Suarez L, Lloyd L, Weiss N, Rainbolt T, Pulley L
Texas Department of Health, Austin 78756.
J Natl Cancer Inst. 1994 May 18;86(10):775-9. doi: 10.1093/jnci/86.10.775.
Previous studies have determined that Hispanic women and, in particular, Mexican-American women have the lowest rates of cancer screening of any race and ethnic group in the United States. In the development of cancer control strategies for this population, little attention has been given to factors that encourage Mexican-American women to seek cancer preventive care. Recent studies suggest that social networks can have a positive influence on cancer-screening participation.
We determined the extent to which differences in social networks account for variations in breast and cervical cancer-screening practices among low-income Mexican-American women.
The data analyzed in this study were obtained from a baseline survey of knowledge, attitudes, and cancer-screening practices conducted prior to implementation of community interventions designed to improve Pap smear and mammography screening in low-income Mexican-American women 40 years old and older living along the U.S.-Mexican border in El Paso County, Texas. A random selection of 1300 households served as a sampling frame to identify Mexican-American women 40 years old and older for personal interviews. Of the 549 households identified as having at least one eligible female, 450 women completed the personal interviews that provided the data for this study. Personal interviews solicited information on age, income, marital status, place of birth, education, health insurance coverage, Pap smear- and mammogram-screening practices, and six questions relating to social network. A social network score was assigned to each woman by summation of the following six variables: number of confidants, number of close friends, number of close relatives, frequency of contact with these close friends or relatives per month, church membership, and church attendance. Women were grouped into three linear strata of social network (low, medium, high) based on tertiles of the scores. Cancer-screening history was also ascertained during the interview.
The 2-year prevalence of Pap smear and mammography use increased with social network. For each gain in social network level (low, medium, high), adjusted for sociodemographic factors, the odds ratio for Pap smear use was 1.33 (95% confidence interval = 1.02-1.73); it was 1.40 (95% confidence interval = 1.02-1.93) for mammogram use. Of the six social network components, the number of close friends was the most important predictor of mammography (P = .002) and Pap smear (P = .025) screening.
Social networks appear to be an important determinant of cancer-screening behavior among low-income, older Mexican-American women.
先前的研究已确定，在美国，西班牙裔女性，尤其是墨西哥裔美国女性，在所有种族和族裔群体中癌症筛查率最低。在为该人群制定癌症控制策略时，很少关注鼓励墨西哥裔美国女性寻求癌症预防护理的因素。近期研究表明，社交网络对癌症筛查参与度可能有积极影响。
我们确定了社交网络差异在多大程度上解释了低收入墨西哥裔美国女性乳腺癌和宫颈癌筛查行为的差异。
本研究分析的数据来自一项基线调查，该调查是在实施社区干预措施之前进行的，旨在改善居住在得克萨斯州埃尔帕索县美墨边境的40岁及以上低收入墨西哥裔美国女性的巴氏涂片检查和乳房X线摄影筛查。随机选择1300户家庭作为抽样框架，以确定40岁及以上的墨西哥裔美国女性进行个人访谈。在确定的549户至少有一名符合条件女性的家庭中，450名女性完成了为本研究提供数据的个人访谈。个人访谈收集了年龄、收入、婚姻状况、出生地、教育程度、医疗保险覆盖情况、巴氏涂片检查和乳房X线摄影筛查情况以及与社交网络相关的六个问题的信息。通过对以下六个变量求和为每位女性分配一个社交网络分数：知己数量、密友数量、近亲数量、每月与这些密友或近亲的联系频率、教会成员身份和教会出勤率。根据分数的三分位数，将女性分为社交网络的三个线性层次（低、中、高）。在访谈期间还确定了癌症筛查史。
巴氏涂片检查和乳房X线摄影的两年患病率随社交网络而增加。在根据社会人口学因素进行调整后，社交网络水平每提高一个层次（低、中、高），巴氏涂片检查的比值比为1.33（95%置信区间=1.02-1.73）；乳房X线摄影的比值比为1.40（95%置信区间=1.02-1.93）。在六个社交网络组成部分中，密友数量是乳房X线摄影（P = 0.002）和巴氏涂片检查（P = 0.025）筛查的最重要预测因素。
社交网络似乎是低收入老年墨西哥裔美国女性癌症筛查行为的重要决定因素。
