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基于诊所的促进乳腺癌和宫颈癌筛查的干预措施。

Clinic-based interventions to promote breast and cervical cancer screening.

作者信息

Paskett E D, McMahon K, Tatum C, Velez R, Shelton B, Case L D, Wofford J, Moran W, Wymer A

机构信息

Department of Public Health Sciences, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157, USA.

出版信息

Prev Med. 1998 Jan-Feb;27(1):120-8. doi: 10.1006/pmed.1997.0254.

Abstract

BACKGROUND

Breast and cervical cancer continue to claim the lives of women. Early detection modalities for these cancers are available; however, utilization rates are far from optimal. Studies have documented the motivating effect that physician recommendations have on compliance with preventive health behaviors. The goal of this study was to develop and implement strategies to improve the use of cervical and breast cancer screening among African-American women age 40 and older who resided in low-income housing communities.

METHODS

Baseline surveys among clinic providers and a random sample of women in the target population indicated areas to be included in intervention material. Community health center-based strategies included educational interventions for providers and patients, follow-up interventions for abnormal screening tests, and the implementation of a computer tracking system. Pap smear and mammogram utilization rates at the health center were tracked throughout the project period to assess the effect of the clinic-based interventions.

RESULTS

Both Pap smear and mammography rates increased over time. Fifteen cases of breast cancer and 1 case of invasive cervical cancer have been detected. Compliance rates for follow-up for cervical dysplasia have increased from 50 to 90%.

CONCLUSIONS

These results suggest that clinic-based interventions can improve the use of breast and cervical cancer screening and follow-up among low-income women.

摘要

背景

乳腺癌和宫颈癌持续夺走女性的生命。这些癌症的早期检测方法是可用的;然而,利用率远未达到最佳状态。研究记录了医生建议对遵守预防性健康行为的激励作用。本研究的目的是制定并实施策略,以提高居住在低收入住房社区的40岁及以上非裔美国女性对宫颈癌和乳腺癌筛查的使用率。

方法

对诊所医护人员以及目标人群中的女性随机样本进行的基线调查表明了干预材料应涵盖的领域。基于社区卫生中心的策略包括对医护人员和患者的教育干预、对异常筛查检测的后续干预以及实施计算机跟踪系统。在整个项目期间跟踪健康中心的巴氏涂片检查和乳房X光检查使用率,以评估基于诊所的干预措施的效果。

结果

随着时间的推移,巴氏涂片检查率和乳房X光检查率均有所提高。已检测出15例乳腺癌和1例浸润性宫颈癌。宫颈发育异常的后续随访依从率从50%提高到了90%。

结论

这些结果表明,基于诊所的干预措施可以提高低收入女性对乳腺癌和宫颈癌筛查及后续随访的利用率。

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