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BACKGROUND: Genital human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection among young adults ages 15-25 years in the United States (US). Although HPV vaccines are recommended for individuals ages through 26 years, vaccine completion rates remain substantially low. METHODS: Accordingly, our study utilized a comprehensive - Theoretical Domains Framework (TDF) of behavior change to systematically identify facilitators and barriers to catch-up HPV vaccinations. Five databases - Medline, Embase, CINAHL, ERIC, and PsycINFO were searched from January 2009 to July 2019 for empirical studies using quantitative and qualitative methods to assess HPV vaccine uptake among males ages 18-26 years within US college and university settings. The TDF analytic process included a content analysis using the mixed deductive-inductive approach to extract, analyze and categorize data into TDF domains/themes and sub-themes. RESULTS: Overall, 17 studies were selected for data extraction. We identified eleven key TDF domains that influenced HPV vaccination behavior among college male students: 'knowledge' (82% of included studies), 'environmental context and resources' (53%), 'beliefs about consequences' (53%), 'unrealistic optimism' (50%) and 'pessimism' (6%), 'emotion' (50%), 'social influences' (50%), 'beliefs about capabilities' (41%), 'intention' (24%), 'reinforcement' (18%), 'social professional role and identity'(12%), and 'behavioral regulation' (12%). Barriers influencing HPV vaccine uptake included lack of knowledge and awareness regarding HPV infections, HPV vaccine safety, effectiveness, side effects, and costs; absence of health providers' recommendations; lack of healthcare and health insurance; low levels of perceived susceptibility and severity for HPV infections; HPV vaccine misinformation; as well as social stigma and peer influences regarding HPV vaccinations. Enablers for HPV vaccine uptake included high levels of perceived benefits for HPV vaccines. DISCUSSION: Our study theoretically identified factors influencing HPV vaccinations. This could inform the efficient planning, support, and implementation of interventions that facilitate catch-up HPV vaccination practices among high-risk males within college/university settings.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Adulto Joven , Humanos , Masculino , Estados Unidos , Infecciones por Papillomavirus/prevención & control , Atención a la Salud , Vacunación/métodos , Estudiantes , Conocimientos, Actitudes y Práctica en SaludRESUMEN
OBJECTIVE: To describe rates and identify factors associated with human papillomavirus (HPV) vaccination among young adult males in college/university settings. METHODS: Study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched for empirical studies published between 2009 and 2019 and focused on predictors for HPV vaccine uptake. Studies' methodological quality scores ranged between 12 and 23 points. RESULTS: Five hundred and ninety eight titles/abstracts and 154 full-text articles were screened. Eighteen studies were included for final analysis. Results depicted participants' attitude, perceived susceptibility, severity, benefits, and barriers in receiving HPV vaccine. Many participants did not perceive themselves to be susceptible to HPV infection, and barriers to receiving HPV vaccine outweighed benefits. HPV knowledge and vaccination rates were relatively low among respondents. CONCLUSION: Prevention campaigns that increase knowledge, promote positive attitudes, change perception of susceptibility, and address barriers may result in higher HPV vaccination rates among males in college/university settings.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Humanos , Masculino , Adulto Joven , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/uso terapéutico , Aceptación de la Atención de Salud , Estudiantes , Universidades , VacunaciónRESUMEN
Co-infection with HIV/HPV and bio-behavioral risk factors (e.g., immunodeficiency, un-protected sex) increase likelihood for developing anal and other HPV-associated cancers among people living with HIV/AIDS (PLWHA). We explored knowledge, attitudes, and health communication regarding HPV-associated anal cancers among HIV/AIDS service organization (ASO) employees/volunteers delivering non-clinical services to PLWHA. Participants (n=59) were recruited from six ASOs located in the South United States Census region and completed a 118-item self-administered survey. For current analyses, outcome measures were knowledge, attitudes, and health communication regarding anal cancer. Descriptive statistics assessed outcome measures which were subsequently dichotomized into binary variables (i.e., high/favorable or low/unfavorable). Fisher's exact test examined associations between outcome measures and ASO employees/volunteers' sex/sexual orientation (i.e., heterosexual female, heterosexual male, LGBTI female, LGBTI male). Mean age for ASO employees/volunteers was 45.5 years (±13.5 SD). Participants were heterosexual females (45.7%), LGBTI males (27.3%), heterosexual males (13.5%), and LGBTI females (13.5%). Almost half (44.8%) had not heard about anal Pap screening and 39.0% did not think HPV can cause anal cancer. Overall, 73.9% had low knowledge scores. Participants (47.4%) were unsure or believed HPV vaccinations were non-protective against anal cancer while 94.9% had favorable health communication behaviors. Knowledge regarding anal cancer being linked to HPV (p=0.006) and health information seeking on anal cancer (p=0.000) were statistically significantly different by sex/sexual orientation. Fostering increased knowledge, favorable attitudes, and improved health communication behaviors among ASO employees/volunteers could facilitate dissemination and promotion of anal cancer prevention strategies (anal Pap screenings, HPV vaccinations) among PLWHA.
