Allen Jennifer D, Stoddard Anne M, Sorensen Glorian
Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Health Educ Behav. 2008 Dec;35(6):763-76. doi: 10.1177/1090198107303251. Epub 2007 Jul 9.
Many breast cancer outreach programs assume that dissemination of information through social networks and provision of social support will promote screening. The authors prospectively examined the relationship between social network characteristics and adherence to screening guidelines.
Employed women age 40 years and older completed baseline and 2-year follow-up assessments (N=1,475) as part of an intervention trial. The authors modeled screening adherence at follow-up as a function of social network characteristics at baseline.
Baseline adherence explained most of the variation in adherence at follow-up. For women age 40 to 51 years, having a mammogram at follow-up was predicted by encouragement by family and/or friends and subjective norms at baseline (odds ratio=2.20 and 1.18, respectively). For women age 52 years and older, the perception that screening was normative was related to adherence at follow-up (odds ratio=1.46).
Previous mammography use is strongly predictive of future screening. Social network characteristics have a modest impact on screening. Outreach efforts should focus on those who have previously underutilized mammography.
许多乳腺癌外展项目认为，通过社交网络传播信息和提供社会支持将促进筛查。作者前瞻性地研究了社交网络特征与遵循筛查指南之间的关系。
作为一项干预试验的一部分，40岁及以上的职业女性完成了基线和2年随访评估（N = 1475）。作者将随访时的筛查依从性建模为基线时社交网络特征的函数。
基线依从性解释了随访时依从性的大部分变异。对于40至51岁的女性，随访时进行乳房X光检查可通过家人和/或朋友的鼓励以及基线时的主观规范来预测（优势比分别为2.20和1.18）。对于52岁及以上的女性，认为筛查是规范的观念与随访时的依从性相关（优势比 = 1.46）。
既往乳房X光检查的使用强烈预测未来的筛查。社交网络特征对筛查有适度影响。外展工作应侧重于那些既往未充分利用乳房X光检查的人群。
