Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA.
J Community Health. 2012 Apr;37(2):307-15. doi: 10.1007/s10900-011-9446-7.
Breast cancer incidence is rising and mortality is disproportionately high among American Indians and Alaska Natives, yet screening rates remain low. Using community-based participatory research, we conducted interviews with community leaders (n = 13) and providers from the Indian Health Service, tribal clinics, and urban safety-net clinics (n = 17). Participants in both groups identified similar needs, including culturally-appropriate mammography education, use of Native elders as patient navigators, and an emphasis on preventive care. Pertinent barriers included culturally-specific issues (e.g., historic mistrust and gender roles), cost, transportation, and fear of mammography and potential results. The results reflect the struggles of promoting mammography across diverse populations.
乳腺癌发病率在美国印第安人和阿拉斯加原住民中不断上升，死亡率也高得不成比例，但筛查率仍然很低。我们采用社区参与式研究方法，对社区领导（n=13）和来自印第安人健康服务、部落诊所和城市公共卫生诊所的提供者（n=17）进行了访谈。两组参与者都确定了类似的需求，包括文化上适宜的乳房 X 光检查教育、利用本土长者作为患者导航员，以及强调预防保健。相关的障碍包括文化特定问题（例如，历史上的不信任和性别角色）、费用、交通以及对乳房 X 光检查和潜在结果的恐惧。研究结果反映了在不同人群中推广乳房 X 光检查所面临的困难。