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Síndrome de Inmunodeficiencia Adquirida , Neoplasias del Ano , Comunicación en Salud , Infecciones por Papillomavirus , Femenino , Masculino , Humanos , Estados Unidos , Persona de Mediana Edad , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/complicaciones , Conocimientos, Actitudes y Práctica en Salud , Neoplasias del Ano/diagnósticoRESUMEN
Prolonged social isolation during the COVID-19 lockdown has adversely impacted the mental, social, and physical wellbeing of the global populace. Coping with mental and physical stressors amidst the global lockdown is especially strenuous for the Lesbian, Gay, Bisexual, Transgender, and more (LGBT+) community, who are frequently subjected to social stigma and minority stress. Systematic stigma and discrimination place LGBT+ individuals at higher risk for deleterious behaviors, such as substance abuse (e.g., injection drug use, smoking, alcohol) and risky sexual practices (e.g., anal/vaginal/oral sex). Maladaptive coping behaviors consequently increase the chances of HIV/AIDS risk among LGBT+ individuals, compared to heterosexual individuals. LGBT+ individuals Living with HIV/AIDS perpetually face higher rates of unemployment, income disparity, and intimate partner violence. Prolonged home confinement, and impaired accessibility to healthcare, legal, and criminal justice services during lockdown may deplete the quality of life of LGBT+ individuals Living with HIV/AIDS. Therefore, it is critical that multidisciplinary service providers, including health professionals, employers, social services providers, educational institutions and community organizations, move toward online service delivery, so that homebound HIV-positive LGBT+ individuals are secured with a wide range of care options. Non-judgemental, tele-counseling may bridge the gap to mental health services. Community clinics catering to HIV-positive and/or LGBT+ clients may consider precociously supplying essential amenities, such as Preexposure (PrEP)/postexposure prophylaxis (PEP), condoms, emergency contraception, and sterile needles. Lastly, efforts directed at the sustenance of at-risk/HIV-positive LGBT+ health should persevere, even after the pandemic.
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OBJECTIVES: To examine the potential moderating effects of explicit racial attitudes and implicit racial attitudes on the relationship between percent of Black county residents and COVID-19 cases and deaths. METHODS: We collected data from a variety of publicly available sources for 817 counties in the US. (26% of all counties). Cumulative COVID-19 deaths and cases from January 22 to August 31, 2020 were the dependent variables; explicit racial attitudes and implicit racial attitudes served as the moderators; subjective poor or fair health, food insecurity, percent uninsured, percent unemployed, median family income, percent women, percent of Asian county resident, percent of Hispanic county residents, and percent of people 65 or older were controls. RESULTS: The percent of Black county residents was positively associated with COVID-19 cases and deaths at the county level. The relationship between percent of Black residents and COVID-19 cases was moderated by explicit racial attitudes and implicit racial attitudes. CONCLUSIONS: Implicit racial attitudes can take on a shared property at the community level and effectively explain racial disparities. COVID-19 cases are highest when both the percent of Black county residents and implicit racial attitudes are high.
