Marlow Laura A V, Meisel Susanne F, Wardle Jane
Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, UCL, Gower Street, London, WC1E 6BT, UK.
BMC Public Health. 2017 Feb 3;17(1):164. doi: 10.1186/s12889-017-4093-2.
Cancer screening invitations can explicitly recommend attendance or encourage individuals to consider the risks and benefits before deciding for themselves. Public preferences for these approaches might vary. We explored ethnic minority women's preferences for a strong recommendation to be screened.
Women aged 30-60 years from Indian, Pakistani, Bangladeshi, Caribbean, African and white British backgrounds (n = 120 per group) completed face-to-face interviews with a multi-lingual interviewer. The interview included a question on which approach to screening invitations they would prefer: i) A strong recommendation from the National Health Service (NHS) to go for screening, ii) A statement that the NHS thinks you should go for screening, but it's up to you to decide, iii) No recommendation. Analyses examined predictors of preference for a strong recommendation.
Preferences varied by ethnicity (χ (5) = 98.20, p <.001). All ethnic minority groups had a preference for a strong recommendation to be screened (53-86% across ethnic groups vs 31% white British). Socio-demographic factors (marital status, education and employment), and indicators of acculturation (main language and migration status), contributed to explaining recommendation preferences (χ (5) = 35.95 and χ (3) = 11.59, respectively, both p <.001), but did not mediate the ethnicity effect entirely. Self-rated comprehension of written health information did not contribute to the model.
A strong recommendation to participate in cancer screening appears to be important for ethnic minority women, particularly non-English speakers. Future research could explore how to best arrive at a consensus that respects patient autonomy while also accommodating those that would prefer to be guided by a trusted source.
癌症筛查邀请可以明确建议参加筛查,或者鼓励个人在自行决定之前考虑风险和益处。公众对这些方式的偏好可能有所不同。我们探讨了少数族裔女性对于强烈建议进行筛查的偏好。
年龄在30至60岁之间、具有印度、巴基斯坦、孟加拉国、加勒比、非洲和英国白人背景的女性(每组n = 120)与一名多语言面试官进行了面对面访谈。访谈包括一个关于她们更喜欢哪种筛查邀请方式的问题:i)国家医疗服务体系(NHS)强烈建议进行筛查,ii)NHS认为你应该进行筛查,但由你自己决定,iii)不做建议。分析研究了强烈建议偏好的预测因素。
偏好因种族而异(χ(5)=98.20,p <.001)。所有少数族裔群体都倾向于强烈建议进行筛查(各民族群体中为53 - 86%,而英国白人中为31%)。社会人口因素(婚姻状况、教育程度和就业情况)以及文化适应指标(主要语言和移民身份)有助于解释建议偏好(χ(5)=35.95和χ(3)=11.59,p均<.001),但并未完全介导种族效应。对书面健康信息的自我评估理解能力对模型没有贡献。
强烈建议参与癌症筛查对少数族裔女性,尤其是非英语使用者似乎很重要。未来的研究可以探索如何最好地达成一种共识,既尊重患者的自主权,又能满足那些希望得到可靠来源指导的人。