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运用安德森医疗服务利用行为模型分析美国南部地区非裔美国男性进行前列腺癌筛查行为的影响因素。

Analyzing Factors Enabling Prostate Cancer Screening Behaviors Among African American Males in the South Region Using the Andersen's Behavioral Model of Healthcare Services Utilization.

作者信息

Kim Youseung, Alhassan Mustapha

机构信息

Whitney M. Young Jr, School of Social Work, Clark Atlanta University, 223 James P Brawley Dr SW, Atlanta, GA, 30314, USA.

出版信息

J Prev (2022). 2023 Apr;44(2):253-266. doi: 10.1007/s10935-023-00722-6. Epub 2023 Jan 19.

Abstract

Prostate cancer is the second leading cause of cancer death among men in the United States, and African American men especially represent a high risk population for prostate cancer. Although the overall prostate cancer incidence rates have been declining since 1992, the average annual prostate cancer incidence rates among African American men were still higher than any other racial groups, and the mortality rates were 2.1 times higher than that of Caucasian men. This study examined what factors including cultural mistrust were related with the prostate cancer screening behaviors among African American males in the South East region. Out of 496 prostate educational seminar attendees, 304 volunteers completed the survey about the behaviors of prostate cancer, cultural mistrust for health providers and general health beliefs and health behaviors. Using Anderson's Behavioral Model of Health Services Use, hierarchical multivariate logistic regression analysis was conducted to identify which predisposing, enabling, and need factors could predict prostate cancer screening behaviors and whether there was any interaction effects among these predictors. Findings revealed that annual household income and annual health check-up were significantly related with the prostate cancer screening behaviors while the effect of health insurance was diminished among older African American males. Overall, results highlight the importance of financial resources as a determinant of prostate cancer screening behaviors among African American males implying the need of substantial support to overcome the obstacles from financial adversity.

摘要

前列腺癌是美国男性癌症死亡的第二大主要原因,非裔美国男性尤其代表了前列腺癌的高风险人群。尽管自1992年以来前列腺癌的总体发病率一直在下降,但非裔美国男性的年平均前列腺癌发病率仍高于任何其他种族群体,死亡率比白人男性高2.1倍。本研究调查了包括文化不信任在内的哪些因素与东南部地区非裔美国男性的前列腺癌筛查行为有关。在496名参加前列腺教育研讨会的人中,304名志愿者完成了关于前列腺癌行为、对医疗服务提供者的文化不信任以及一般健康信念和健康行为的调查。使用安德森的卫生服务利用行为模型,进行了分层多变量逻辑回归分析,以确定哪些易患因素、促成因素和需求因素可以预测前列腺癌筛查行为,以及这些预测因素之间是否存在任何交互作用。研究结果显示,家庭年收入和年度健康检查与前列腺癌筛查行为显著相关,而在年龄较大的非裔美国男性中,医疗保险的影响减弱。总体而言,结果突出了经济资源作为非裔美国男性前列腺癌筛查行为决定因素的重要性,这意味着需要大量支持来克服经济困境带来的障碍。

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