美国非洲移民中的乳腺癌筛查:障碍、促进因素和干预措施的综合回顾。

Breast Cancer Screening among African Immigrants in the United States: An Integrative Review of Barriers, Facilitators, and Interventions.

机构信息

Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA.

出版信息

Int J Environ Res Public Health. 2024 Jul 30;21(8):1004. doi: 10.3390/ijerph21081004.

Abstract

The purpose of this review was to synthesize the available literature on breast cancer-screening barriers, facilitators, and interventions among U.S. African immigrants. Following the integrative review framework and PRISMA guidelines for reporting systemic reviews, five electronic databases were searched: PubMed, CINAHL, PsycINFO, Medline, and Google Scholar. Studies were included if they were published in English language journals after 1 January 2000 and reported data on breast cancer-screening barriers, facilitators, or interventions among U.S. African immigrants. Barriers and facilitators reported by studies were descriptively examined and synthesized by two authors and classified as aligning with one of the three levels of influences based on the social-ecological model (intrapersonal, interpersonal, and community). Interventions promoting breast cancer screening were narratively summarized. Search procedures retrieved 1011 articles, with 12 meeting the criteria for inclusion in the review (6 qualitative and 6 quantitative). Intrapersonal barriers included limited awareness, fear of pain, language barriers, health concerns, transportation issues, costs, and negative past experiences. Interpersonal barriers involved modesty, spiritual beliefs, and lack of support, while community-level barriers included provider and healthcare-system challenges. Regarding facilitators, past screening experiences and health insurance were the most commonly reported intrapersonal facilitators. The only interpersonal facilitator identified was observing other women experience a breast cancer diagnosis and undergo treatment. Community-level facilitators included appointment reminders, scheduling assistance, culturally congruent interpreters, transportation to screening facilities, and patient navigators. Three articles reported outcomes of breast cancer-screening interventions. All three were pilot studies and reported increased knowledge and attitudes regarding breast cancer screening following the respective interventions. One study examined the uptake of breast cancer screening following the intervention, with results indicating an increase in screening. Findings provide a comprehensive synthesis of factors influencing breast cancer screening among African immigrants and highlight the need for future research on the topic. This review was registered with Prospero (CRD42024502826) before the initiation of search procedures.

摘要

本次综述的目的是综合美国非洲移民中乳腺癌筛查障碍、促进因素和干预措施的现有文献。根据系统综述的综合审查框架和 PRISMA 报告指南,我们在五个电子数据库中进行了搜索:PubMed、CINAHL、PsycINFO、Medline 和 Google Scholar。如果研究发表于 2000 年 1 月 1 日之后的英文期刊,并报告了美国非洲移民中乳腺癌筛查障碍、促进因素或干预措施的数据,则纳入研究。两名作者对研究报告的障碍和促进因素进行了描述性检查和综合,并根据社会生态学模型(个体内、人际间和社区)将其分类为符合三个影响层次之一。促进乳腺癌筛查的干预措施进行了叙述性总结。搜索过程共检索到 1011 篇文章,其中 12 篇符合纳入综述的标准(6 篇定性研究,6 篇定量研究)。个体内障碍包括认知有限、害怕疼痛、语言障碍、健康问题、交通问题、费用和负面的既往经历。人际间障碍涉及谦逊、精神信仰和缺乏支持,而社区层面的障碍包括提供者和医疗保健系统的挑战。关于促进因素,过去的筛查经历和医疗保险是最常报告的个体内促进因素。唯一确定的人际促进因素是观察其他女性经历乳腺癌诊断并接受治疗。社区层面的促进因素包括预约提醒、安排协助、文化相符的口译员、前往筛查机构的交通和患者导航员。有三篇文章报告了乳腺癌筛查干预措施的结果。这三篇文章都是试点研究,在各自的干预措施之后,报告了对乳腺癌筛查的知识和态度的提高。有一项研究调查了干预措施后乳腺癌筛查的采用情况,结果表明筛查有所增加。研究结果全面综合了影响非洲移民乳腺癌筛查的因素,并强调了该主题未来研究的必要性。本综述在开始搜索程序之前已在 Prospero(CRD42024502826)进行了注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22db/11353535/99e20b6d633f/ijerph-21-01004-g001.jpg

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