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Actitud/etnología , COVID-19/etnología , COVID-19/mortalidad , Grupos Raciales/psicología , Grupos Raciales/estadística & datos numéricos , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Humanos , Características de la Residencia/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
This study describes knowledge and attitude/beliefs about HPV-associated oropharyngeal cancer among non-clinical staff, at community-based HIV/AIDS Service Organizations (ASOs) located in the Southern U.S. states of South Carolina and Texas. It also explores the difference in knowledge and attitude/beliefs between Texas-based (n = 21) and South Carolina-based (n = 30) ASO staff. The ASOs in our study provide comprehensive HIV prevention, supportive and care services to individuals living with HIV/AIDS or at risk for HIV/AIDS, through partnerships and collaborations. We collected data from the two Texas-based ASOs in 2018 and the three South Carolina-based ASOs in 2016 via a 118-item, self-administered needs assessment survey. Data were analysed using Stata/SE 15.1. Over half the study participants were females (59%), black (78%), heterosexual (61%) and mean age (years) 44.2 ± 12.8 SD. Most participants (73%) believed that quitting smoking positively impacts health. Alarmingly though, only 32% were aware about HPV as a risk factor for oropharyngeal cancer, and over half (53%) were unsure about the success of the HPV vaccine in preventing oropharyngeal cancer. In addition, there were no statistically significant differences observed in the oropharyngeal cancer-related knowledge and attitudes/beliefs, between ASOs in Texas and South Carolina. ASO staff work closely with people living with HIV (PLWH), who are disproportionately affected by HPV-associated cancers. The low/poor knowledge and attitudes/beliefs regarding the role of HPV in causing oropharyngeal cancer ascertain the need for equipping community health workers with adequate education/training that improves their knowledge and attitudes/beliefs about the role of HPV in causing various forms of cancer.
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Agentes Comunitarios de Salud/psicología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Neoplasias Orofaríngeas/prevención & control , Infecciones por Papillomavirus/prevención & control , Adulto , Concienciación , Censos , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Neoplasias Orofaríngeas/epidemiología , Infecciones por Papillomavirus/epidemiología , Factores de Riesgo , Encuestas y Cuestionarios , Estados UnidosRESUMEN
To describe non-clinical HIV service providers (NCHSPs) as surrogate seekers and health information mavens for people living with HIV (PLWH), men who have sex with men (MSM), and other vulnerable populations.In May/June 2016, we recruited 30 NCHSPs from three community-based HIV/AIDS service organizations. NCHSPs completed a 118-item self-administered, paper-and-pencil survey about HPV, cancer, and health communication. Data were analyzed using Stata/SE 14.1.Almost all (97%) NCHSPs were surrogate seekers and had looked for HIV/AIDS (97%), STD (97%), and cancer (93%) information. Most (60%) cancer information seekers had looked for information about HPV. The Internet (97%) and healthcare providers (97%) were health information sources almost all NCHSPs trusted. Nearly all NCHSPs (93%) were completely or very confident about their ability to find health information. The mean health information mavenism score (17.4 ± 2.1) was significantly higher than the scale's high-score cutoff (15.0) (p < 0 .001).NCHSPs look for and share health information with the vulnerable populations (e.g., PLWH, MSM) they serve. More research is needed to understand what NCHSPs' know and think about the health information they are sharing with vulnerable populations.
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Servicios de Salud Comunitaria/organización & administración , Infecciones por VIH/terapia , Comunicación en Salud/métodos , Neoplasias/prevención & control , Infecciones por Papillomavirus/complicaciones , Adulto , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Conducta en la Búsqueda de Información , Masculino , Persona de Mediana Edad , Neoplasias/virología , Relaciones Profesional-Paciente , Medición de Riesgo , South Carolina , Encuestas y Cuestionarios , Poblaciones Vulnerables/estadística & datos numéricosRESUMEN
Although diabetes education plays an important role in self-management for people living with diabetes, male health "help-seeking" lags far behind women. These gender-related "help-seeking" disparities often result in males being less engaged in their health care, which subsequently leads to poorer health outcomes among males. In this cross-sectional study, we used data from the 2017 Health Information National Trends Survey (HINTS) to identify factors that may contribute to communication inequalities between males and females. A hierarchical {linear/logistic} regression model was used to examine factors associated with online health information seeking among males living with diabetes. The results suggest that education, income, age, identifying as Hispanic, being a smoker, using a device to track progress toward a health-related goal, and using device to seek health information were all related to eHealth sum scores. Future research should consider testing applications among various at-risk groups to determine if the technology itself is becoming a barrier to eHealth.
