Gynaecologic cancer symptom awareness, concern and care seeking among US women: a multi-site qualitative study.

BACKGROUND: With limited screening options, early detection of gynaecologic cancers can depend on women recognizing the potential significance of symptoms and seeking care. OBJECTIVE: We investigated women's concern about symptoms that might be related to gynaecologic cancers, the underlying conditions they associated with symptoms and their actual and hypothetical response to symptoms. METHODS: Fifteen focus groups with women aged 40-60 years were conducted in Chicago, Los Angeles, Miami and New York City. Participants were given an untitled list of symptoms that could indicate various gynaecologic cancers and asked if any would concern them, what could cause each and what they would do if they experienced any of them. RESULTS: Overall, participants expressed greater concern about symptoms clearly gynaecologic in nature than other symptoms. Participants generally did not associate symptoms with any form of cancer. Some women who had experienced symptoms reported waiting an extended period before seeking care or not seeking care at all. The belief that a symptom indicated a benign condition was the most common reason given for delaying or foregoing care seeking. Strategies participants reported using to supplement or replace consultations with health care providers included Internet research and self-care. CONCLUSION: Raising awareness of symptoms that can indicate gynaecologic cancers may lead to earlier detection and improved survival. In particular, women should be informed that gynaecologic cancers can cause symptoms that may not seem related to the reproductive organs (e.g. back pain) and that unusual vaginal bleeding should prompt them to seek care immediately.

Can donated media placements reach intended audiences?

Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.

Intention to seek care for symptoms associated with gynecologic cancers, HealthStyles survey, 2008.

INTRODUCTION: Women with ovarian cancer typically experience symptoms before diagnosis; such symptoms for other gynecologic cancers have not been systematically studied. We investigated which symptoms of gynecologic cancers prompt intention to seek care among women and whether demographic differences in intention exist. This study was undertaken, in part, to inform development of the Centers for Disease Control and Prevention's campaign, Inside Knowledge: Get the Facts About Gynecologic Cancer. METHODS: We analyzed the 2008 HealthStyles dataset (n = 2,991 women), an annual, cross-sectional, national mail survey. We calculated weighted percentages of women who indicated an intention to seek care for symptoms (defined as intention to call or see a doctor) by demographic characteristics and level of concern about developing a gynecologic cancer. We evaluated independent predictors of intention to seek care for each symptom. RESULTS: For most symptoms, more than 50% of women reported an intention to seek care. Greater percentages of women indicated an intention to seek care for symptoms clearly gynecologic (eg, 91%, postmenopausal bleeding) than for symptoms not clearly gynecologic (eg, 37%, feeling full after eating a small amount). For most symptoms, after adjustment, black women, postmenopausal women, and women with greater concern about developing gynecologic cancers were more likely than their counterparts to intend to seek care. CONCLUSION: Intention to seek care differed by race, menopausal status, and level of concern about developing a gynecologic cancer. These findings will help in developing messages to educate women about the array of gynecologic and nongynecologic cancer symptoms.

Physicians who use social media and other internet-based communication technologies.

The demographic and practice-related characteristics of physicians who use social networking websites, portable devices to access the internet, email to communicate with patients, podcasts, widgets, RSS feeds, and blogging were investigated. Logistic regression was used to analyze a survey of US primary care physicians, pediatricians, obstetrician/gynecologists, and dermatologists (N=1750). Reported technology use during the last 6 months ranged from 80.6% using a portable device to access the internet to 12.9% writing a blog. The most consistent predictors of use were being male, being younger, and having teaching hospital privileges. Physician specialty, practice setting, years in practice, average number of patients treated per week, and number of physicians in practice were found to be inconsistently associated or unassociated with use of the technologies examined. Demographic characteristics, rather than practice-related characteristics, were more consistent predictors of physician use of seven internet-based communication technologies with varying levels of uptake.

Women's knowledge and awareness of gynecologic cancer: a multisite qualitative study in the United States.

BACKGROUND: U.S. women's awareness and knowledge of gynecologic cancer have not been well studied, with the exception of cervical cancer screening and risk factors. METHODS: Fifteen focus groups were conducted with women aged 40-60 years in Miami, New York City, Chicago, and Los Angeles. RESULTS: Most participants said they had heard of cervical, ovarian, and uterine cancers but were unfamiliar with vaginal and vulvar cancers. The misconception that the Pap test screens for multiple gynecologic cancers was prevalent and engendered a false sense of security in some women. An annual Pap screening interval was most familiar to participants; some mentioned a shorter screening interval for high-risk women; few mentioned an extended screening interval. A few participants thought the pelvic examination could detect a variety of conditions, including ovarian cancer. Some knew that the human papillomavirus (HPV) could cause cervical cancer, but no other risk factors for specific cancers were mentioned with any consistency. Although some recognized unexplained vaginal bleeding as a symptom of cervical cancer, participants generally were unfamiliar with gynecologic cancer symptoms. Participants reported learning about the discussion topics from a variety of sources, including the mass media. CONCLUSIONS: Participants lacked critical knowledge needed to understand their gynecologic cancer risk and seek appropriate care. Pap tests and routine examinations offer ideal opportunities to educate women about the purpose of the Pap test as well as risk factors and symptoms associated with various gynecologic cancers. The reported influence of the mass media also supports the viability of multimedia educational strategies.

A national initiative for women and healthcare providers: CDC's Inside Knowledge: Get the Facts About Gynecologic Cancer campaign.

The Inside Knowledge: Get the Facts About Gynecologic Cancer campaign raises awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. It encourages women to pay attention to their bodies and know what is normal for them so they can recognize the warning signs of gynecologic cancers and seek medical care. This report provides an overview of the development of this national campaign.

Why the Pap test? Awareness and use of the Pap test among women in the United States.

OBJECTIVE: To inform campaign development by assessing awareness, previous receipt, and knowledge of the purpose of Papanicolaou (Pap) testing among women aged ≥ 18 years and to identify differences in awareness, receipt, and knowledge by demographic characteristics. METHODS: Data were analyzed from the 2008 HealthStyles survey, an annual mail survey conducted in the United States covering trends in health-related behavior. Women were asked questions on awareness, past use, and knowledge of the purpose of the Pap test and other gynecologic tests and procedures; 2991 women participated. RESULTS: Although 96.7% of the women had heard of and 93.0% reported having received a Pap test, these proportions were lower among those who were 18-34 years old and among those who had lower levels of education and income. Over 80% knew the Pap test was used to screen for cervical cancer, but 63.3% believed it also was used to screen for vaginal cancer (44.9%), sexually transmitted diseases (STDs) other than human papillomavirus (HPV) (41.7%), ovarian cancer (40.6%), and other cancers and infections. CONCLUSIONS: General familiarity and past receipt of the Pap test were high, but misconceptions about its purpose were prevalent. It is important that women understand what a routine Pap test is and is not capable of detecting so that signs and symptoms of gynecologic conditions other than cervical cancer may be recognized and addressed appropriately.

Evaluating the believability and effectiveness of the social norms message "most students drink 0 to 4 drinks when they party".

In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption.