Brown Heidi E, Boyd Krystelle, Howard Melissa, Seaton Denver, Begay Rachelle L, Sanderson Priscilla R, Harris Robin B
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
Department of Health Sciences, College of Health and Human Services, Northern Arizona University, Flagstaff, Arizona.
Am J Trop Med Hyg. 2024 Dec 24;112(3):518-524. doi: 10.4269/ajtmh.24-0393. Print 2025 Mar 5.
Helicobacter pylori is one of the most common infectious agents linked to any malignancy. Recent studies report higher H. pylori prevalence and gastric cancer incidence rates in the Navajo Nation than in general U.S. populations. Little is known about barriers to care and treatment. Participants of the 2022 Navajo Healthy Stomach Project who had a positive urea breath test for H. pylori were contacted after 6 months to assess health care services sought, treatment received, and barriers to accessing care. Descriptive statistics identified perceived barriers to care seeking and treatment. Of individuals consented to recontact, 83 were surveyed (69.8% response rate). Just over half (52.8%) reported following up with an allopathic clinician. The most common reasons for not seeking care were lack of time (37.5%) and forgetting (25.0%). Care seeking was more common among those who felt that H. pylori was linked to their gastrointestinal symptoms (P = 0.03) or those less concerned about adverse effects of antibiotics (P = 0.07). Community engagement throughout the research process and intentionally sharing research finding with communities may be strategies to reduce barriers to care seeking after a positive H. pylori infection diagnosis.
幽门螺杆菌是与任何恶性肿瘤相关的最常见感染因子之一。最近的研究报告称,纳瓦霍族中幽门螺杆菌的患病率和胃癌发病率高于美国普通人群。对于医疗保健和治疗的障碍知之甚少。2022年纳瓦霍族健康胃部项目中尿素呼气试验检测幽门螺杆菌呈阳性的参与者在6个月后被联系,以评估他们寻求的医疗服务、接受的治疗以及获得医疗服务的障碍。描述性统计确定了寻求医疗和治疗过程中察觉到的障碍。在同意再次联系的个体中,有83人接受了调查(回复率为69.8%)。略超过一半(52.8%)的人报告说他们去看了西医临床医生。不寻求医疗服务的最常见原因是没有时间(37.5%)和忘记了(25.0%)。在那些认为幽门螺杆菌与他们的胃肠道症状有关(P = 0.03)或不太担心抗生素副作用的人(P = 0.07)中,寻求医疗服务更为常见。在整个研究过程中进行社区参与,并有意与社区分享研究结果,可能是减少幽门螺杆菌感染诊断呈阳性后寻求医疗服务障碍的策略。