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Enfermedad Crónica , Conducta en la Búsqueda de Información , Salud del Hombre , Telemedicina , Adolescente , Adulto , Anciano , Estudios Transversales , Humanos , Almacenamiento y Recuperación de la Información , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To examine providers' HPV vaccine communication among adult cigarette smokers with household members aged ≤26 years. METHODS: In this cross-sectional study, we used 2017 Health Information National Trends Survey (HINTS 5, Cycle 1; N = 3191) data to derive a subsample (n = 725/3191; 22.7%) of adults with household members aged ≤26 years. Forward stepwise multivariable logistic regression analyses were performed to examine providers' HPV vaccine communication, adjusting for patients' smoking status (main independent variable); HPV awareness and knowledge; HPV vaccine awareness and beliefs; and sociodemographic characteristics that contribute to disparities in HPV vaccine coverage. RESULTS: Current/former smokers (35.0%) had lower HPV-related awareness/knowledge than nonsmokers (65%). Few reported providers discussed (27.4%) or recommended (24.0%) HPV vaccine. Non-Hispanic Whites who knew HPV was a sexually transmitted disease and heard of HPV vaccine were 2-6 times more likely to report provider HPV vaccine communication. Provider HPV vaccine communication differences by smoking status were not statistically significant. CONCLUSION: Providers' HPV vaccine communication was higher among adults who had higher HPV-related awareness/knowledge. Although active/passive exposure to cigarette smoke increases cervical cancer risk, providers' HPV vaccine communication was not increased for current/former smokers. PRACTICE IMPLICATIONS: Current/former smokers' HPV-related awareness/knowledge and providers' HPV vaccine communication need to be increased.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Productos de Tabaco , Adulto , Anciano , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Humanos , Infecciones por Papillomavirus/prevención & control , Fumadores , VacunaciónRESUMEN
Breast and cervical cancer screening are associated with dramatically reduced cancer mortality. Mental illnesses have been demonstrated to influence preventative behaviours. This study aims to explore whether anxiety or depressive symptoms is associated with breast and cervical cancer screening. We analyzed data (n = 3104) from the 2013 Brazos Valley Community Health Assessment. The GAD-7 Scale was used to assess the anxiety level, and PHQ-2 was used to assess the depressive symptoms. Stata 15.0 statistical software was used to perform descriptive and logistic regression analysis. Overall, 80.61% of women in each sample met breast cancer or cervical cancer screening guidelines, respectfully. Anxiety was associated with missing breast and cervical cancer screening, but the association was only significant for cervical cancer (OR = 1.430, CI = 1.009, 2.026), not for breast cancer (OR = 1.406, CI = .952, 2.078). Depressive symptom was significantly associated with missing breast (OR = 1.502, CI = 1.051, 2.149) and cervical (OR = 1.689, CI = 1.208, 2.362) cancer screening after controlling for demographics. Women with depressive symptoms and anxiety had higher odds of missing breast and cervical cancer screening. Health promotion programs should consider targeting individuals with anxiety and depression to improve cancer-screening rates..
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Ansiedad/epidemiología , Neoplasias de la Mama/diagnóstico , Depresión/epidemiología , Detección Precoz del Cáncer/estadística & datos numéricos , Mamografía/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , Texas/epidemiologíaRESUMEN
[This corrects the article DOI: 10.2196/12521.].
