Fisher Bernadette, Dowding Dawn, Pickett Kate E, Fylan Fiona
Department of Health Sciences, University of York, York YO10 5DD, UK.
Health Promot Int. 2007 Jun;22(2):137-45. doi: 10.1093/heapro/dal043. Epub 2007 Jan 11.
Suboptimal diets, sedentary lifestyles, overweight and obesity expose two-thirds of women in England aged over 50 to a heightened risk of lifestyle-related morbidities. The UK's NHS Breast Cancer Screening Programme now reaches 75% of all women aged 53-64 but provides only mammography screening. This cross-sectional survey of 413 women attending two NHS breast screening clinics in North Yorkshire found that the majority of women were interested in having diet and exercise advice at screening clinics and anticipated a neutral or positive effect on their future screening appointments. Interest was highest among older, less educated and overweight women suggesting that this may be a particularly effective medium for reaching higher risk subgroups. Women showed most interest in problem-solving advice, which provided short-term, life-enhancing benefits such as looking and feeling better, having more energy, losing weight and reducing menopausal symptoms, as well as potentially reducing their disease risk. Most appeared to find doing sufficient exercise more problematic than eating healthily and this might be exacerbated by low awareness of exercise guidelines. Given a choice, preferences were to access advice in leaflets or one to one from an expert; however, many younger, professional women were also interested in computer access. Findings indicate the need first for flexible, multi-level access, combining some broad-based information dissemination with pathways to more personalized support and secondly for the relevant 'consumer benefits' associated with better diet and exercise to be promoted as well as longer-term disease prevention. Overall, this study indicates that the UK's NHS Breast Cancer Screening Programme may be uniquely placed to provide health-enhancing advice as well as mammography screening to the majority of women in England, throughout the course of their mid-life.
不良饮食、久坐不动的生活方式、超重和肥胖使英国三分之二年龄在50岁以上的女性面临与生活方式相关疾病的更高风险。英国国民保健服务体系（NHS）的乳腺癌筛查项目目前覆盖了所有53 - 64岁女性的75%，但仅提供乳房X光检查筛查。这项对在北约克郡两家NHS乳房筛查诊所就诊的413名女性进行的横断面调查发现，大多数女性有兴趣在筛查诊所获得饮食和运动建议，并预期这会对她们未来的筛查预约产生中性或积极影响。年龄较大、受教育程度较低和超重的女性兴趣最高，这表明这可能是接触高风险亚组的特别有效方式。女性对解决问题的建议最感兴趣，这些建议能带来短期的、提升生活质量的益处，比如看起来和感觉更好、更有精力、减肥以及减轻更年期症状，还有可能降低患病风险。大多数人似乎觉得进行足够的运动比健康饮食更成问题，而对运动指南的低认知可能会加剧这一情况。如果可以选择，她们更倾向于通过宣传册获取建议或由专家一对一提供建议；然而，许多年轻的职业女性也对通过电脑获取建议感兴趣。研究结果表明，首先需要灵活的多层次获取方式，将一些广泛的信息传播与获得更个性化支持的途径相结合；其次，要宣传与更好的饮食和运动相关的“消费者益处”以及长期疾病预防。总体而言，这项研究表明，英国国民保健服务体系的乳腺癌筛查项目在为英格兰大多数处于中年阶段的女性提供增强健康的建议以及乳房X光检查筛查方面可能具有独特优势。
