Luque John S, Logan Ayaba, Soulen Grace, Armeson Kent E, Garrett Danielle M, Davila Caroline B, Ford Marvella E
Institute of Public Health, Science Research Center, Florida A&M University, 1515 South MLK Blvd. Suite 207B, Tallahassee, FL, 32307, USA.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
J Cancer Educ. 2019 Jun;34(3):412-422. doi: 10.1007/s13187-018-1321-0.
In the United States (U.S.), Hispanics experience breast cancer disparities. Breast cancer is the leading cause of cancer-related death among Hispanic women, and Hispanic women receive mammography screening at lower rates than some other ethnic groups. This low rate of screening mammography is associated with increased risk for possible late-stage diagnosis and lower survival rates. Educational interventions could play a role in increasing screening mammography rates among Hispanic women. This systematic review synthesized the current literature on educational interventions to increase mammography screening among Hispanic women. The review included studies published between May 2003 and September 2017 with experimental and quasi-experimental interventions to increase mammography screening among Hispanics in the U.S. Five studies out of an initial 269 studies met inclusion criteria for the review. All studies employed an interpersonal intervention strategy with community health workers, or promotoras, to deliver the mammography screening intervention. For each study, odds ratios (OR) were calculated to estimate intervention effectiveness based on similar follow-up time periods. The study ORs resulted in a narrow range between 1.02 and 2.18, indicating a low to moderate intervention effect for these types of interpersonal cancer education interventions. The summary OR for the random effects model was 1.67 (CI 1.24-2.26). Hispanics exhibit lower levels of adherence to screening mammography than non-Hispanic whites. Interpersonal cancer education interventions such as the use of promotoras may help to mediate the impact of barriers to receiving a mammogram such as low health literacy, deficits in knowledge about the benefits of screening, and low awareness of the availability of screening services.
在美国,西班牙裔人群面临乳腺癌差异问题。乳腺癌是西班牙裔女性癌症相关死亡的主要原因,而且西班牙裔女性接受乳房X光检查筛查的比例低于其他一些种族群体。这种乳房X光检查筛查率低与晚期诊断可能性增加及生存率降低相关。教育干预可能有助于提高西班牙裔女性的乳房X光检查筛查率。本系统综述综合了当前关于提高西班牙裔女性乳房X光检查筛查率的教育干预措施的文献。该综述纳入了2003年5月至2017年9月期间发表的、采用实验性和准实验性干预措施来提高美国西班牙裔人群乳房X光检查筛查率的研究。在最初的269项研究中,有5项研究符合该综述的纳入标准。所有研究都采用了人际干预策略,通过社区卫生工作者或健康促进员来实施乳房X光检查筛查干预措施。对于每项研究,计算优势比(OR)以根据相似的随访时间段来估计干预效果。研究的优势比在1.02至2.18之间,表明这类人际癌症教育干预措施的干预效果为低到中度。随机效应模型的汇总优势比为1.67(置信区间1.24 - 2.26)。西班牙裔人群对乳房X光检查筛查的依从性低于非西班牙裔白人。人际癌症教育干预措施,如使用健康促进员,可能有助于调节接受乳房X光检查的障碍的影响,如健康素养低、对筛查益处的知识欠缺以及对筛查服务可获得性的知晓度低等。