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BACKGROUND: The number of patient online reviews (PORs) has grown significantly, and PORs have played an increasingly important role in patients' choice of health care providers. OBJECTIVE: The objective of our study was to systematically review studies on PORs, summarize the major findings and study characteristics, identify literature gaps, and make recommendations for future research. METHODS: A major database search was completed in January 2019. Studies were included if they (1) focused on PORs of physicians and hospitals, (2) reported qualitative or quantitative results from analysis of PORs, and (3) peer-reviewed empirical studies. Study characteristics and major findings were synthesized using predesigned tables. RESULTS: A total of 63 studies (69 articles) that met the above criteria were included in the review. Most studies (n=48) were conducted in the United States, including Puerto Rico, and the remaining were from Europe, Australia, and China. Earlier studies (published before 2010) used content analysis with small sample sizes; more recent studies retrieved and analyzed larger datasets using machine learning technologies. The number of PORs ranged from fewer than 200 to over 700,000. About 90% of the studies were focused on clinicians, typically specialists such as surgeons; 27% covered health care organizations, typically hospitals; and some studied both. A majority of PORs were positive and patients' comments on their providers were favorable. Although most studies were descriptive, some compared PORs with traditional surveys of patient experience and found a high degree of correlation and some compared PORs with clinical outcomes but found a low level of correlation. CONCLUSIONS: PORs contain valuable information that can generate insights into quality of care and patient-provider relationship, but it has not been systematically used for studies of health care quality. With the advancement of machine learning and data analysis tools, we anticipate more research on PORs based on testable hypotheses and rigorous analytic methods. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42018085057; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=85057 (Archived by WebCite at http://www.webcitation.org/76ddvTZ1C).
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Personal de Salud/normas , Médicos/normas , Calidad de la Atención de Salud/normas , Femenino , Humanos , Masculino , Encuestas y CuestionariosAsunto(s)
Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus/prevención & control , Educación del Paciente como Asunto/métodos , Neoplasias del Cuello Uterino/prevención & control , Centers for Disease Control and Prevention, U.S. , Femenino , Humanos , Narración , Evaluación de Programas y Proyectos de Salud , Estados UnidosRESUMEN
Background: People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and, men who have sex with men (MSM) are disproportionately affected by genital warts and cancers caused by human papillomavirus (HPV). We assessed community-based HIV/AIDS service organizations' (ASOs) staff awareness, knowledge, attitudes, and beliefs about HPV and effective cancer prevention tools, namely HPV vaccination, Pap, and HPV tests. The potential engagement of ASO staff in future efforts to reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM was explored. Methods: In May-June 2016, staff were recruited from three ASOs located in the South United States Census region-a geographical area disproportionately affected by HIV/AIDS. Participants completed a 30-min self-administered, 118-item paper and pencil survey about HPV and cancer. Data analysis was conducted using Stata/SE 14.2. Results: ASO staff (n = 30) were 83% non-Hispanic Black, 40% lesbian/gay, and worked with people living with HIV for an average of 11.4 ± 7.7 years. All reported hearing of HPV and 77% had heard of the HPV vaccine (n = 23). While all knew HPV can cause cervical cancer, only 67% knew HPV can cause anal cancer. Most (61%) thought the HPV vaccine could prevent cervical cancer. Fewer (39-48%) thought the HPV vaccine could prevent anal, oral, penile, vaginal, and vulvar cancers. All were willing to encourage MSM and female clients to talk to a healthcare provider about HPV vaccination. Almost all were willing to promote HPV vaccination to clients (91-95%) and navigate clients to adult safety net HPV vaccine providers (86-95%). More than half (59-67%) thought they could positively influence their MSM and female clients' HPV vaccine decision-making. Conclusion: HPV vaccination and the Pap and HPV tests are effective cancer prevention tools that can reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM. Engaging ASO staff in cancer prevention efforts may increase HPV vaccination rates and early detection of HPV-related cancers among HIV-positive women and MSM. Exploring ASOs as community-based settings for promoting effective cancer prevention tools may foster opportunities to reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM.
