Health Disparity in Effective Cervical Cancer Screening: Findings from a National Survey of U.S.

Background: Cervical cancer is one of the most common causes of cancer death for women, but it can often be detected early and sometimes even prevented entirely by having regular tests. An effective way to prevent cervical cancer is to have screening tests. Even though cervical cancer screening programs are implemented in many countries and regions especially in developed countries, cervical cancer incidence has not been effectively controlled and there is still certain health disparity in the population. Inappropriate screening frequency may be the cause of the health disparity. Methods: Drawing on the data from the 2017 Health Information National Trends Survey (Cycle5.1), a national survey conducted by the National Cancer Institute (NCI), we characterized cervical cancer screening (CCS) as two dimensions by the item of screening frequency, namely, active screening and effective screening. We compared the differences between these two screening behavior applying ordered logistic regression and binary logistic regression, and explored the mechanisms of effective screening. Results: The impact factors differed between active screening and effective screening based on theory. Only self-efficacy (β=0.16, p=0.023) had a positively significant association with active screening behavior and both online health information seeking (β=-0.102, p<0.001) and social media participation (β=-0.466, p=0.001) negatively and significantly influenced effective screening behavior. Second, a theory-based mechanism of effective screening behavior found that traditional health perception factors no longer influence effective screening behavior, while environmental factors (social media) significantly reduce women's effective screening. In addition, the higher the level of education, the less inclined to conduct effective screening, but the more inclined to active screening for cervical cancer. Conclusions: Our results indicate that while the Internet has become the main channel through which women acquire health resources, and social media has become a main platform for people to obtain health information, online information cannot guide people to engage in appropriate healthy behaviors. Overloading of online health information and digital divide may cause excessive screening or screening avoidance. Consequently, we must pay attention to the health disparity caused by unreasonable health behaviors caused by factors such as environmental factors and the divide in the use of IT.

HEALTH BELIEFS ON THE BEHAVIORAL ADOPTION OF MAMMOGRAPHY SCREENING MODERATED BY KNOWLEDGE AND MARITAL STATUS: A PATH ANALYTIC MODEL

Despite the effectiveness of mammography for early breast cancer detection, its’ utilization among Malaysian women remains low. Health beliefs are closely related to health screening behavior. Hence, it is important that health beliefs are employed when exploring mammography screening behavior. Thus, the study utilized HBM constructs in predicting the variance in adoptive behavior of mammography. A multi-stage, stratified random sampling method was utilized to select the polyclinics in Kuantan, Pahang. Using sample size calculation at 5% type 1 error, p < 0.05 and absolute error at 2%, 520 Malaysian women aged 35 to 70 years were randomly selected. Sets of copyrighted, validated questionnaire were used to obtain the data. Structural equation modeling using Mplus was used to test the model. All health beliefs were found to significantly influence the behavioral adoption of mammography screening. Socio-demographic factors (married women) were found to moderate significantly the relationship between perceived susceptibility and behavioral adoption of mammography. Further, knowledge and married women were found to significantly affect self-efficacy. Additionally, perceived severity, motivator factors and perceived benefits were found to significantly influence self-efficacy and that self-efficacy significantly influences the behavioral adoption of mammography screening. However, a negative correlation was found between perceived severity and perceived barriers on the behavioral adoption of mammography. The model can be used as an interventional tool in designing promotional and educational programs to encourage women to adopt mammography screening.

Demographic variables affecting participation in mammography screening: a cross-sectional study

Breast cancer is one of the most common cancers among women. There are three commonly used diagnostic methods in this cancer type, in which the survival rate can be quite high with early diagnosis. Compared to breast self-examination and clinical examination, mammography stands out as a more accurate diagnostic method. Although there are health policies regarding mammography screening in many countries, mammography screening behavior has not reached the desired level worldwide. In this study, we tried to reveal the demographic factors affecting the frequency of women getting mammograms in Turkey. The frequency of mammography screening was estimated with a generalized logit model using the microdata of TURKSTAT Turkey Health Survey. As a result of the model, it was observed that mammography screening differentiated in different age and income groups. It was determined that the disease status increased the frequency of mammography screening, however, marital status and employment status did not have a significant effect.

A Multi-Center Structural Equation Modeling Approach to Investigate Interpersonal Violence Screening for Public Health Promotion

Background: Interpersonal violence is a significant public health issue. Routine health screening is a cost-effective strategy that may reduce harmful physical and mental consequences. However, existing research finds consistently low rates of violence screening offered by healthcare providers, e.g., nurses, nurse practitioners, physicians. There is a critical need for research that helps understand how providers' screening behaviors are impacted by individual-level and organizational-level factors to promote the uptake of routine screening for interpersonal violence. Two recent studies, i.e., The Health Care Providers study and Nurse Practitioners Violence Screening study, involved quantitative data collected to measure providers' screening behavior and multi-level factors impacting violence screening.Methods: The current analysis includes a combination of multi-center data collected from The Health Care Providers and Nurse Practitioners Violence Screening studies, respectively. The total sample is 389 providers across the United States. The proposed research develops a system-level multi-center structural equation model framework to rigorously integrate data from the two studies and examine providers' screening behavior for interpersonal violence based upon Theory of Planned Behavior from a quantitative perspective.Results &amp; Conclusions: We successfully examine the efficacy of the Theory of Planned Behavior proposed by Ajzen to predict healthcare providers' screening behavior for interpersonal violence. Organizational factors, e.g., availability of policy for interpersonal violence screening, organizational priority given to violence screening relative to other priorities, and if providers within the health center are interested in improving care quality, were significantly associated with providers' screening behavior. The knowledge and insights generated from our study may facilitate the design and optimization of health professional training and practice environment, and lead to improved women's health and quality of care.