Tabung Fred K, Daguisé Virginie G, Lydiard Dianna, Steck Susan E
1 Department of Epidemiology and Biostatistics, Arnold School of Public Health, and the Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina.
2 South Carolina Department of Health and Environmental Control, Division of Cancer Prevention and Control, Columbia, South Carolina.
Am J Health Promot. 2017 Jul;31(4):325-332. doi: 10.4278/ajhp.141010-QUAN-512. Epub 2016 Nov 17.
We combined data from the National Breast and Cervical Cancer Early Detection (NBCCEDP) and Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) programs in South Carolina to assess whether cancer screening outcomes in NBCCEDP impacted participation in WISEWOMAN lifestyle interventions, and whether the status of WISEWOMAN baseline risk factors (obesity, diabetes, hypercholesterolemia, hypertension, and smoking) determined subsequent completion of lifestyle interventions.
Case-control.
Three WISEWOMAN implementation sites in South Carolina.
The study comprised 7841 NBCCDEP participants in three WISEWOMAN program sites. The two programs serve financially disadvantaged women.
Outcome measures were participation in WISEWOMAN lifestyle interventions and completion of lifestyle interventions. The main predictor measures were cancer screening outcomes and baseline chronic disease risk factors. Covariate measures included age, race, body mass index, smoking status, and education.
We used multivariable logistic regression models to examine the odds of participation in and completion of WISEWOMAN lifestyle interventions.
The association between cancer screening outcome and participation in WISEWOMAN lifestyle interventions among NBCCEDP participants differed significantly by education and smoking status. Among smokers or highly educated women, having an outcome of cancer or precancerous lesion through the NBCCEDP screening compared to normal screening outcomes was significantly associated with participation in lifestyle interventions, with odds ratios of 2.69 (95% confidence interval [CI], 1.10-6.58) for highly educated women and 1.82 (95% CI, 1.00-3.31) for smokers. Similarly, smokers or diabetics were more likely than nonsmokers or nondiabetics, respectively, to complete lifestyle interventions.
Nonsmokers and women with lower education in NBCCEDP may need additional navigation to lifestyle interventions in an integrated program implementation approach to improve participation in and completion of WISEWOMAN interventions.
我们整合了南卡罗来纳州国家乳腺癌和宫颈癌早期检测（NBCCEDP）项目以及全国妇女综合筛查与评估（WISEWOMAN）项目的数据，以评估NBCCEDP中的癌症筛查结果是否会影响参与WISEWOMAN生活方式干预，以及WISEWOMAN基线风险因素（肥胖、糖尿病、高胆固醇血症、高血压和吸烟）的状况是否决定生活方式干预的后续完成情况。
病例对照研究。
南卡罗来纳州的三个WISEWOMAN实施地点。
该研究包括三个WISEWOMAN项目地点的7841名NBCCDEP参与者。这两个项目服务于经济上处于不利地位的女性。
结果指标为参与WISEWOMAN生活方式干预和完成生活方式干预。主要预测指标为癌症筛查结果和基线慢性病风险因素。协变量指标包括年龄、种族、体重指数、吸烟状况和教育程度。
我们使用多变量逻辑回归模型来检验参与和完成WISEWOMAN生活方式干预的几率。
NBCCEDP参与者中，癌症筛查结果与参与WISEWOMAN生活方式干预之间的关联因教育程度和吸烟状况而有显著差异。在吸烟者或高学历女性中，通过NBCCEDP筛查得出癌症或癌前病变结果与正常筛查结果相比，与参与生活方式干预显著相关，高学历女性的比值比为2.69（95%置信区间[CI]，1.10 - 6.58），吸烟者为1.82（95%CI，1.00 - 3.31）。同样，吸烟者或糖尿病患者分别比非吸烟者或非糖尿病患者更有可能完成生活方式干预。
在综合项目实施方法中，NBCCEDP中的非吸烟者和低学历女性可能需要更多关于生活方式干预的引导，以提高对WISEWOMAN干预的参与度和完成率。
