Rimer B K, Conaway M R, Lyna P R, Rakowski W, Woods-Powell C T, Tessaro I, Yarnall K S, Barber L T
Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina, USA.
Am J Prev Med. 1996 Sep-Oct;12(5):351-7.
Cancer takes a disproportionate toll on disadvantaged Americans. Poverty and low education are risk factors for underuse of cancer screening.
In this report, we discuss predictors of adherence to cancer screening (mammography, clinical breast exam [CBE], and Pap tests) among 926 women who receive care at a community health center that serves a predominantly low-income and minority population. We examine predictors for each of the tests and for a composite measure of overall cancer screening test compliance. In studying multiple screening behaviors we not only investigate factors associated with each individual behavior, but we also identify consistently effective factors across several behaviors.
The analysis indicates consistent effects of age, education, and insurance status on cancer screening. In addition, decisional balance, a measure of a person's beliefs about the pros and cons of complying with the screening test, is associated strongly with adherence. We have extended earlier findings about the positive relationship between decisional balance and mammography to include decisional balance and Pap tests, as well. This finding suggests that behavioral interventions that target decisional balance can effectively promote adherence to cancer screening tests.
癌症对处于不利地位的美国人造成了不成比例的影响。贫困和低教育水平是癌症筛查利用率低的风险因素。
在本报告中，我们讨论了在一家主要为低收入和少数族裔人群服务的社区健康中心接受治疗的926名女性中，坚持进行癌症筛查（乳房X线摄影、临床乳房检查[CBE]和巴氏试验）的预测因素。我们研究了每项检查以及总体癌症筛查试验依从性综合指标的预测因素。在研究多种筛查行为时，我们不仅调查与每种个体行为相关的因素，还识别出在多种行为中始终有效的因素。
分析表明年龄、教育程度和保险状况对癌症筛查有一致的影响。此外，决策平衡，即衡量一个人对进行筛查试验利弊的信念，与坚持程度密切相关。我们将早期关于决策平衡与乳房X线摄影之间正相关关系的发现进行了扩展，以纳入决策平衡与巴氏试验的关系。这一发现表明，针对决策平衡的行为干预可以有效地促进对癌症筛查试验的坚持。
