RESUMO
OBJECTIVE: The purpose of this study was to report the results of a meta-analysis conducted on the effects of clinical trials in breast cancer screening for African American women between 1997 and 2017. DATA SOURCES: Articles published in English and in the United States, between January 1997 and March 2017, were eligible for inclusion if they (1) conducted psychosocial, behavioral, or educational interventions designed to increase screening mammography rates in predominantly African American women of all ages; (2) utilized a randomized, controlled trial (RCT) design; and (3) reported quantitative screening rates following the intervention. STUDY DESIGN: Randomized clinical trials on breast cancer screening in African American women, published between January 1997 and March 2017, were selected from database searches. DATA COLLECTION METHODS: Data collected included effect size of screening versus comparison interventions, intervention characteristics, and a number of study characteristics to explore potential moderators. Search results yielded 327 articles, of which 14 met inclusion criteria and were included in analyses. PRINCIPAL FINDINGS: Findings indicated that screening interventions for African American women were significantly more likely to result in mammography than control (OR = 1.56 [95 percent CI = 1.27-1.93], p < .0001). Although no patient or study characteristics significantly moderated screening efficacy, the most effective interventions were those specifically tailored to meet the perceived risk of African American women. CONCLUSIONS: Screening interventions are at least minimally effective for promoting mammography among African American women, but research in this area is limited to a small number of studies. More research is needed to enhance the efficacy of existing interventions and reduce the high morbidity and mortality rate of this underserved population.
Assuntos
Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Neoplasias da Mama/etnologia , Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias da Mama/diagnóstico , Competência Cultural , Detecção Precoce de Câncer/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Mamografia/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Estados UnidosRESUMO
Sense of control is known to be related to depression. Yet, few studies have examined the role of sense of control as related to depression for discharged psychiatric patients. In this study the longitudinal relationship between sense of control and depressive mood was examined using the MacArthur Violence Risk Assessment Study, a 6-wave, 1-year study of 948 ethnically diverse postdischarge psychiatric patients. Sense of control was decomposed into 2 components (i.e., a time-invariant as well as a time-varying component) and so as to examine which component of sense of control would more accurately explain this relationship. Results demonstrated that time-varying sense of control significantly predicted changes in depressive mood during the transition to community environment. Time-invariant sense of control, however, was not significantly related to changes in depressive mood. Findings of this study hold important implications for intervention practice with people before or after psychiatric discharge, including the need for incorporation of therapeutic and psychoeducational efforts that bolster sense of control.