Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University and Mount Sinai School of Medicine, New York, NY, USA.
Health Educ Behav. 2011 Oct;38(5):471-81. doi: 10.1177/1090198110382502. Epub 2011 Aug 19.
Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews (n = 64) with low-income Black and Latina women who shared the experience of requiring diagnostic follow-up after having a screening mammography with abnormal findings. We found that in addition to holding negative and fatalistic cancer-related beliefs, the social context of these women was largely defined by multiple challenges and major life stressors, factors that may interfere with their ability to attain health. Factors commonly mentioned included competing health issues, economic hardship, demanding caretaking responsibilities and relationships, insurance-related challenges, distrust of health care providers, and inflexible work policies. Black women also reported discrimination and medical mistrust, whereas Latinas experienced difficulties associated with immigration and social isolation. These results suggest that effective health interventions not only address change among individuals but must also change health care systems and social policies in order to reduce health disparities.
了解促进或阻碍遵循推荐健康行为的因素对于制定有效的健康计划至关重要，特别是在那些患有不成比例疾病负担的低收入人群中。我们对 64 名经历过筛查性乳房 X 光检查异常结果后需要进行诊断随访的低收入黑人和拉丁裔妇女进行了深入的定性访谈。我们发现，除了持有消极和宿命论的癌症相关信念外，这些妇女的社会环境主要受到多种挑战和重大生活压力源的影响，这些因素可能会干扰她们获得健康的能力。常提到的因素包括健康问题、经济困难、照顾责任和关系、保险相关挑战、对医疗保健提供者的不信任以及工作政策缺乏灵活性。黑人妇女还报告了歧视和医疗不信任，而拉丁裔妇女则经历了与移民和社会孤立相关的困难。这些结果表明，有效的健康干预措施不仅要针对个体的改变，还要改变医疗保健系统和社会政策，以减少健康差距。
