非裔美国人结直肠癌筛查采用阶段的社会人口学相关因素
Sociodemographic correlates of stage of adoption for colorectal cancer screening in African Americans.
作者信息
Christie Jennifer, Jandorf Lina, Itzkowitz Steven, Halm Ethan, Freeman Kim, King Sheba, Dhulkifl Rayhana, McNair Michelle, Thelemaque Linda, Lawsin Catalina, Duhamel Katherine
机构信息
Emory University School of Medicine, Department of Medicine, Atlanta, GA 30322, USA.
出版信息
Ethn Dis. 2009 Summer;19(3):323-9.
OBJECTIVES
African Americans have the highest incidence and mortality rates from colorectal cancer in the United States. Endoscopic screening, while effective in reducing both, is greatly underutilized. This research sought to understand sociodemographic factors related to stage of readiness for endoscopic screening.
DESIGN
One hundred fifty nine African American women (76.1%) and men (mean age = 57.0 years) who were non-adherent to endoscopic screening guidelines were recruited and asked to complete semi-structured interviews.
SETTING
Participants were all being seen for a non-acute primary care medical visit at one of two urban hospitals. The theoretical framework that informed this study was the Trans-theoretical Model (TTM) and the emphasis on Stage of Change or intention for undergoing endoscopic screening.
MAIN OUTCOME AND MEASURES
Based on their stage of readiness to undergo screening, 67 (42%) were categorized as precontemplative (Has no plans to have a colonoscopy) while 92 were categoriezed as being in a contemplative or preparation stage. Using chi-square and Student t-tests, differences were examined between the two groups.
RESULTS
No sociodemographic variables distinguished the two groups. However, people in the contemplative/preparation group were more likely to: have a regularly seen healthcare professional (63.7% vs 36.3%; P = .005), have had a previous recommendation for screening (65.7% vs 34.3%; P = .003); had heard of a colonoscopy (63.6% vs 36.4%; P = .000) and have been told by a healthcare professional that they needed a colonoscopy (73.1% vs 26.9%; P = .000).
CONCLUSIONS
This study helps us to better understand the relevance of sociodemographic characteristics that may be associated with completing endoscopic colorectal cancer screening. In addition, we confirm that physician recommendation and individual awareness of the procedure are significant factors in readiness to get screened.
目的
非裔美国人在美国患结直肠癌的发病率和死亡率最高。内镜筛查虽然在降低这两者方面有效，但却未得到充分利用。本研究旨在了解与内镜筛查准备阶段相关的社会人口学因素。
设计
招募了159名未遵循内镜筛查指南的非裔美国女性（76.1%）和男性（平均年龄 = 57.0岁），并要求他们完成半结构化访谈。
背景
所有参与者均在两家城市医院之一进行非急性初级保健医疗就诊。为本研究提供信息的理论框架是跨理论模型（TTM），重点是改变阶段或接受内镜筛查的意愿。
主要结果和测量指标
根据其接受筛查的准备阶段，67人（42%）被归类为未考虑阶段（没有进行结肠镜检查的计划），而92人被归类为考虑或准备阶段。使用卡方检验和学生t检验，对两组之间的差异进行了检验。
结果
没有社会人口学变量能够区分这两组。然而，处于考虑/准备组的人更有可能：有定期就诊的医疗保健专业人员（63.7%对36.3%；P = .005），之前曾被推荐进行筛查（65.7%对34.3%；P = .003）；听说过结肠镜检查（63.6%对36.4%；P = .000），并且被医疗保健专业人员告知他们需要进行结肠镜检查（73.1%对26.9%；P = .000）。
结论
本研究有助于我们更好地理解可能与完成内镜结直肠癌筛查相关的社会人口学特征的相关性。此外，我们证实医生的推荐和个人对该检查的认识是准备接受筛查的重要因素。
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