RESUMO
OBJECTIVES: Get It & Forget It, an educational video about intrauterine devices (IUDs), was developed and evaluated. STUDY DESIGN: A feasibility study and a pre/post evaluation nested within a randomized trial were conducted to test change in knowledge about IUDs and intention to get an IUD after viewing a theory-driven dramatic video. Participants (n=315) completed surveys before and after watching the video. RESULTS: Knowledge about IUD effectiveness increased significantly (33% to 64%, p<.001), as did intention to use an IUD (18% to 36%, p<.001) postvideo. CONCLUSION: An online theory-driven video intervention can reach young women seeking information about long-acting contraception.
Assuntos
Assistência à Saúde Culturalmente Competente , Serviços de Planejamento Familiar/educação , Dispositivos Intrauterinos/efeitos adversos , Modelos Educacionais , Educação de Pacientes como Assunto , Saúde Reprodutiva/educação , Webcasts como Assunto , Adolescente , Adulto , Comportamento Contraceptivo , Estudos de Viabilidade , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Humanos , Pessoa de Meia-Idade , Porto Rico , Estados Unidos , Adulto JovemRESUMO
A telephone-based survey regarding breast cancer screening practices among 300 African American and Caribbean women age 40 and over in New York City revealed that while U.S.-born women had significantly different sociodemographic profiles (in terms of insurance status, marital status, educational attainment), they were no more likely to have had a mammogram than the foreign-born women. Adjusting for insurance status and source of care, women with a provider recommendation were 8 times more likely ever to have had a mammogram (AOR 8.01, 95%CI: 3.74-17.14). Among foreign-born Caribbean women in the U.S. for less than half their lives, only 52% ever had a provider recommend a mammogram, compared with 77% of U.S.-born women. The findings confirm previous reports of the importance of physician recommendation in increasing mammography screening among urban Black women, and suggest that efforts to reach Caribbean-born women with breast cancer screening messages should emphasize the important role of providers.
Assuntos
Negro ou Afro-Americano , Neoplasias da Mama/prevenção & controle , Mamografia/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Análise de Variância , Emigração e Imigração , Feminino , Humanos , Modelos Logísticos , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , Cidade de Nova Iorque , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Encaminhamento e Consulta , Fatores Socioeconômicos , Índias Ocidentais/etnologiaRESUMO
BACKGROUND: In medically underserved communities, the transfer of information through social networks may help promote healthy behaviors when traditional health education channels are not effective. MATERIAL/METHODS: A cross-sectional survey was conducted with 212 young Mexican and Dominican women and 212 of their older female relatives (age 40-88) regarding knowledge and practices of breast cancer screening, allowing analysis of agreement between women of different generations in the same family. RESULTS: Women in the study had low educational attainment and had poor access to health care. Two-thirds of all participants reported that they talked to their relatives about breast cancer screening; these women were significantly more likely to perform BSE, but not to have had clinical breast exams or mammograms. Measurement of prevalence-adjusted bias-adjusted kappa between the 212 family pairs found agreement on knowledge of the various screening methods and on sources of health information, but not on BSE or clinical breast exam behavior. CONCLUSIONS: These mixed findings do not suggest a direct relationship between information sharing within a family and screening behavior. An innovative model of training young women connected to regular medical care to convey information and reinforce existing educational messages for the older women in their families may be successful. But the lack of a pattern of similar screening behaviors within the family pairs indicates that any such effort would need to begin by providing the young women with accurate information about screening.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Hispânico ou Latino , Programas de Rastreamento , Adulto , Idoso , Idoso de 80 Anos ou mais , Dominica/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Americanos Mexicanos , Pessoa de Meia-Idade , Cidade de Nova IorqueRESUMO
The proportion of Mexican and Dominican women has increased rapidly in New York City and in other urban areas, and breast cancer screening rates continue to be lower for Latina women as a whole, but particularly for some nationality subgroups. The current analysis explored the reasons why Mexican and Dominican women from medically underserved communities in New York City do not seek breast cancer screening. Data were collected through interviews with 298 Mexican and Dominican women aged 40-88 years; the interviews included an open-ended question on the barriers women face in seeking screening. The three most commonly cited barriers were not taking care of oneself (descuido) (52.3%), lack of information (49.3%), and fear (44.6%). Women who had been screened cited fear, pain, or other personal barriers more often, but women who had never had a mammogram cited cost or other logistical barriers. Responses from Dominican and Mexican women were significantly different, with Mexican women more often citing shame or embarrassment and Dominican women more often citing fear. The dependent variable, barriers to screening, was grouped into major categories. When sociodemographic factors were controlled for, the effect of ethnicity disappeared. Multivariate logistic regression revealed that women with a source of health care were less likely to cite any logistical barriers, but significantly more likely to report only personal barriers (such as fear or descuido). The analysis indicated that personal barriers were very prevalent in the communities studied. It may not be sufficient merely to increase access to breast cancer screening services for low-income Latinas: even when women have a source of health care, personal barriers may prevent many women from seeking screening. Outreach programs need to be tailored to the target communities as there are significant differences among groups of Latinas. Targeted outreach programs must work in tandem with programs to increase access to ensure that both personal and logistical barriers to screening are addressed.