Levy-Storms Lené, Wallace Steven P
UCLA Borun Center for Gerontological Research, Jewish Home for the Aging, 7150 Tampa Avenue, Reseda, CA 91335, USA.
Soc Sci Med. 2003 Sep;57(6):987-1000. doi: 10.1016/s0277-9536(02)00474-4.
Minority migrant populations, such as older Samoan women, are likely to underuse preventive health services, including mammography screening. The purpose of this paper is to explore how informal (lay peers from churches) and formal (health care providers) health communication networks influence mammography screening use among older Samoan women. To do so, we apply diffusion of innovation theory and network analysis to understand how interpersonal networks may affect mammography use in this urban-dwelling, migrant population. The data come from a survey of 260 Samoan women, aged 50 years or older, who attended 39 randomly sampled Samoan churches in Los Angeles County (USA) between 1996 and 1997. Retrospective data, based over a 20-year period from this sample's year of first use of mammography screening, suggest that interpersonal networks may have accounted for the dramatic increase in the rate of adoption within the past 5 years of the survey. Using this information, we categorized women into mutually exclusive stages of mammography use and regressed these stages of mammography use on formal (had a provider referral) and informal (level of connectedness with peers in churches) health communication networks. The results indicated that being well-connected within women's informal, church-based health communication networks increased the likelihood of being in the decision (planned to have) and implementation and confirmation (had a recent mammogram) stages, but having a provider referral for a mammogram (formal networks) only increased the likelihood of being in the latter stages compared to women in the knowledge and persuasion stages. Formal and informal health communication networks influence recent use of mammography screening, but informal networks, in and of themselves, are also influential on future intention to use mammography screening.
少数族裔移民群体，如老年萨摩亚女性，很可能未充分利用预防性健康服务，包括乳房X光检查。本文旨在探讨非正式（来自教会的非专业同龄人）和正式（医疗保健提供者）健康传播网络如何影响老年萨摩亚女性对乳房X光检查的使用。为此，我们应用创新扩散理论和网络分析来理解人际网络如何可能影响这个居住在城市的移民群体对乳房X光检查的使用。数据来自对260名年龄在50岁及以上的萨摩亚女性的调查，这些女性于1996年至1997年期间参加了美国洛杉矶县39个随机抽样的萨摩亚教会。基于该样本首次使用乳房X光检查后的20年期间的回顾性数据表明，人际网络可能是调查过去5年中采用率急剧上升的原因。利用这些信息，我们将女性分为乳房X光检查使用的相互排斥阶段，并将这些乳房X光检查使用阶段与正式（有医疗服务提供者推荐）和非正式（与教会同龄人联系程度）健康传播网络进行回归分析。结果表明，在女性基于教会的非正式健康传播网络中联系紧密，会增加处于决策（计划进行）以及实施和确认（最近进行了乳房X光检查）阶段的可能性，但与处于知晓和说服阶段的女性相比，有医疗服务提供者推荐进行乳房X光检查（正式网络）仅增加了处于后一阶段的可能性。正式和非正式健康传播网络影响乳房X光检查的近期使用，但非正式网络本身也对未来使用乳房X光检查的意愿有影响。
