis was conducted using SAS version 9.4.Results: Our study showed 4.6% had SPD, and 17.9% had MPD. The latter group (MPD) was included in the NPD group in the dichotomous analysis. In the dichotomous analysis, women with SPD (adjusted Odds Ratio (aOR) = 0.71, 95% CI = 0.63, 0.81, p < .00001) were less likely to have received a mammogram than those with NPD. In the trichotomous model, women with SPD (aOR = 0.76, 95% CI = 0.67, 0.87, p = .0001) and MPD (aOR = 0.84, 95% CI = 0.78, 0.91, p <.00001) were both less likely to have had a mammogram than those with NPD.Conclusions: Prior studies that included individuals with MPD among those with NPD overestimated the effect of SPD on mammography and minimized the importance of targeting women with MPD along with those that have SPD to enhance the uptake of mammography.

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