Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Uganda Martyrs University, Nkozi, Uganda.
BMC Womens Health. 2024 May 18;24(1):296. doi: 10.1186/s12905-024-03129-5.
INTRODUCTION: Cervical cancer continues to pose a major public health challenge in low-income countries. Cervical cancer screening programs enable early detection and effectively reduce the incidence of cervical cancer as well as late-stage diagnosis and mortality. However, screening uptake remains suboptimal in Uganda. This study assessed correlates of intention to screen for cervical cancer among women in the Kyotera district of Central Uganda. METHODS: We analyzed cross-sectional data collected to determine the effectiveness of community audio towers (CATs) as a modality of health communication to support cervical cancer prevention. Women (n = 430) aged 21-60 years without a prior history of cervical cancer screening were surveyed about demographics, sources of health information and cervical cancer screening intentions in 2020. We used generalized linear modelling with modified Poisson regression and backwards variable elimination to identify adjusted prevalence ratios and 95% confidence intervals (CI) to determine factors associated with intention to screen for cervical cancer. RESULTS: Half (50.2%) of the participants had intentions to screen for cervical cancer within twelve months and 26.5% had moderate knowledge about cervical cancer. Nearly half (46.0%) considered themselves at risk of cervical cancer. Compared to residents who primarily received their health information from social media and radio, participants who received health information primarily from CATs (aPR:0.64, 95% CI:0.52-0.80, p < 0.001) and TV (aPR:0.52, 95% CI:0.34-0.82, p = 0.005) had a lower prevalence of intention to screen for cervical cancer. The prevalence of intentions to screen for cervical cancer in twelve months was higher among those resided in town councils (aPR:1.44, 95% CI:1.12-1.86, p = 0.004) compared to rural areas, and higher among those who considered themselves to be at risk of cervical cancer (aPR:1.74, 95% CI:1.28-2.36, p < 0.001) compared to those who did not. CONCLUSIONS: We found suboptimal prevalence of intentions to screen for cervical cancer among women in central Uganda. Additional research and implementation projects are needed to increase cervical cancer screening. Targeting risk perceptions and behavioral approaches to increase intentions could be effective in future intervention work. Based on urban-rural differences, additional work is needed to support equitable sharing of information to support cancer prevention messaging; CATs and TV may best help reach those with lower intentions to screen based on our research.
简介:在低收入国家,宫颈癌仍然是一个重大的公共卫生挑战。宫颈癌筛查计划能够实现早期发现,并有效降低宫颈癌的发病率和晚期诊断及死亡率。然而,在乌干达,筛查的参与率仍然不理想。本研究评估了乌干达中部 Kyotera 区妇女进行宫颈癌筛查的意向相关因素。
方法:我们分析了为确定社区音频塔(CAT)作为支持宫颈癌预防的一种健康传播模式的有效性而收集的横断面数据。2020 年,对 430 名年龄在 21-60 岁之间、无宫颈癌筛查既往史的妇女进行了人口统计学、健康信息来源和宫颈癌筛查意向调查。我们使用广义线性模型进行分析,采用改良泊松回归和向后变量消除法,确定调整后的患病率比和 95%置信区间(CI),以确定与宫颈癌筛查意向相关的因素。
结果:有一半(50.2%)的参与者在 12 个月内有进行宫颈癌筛查的意向,26.5%的人对宫颈癌有中等程度的了解。近一半(46.0%)的人认为自己有患宫颈癌的风险。与主要通过社交媒体和广播获取健康信息的居民相比,主要通过 CAT(调整后患病率比:0.64,95%CI:0.52-0.80,p<0.001)和电视(调整后患病率比:0.52,95%CI:0.34-0.82,p=0.005)获取健康信息的参与者,其宫颈癌筛查意向的患病率较低。与农村地区相比,居住在城镇议会的参与者在 12 个月内进行宫颈癌筛查的意向更高(调整后患病率比:1.44,95%CI:1.12-1.86,p=0.004);与没有风险认知的参与者相比,认为自己有患宫颈癌风险的参与者(调整后患病率比:1.74,95%CI:1.28-2.36,p<0.001)进行宫颈癌筛查的意向更高。
结论:我们发现乌干达中部妇女进行宫颈癌筛查的意向率不理想。需要开展更多的研究和实施项目来提高宫颈癌筛查率。针对风险认知并采取行为干预措施来提高意向可能是未来干预工作的有效手段。基于城乡差异,需要开展更多工作,以支持公平分享信息,以支持癌症预防信息传递;根据我们的研究,CAT 和电视可能是提高低筛查意向人群参与度的最佳方式。
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