Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Department of Implementation Science, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
J Cancer Educ. 2022 Aug;37(4):1043-1052. doi: 10.1007/s13187-020-01918-8. Epub 2020 Nov 5.
This study examines breast and cervical cancer screening uptake in a cancer education and patient navigation (PN) program for residents of rural and border counties in Texas by level of participation (education only, PN only, or education and PN). Data collected from March 1, 2012, to November 5, 2016, included 6663 follow-up surveys from participants aged 21-74. Logistic regression models assessed program participation on the odds of completing breast or cervical cancer screening. For women aged 40-74 years (N = 4942; mean age = 52 years), 58.4% reported a mammogram within 6 months on average from initial contact. In the breast cancer screening model, women who only received PN (OR: 6.06, CI: 4.87-7.53) or who participated in both the education plus PN program (OR: 3.33, CI: 2.77-4.02) had higher odds of mammogram screening compared to women who only received education. For women aged 21-64 years (N = 6169; mean age = 46 years), 37.7% received a Papanicolaou (Pap) test within 6 months on average from initial contact. In the Pap screening model, both education and PN (OR: 3.23, CI: 2.66-3.91) and PN only (OR: 2.35, CI: 1.88-2.93) groups had higher odds of screening for cervical cancer compared to those only receiving education. Graphed predicted probabilities examined significant interactions between race/ethnicity/language and program participation (P < 0.0001) for both screenings. PN, solely or in combination with education, is an effective strategy to increase screening for breast and cervical cancer, beyond educational outreach efforts alone, among un-/underserved, racially/ethnically diverse women in rural and border Texas counties.
本研究通过参与程度（仅接受教育、仅接受患者导航、接受教育和患者导航），考察了德克萨斯州农村和边境县癌症教育和患者导航（PN）计划中乳腺癌和宫颈癌筛查的参与情况。研究数据收集自 2012 年 3 月 1 日至 2016 年 11 月 5 日，共纳入 6663 名年龄在 21-74 岁之间的参与者的随访调查。逻辑回归模型评估了计划参与对完成乳腺癌或宫颈癌筛查的可能性的影响。对于 40-74 岁的女性（N=4942；平均年龄 52 岁），58.4%的人报告在初次接触后平均 6 个月内进行了乳房 X 光检查。在乳腺癌筛查模型中，仅接受 PN 的女性（OR：6.06，CI：4.87-7.53）或同时接受教育加 PN 项目的女性（OR：3.33，CI：2.77-4.02）进行乳房 X 光检查的可能性高于仅接受教育的女性。对于 21-64 岁的女性（N=6169；平均年龄 46 岁），37.7%的人在初次接触后平均 6 个月内接受了巴氏试验。在巴氏筛查模型中，教育加 PN（OR：3.23，CI：2.66-3.91）和仅 PN（OR：2.35，CI：1.88-2.93）组进行宫颈癌筛查的可能性均高于仅接受教育的组。对于两种筛查，种族/族裔/语言和计划参与之间的显著相互作用（P<0.0001）的图形预测概率。PN 单独或与教育结合，是一种有效的策略，可在德克萨斯州农村和边境县的未服务/服务不足、种族/族裔多样化的女性中，提高乳腺癌和宫颈癌的筛查率，超出单纯的教育推广。
