种族间预测医生沟通的过程差异，对接受乳腺密度通知的非裔美国人和欧洲裔美国人的影响。
Between-Race Differences in Processes Predicting Physician Communication for African American and European American Recipients of Breast Density Notifications.
机构信息
Department of Oncology, Karmanos Cancer Institute/Wayne State University School of Medicine, Detroit, MI, USA.
出版信息
Ann Behav Med. 2019 Jul 17;53(8):721-731. doi: 10.1093/abm/kay079.
BACKGROUND
Breast density notification laws mandate reporting of dense breast to applicable women. The same psychological and systemic barriers that yield between-race differences in mammography use will probably yield between-race differences in women's psychological and behavioral responses to breast density notifications.
PURPOSE
We used the theory of planned behavior as a framework to examine between-race differences in the likelihood of following-up with physicians after receiving breast density notifications and to examine differences in African American and Caucasian American women's behavioral decision-making processes.
METHODS
A subset of 212 African American and Caucasian American women who participated in an initial and follow-up survey examining responses to breast density notifications were examined for this study. Participants reported background and demographic measures, psychological responses to receiving notifications, and planned behavior measures related to following up with physicians approximately 2 weeks after receiving their mammogram reports. Participants self-reported their behaviors 3 months later.
RESULTS
There were no between-race differences in self-reported physician communication; however, there were differences in processes that predicted behavior. For Caucasian American women, behavioral intentions, education, and income predicted behaviors. Instead of intentions, group-based medical suspicion, confusion, breast cancer worry, and breast density anxiety predicted behaviors for African American women.
CONCLUSIONS
Behavioral decision-making processes for Caucasian American women were in line with well-validated theoretical predictions. For African American women, race-related medical suspicion, prior breast density awareness, and emotional responses to breast density notifications predicted behavior. The results highlight the need to focus on racially distinct psychological targets when designing interventions to support guideline concordant behavioral decisions among women who receive breast density notifications.
背景
乳腺密度通知法规要求向适用的女性报告致密乳腺。在乳腺 X 光检查使用方面产生种族差异的同样的心理和系统障碍，可能会在女性对乳腺密度通知的心理和行为反应方面产生种族差异。
目的
我们使用计划行为理论作为框架，检查在收到乳腺密度通知后与医生跟进的可能性方面存在种族差异，并检查非裔美国女性和白种美国女性的行为决策过程存在差异。
方法
本研究对 212 名非裔美国女性和白种美国女性进行了初步和随访调查，以检查对乳腺密度通知的反应，这些女性被纳入了这项研究。参与者报告了背景和人口统计学指标、收到通知后的心理反应，以及在收到乳腺 X 光报告后大约两周内与医生跟进的计划行为措施。参与者在 3 个月后报告了他们的行为。
结果
在自我报告的医生沟通方面，没有种族差异；然而，在预测行为的过程中存在差异。对于白种美国女性，行为意图、教育和收入预测行为。而非意图，群体医学怀疑、困惑、乳腺癌担忧和乳腺密度焦虑预测了非裔美国女性的行为。
结论
白种美国女性的行为决策过程符合经过充分验证的理论预测。对于非裔美国女性，与种族相关的医学怀疑、先前对乳腺密度的认识以及对乳腺密度通知的情绪反应预测了行为。结果强调了在设计干预措施时需要关注种族差异的心理目标，以支持接收乳腺密度通知的女性做出符合指南的行为决策。
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