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The objective of this study is to examine the relationship between health literacy, health-care engagement, and shared decision-making (SDM). We analyzed Health Information National Trends Survey 4 (cycle 3) data for 1604 information seekers who had one or more non-emergency room health-care visits in the previous year. SDM was more than two times higher among adults who "always" versus "usually/sometimes/never" take health information to doctor visits (OR = 2.54; 95 % CI 1.19-5.43). There was a twofold increase in SDM among adults who were "completely/very confident" versus "somewhat/a little/not confident" about finding health information (OR = 2.03; 95 % CI 1.37-3.02). Differences in SDM between adults who understood health information and those who had difficulty understanding health information were not statistically significant (OR = 1.39; 95 % CI 0.93-2.07). A Healthy People 2020 goal is to increase SDM. Previous research has suggested that SDM may improve health outcomes across the continuum of care. Only about half of adults report always being involved in health-care decisions. Even more alarming is the fact that SDM has not increased from 2003 to 2013. Our findings suggest that increasing health literacy has the potential to increase health-care engagement and subsequently increase SDM. Effective intervention strategies are needed to improve health literacy and promote health-care engagement.
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Toma de Decisiones , Alfabetización en Salud , Conducta en la Búsqueda de Información , Participación del Paciente , Adulto , Análisis de Datos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Encuestas de Atención de la Salud , Encuestas Epidemiológicas , Humanos , Masculino , Estados UnidosRESUMEN
In this article, the authors examine communication between women living with human immunodeficiency virus (WLH) and health care providers (HCPs) regarding abnormal Pap tests. During the period of March 2011 through April 2012, 145 WLH were recruited from Ryan White funded clinics and community-based AIDS service organizations located in the southeastern United States. WLH who had an abnormal Pap test (69%, n = 100/145) were asked if their HCP shared and explained information about abnormal Pap tests. The authors performed chi-square tests and multivariable logistic regression analyses using Stata I/C 13. HCPs shared information about abnormal Pap tests with 60% of participants, and explained the information they shared to 78% of those. Health literate participants were more than three times as likely to have read the information received about abnormal Pap tests (adjusted odds ratio [aOR] = 3.49, 95% confidence interval [CI] 1.19-10.23), and almost five times as likely to have understood the cancer information they read (aOR = 4.70, 95% CI 1.55-14.24). Knowing other women who had had an abnormal Pap test was not significantly associated with cancer information seeking or processing after controlling for confounding factors. The present findings underscore the need to increase WLH's health literacy as an intermediate step to improving patient-provider communication among WLH. Lay sources of cancer information for WLH warrant further study.
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Comunicación , Infecciones por VIH/complicaciones , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo , Cooperación del Paciente , Neoplasias del Cuello Uterino/prevención & control , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Humanos , Conducta en la Búsqueda de Información , Prueba de Papanicolaou , Relaciones Profesional-Paciente , Población Rural , Fumar/epidemiología , Población Urbana , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Frotis VaginalRESUMEN
Cancer is a leading cause of death among adults in the United States. Only 54% of U.S. adults reported seeking cancer information in 2014. Cancer information seeking has been positively associated with cancer-related health outcomes such as screening adherence. We conducted a scoping review of studies that used data from the Health Information National Trends Survey (HINTS) in order to examine cancer information seeking in depth and the relationship between cancer information seeking and cancer-related health outcomes. We searched five databases and the HINTS website. The search yielded a total of 274 article titles. After review of 114 de-duplicated titles, 66 abstracts, and 50 articles, 22 studies met inclusion criteria. Cancer information seeking was the outcome in only four studies. The other 18 studies focused on a cancer-related health outcome. Cancer beliefs, health knowledge, and information seeking experience were positive predictors of cancer information seeking. Cancer-related awareness, knowledge, beliefs, preventive behaviors, and screening adherence were higher among cancer information seekers. Results from this review can inform other research study designs and primary data collection focused on specific cancer sites or aimed at populations not represented or underrepresented in the HINTS data (e.g., minority populations, those with lower socioeconomic status).
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Información de Salud al Consumidor , Conducta en la Búsqueda de Información , Neoplasias/psicología , Neoplasias/terapia , Encuestas Epidemiológicas , Humanos , Resultado del Tratamiento , Estados UnidosRESUMEN
Cervical cancer prevention/control efforts among women living with HIV/AIDS (WLH) are socially and structurally challenging. Healthcare access and perceived HIV stigma and discrimination are factors that may challenge risk reduction efforts. This study examined socio-structural determinants of cervical cancer screening among women engaged in HIV care. One hundred forty-five WLH seeking health/social services from AIDS Service Organizations in the southeastern US completed a questionnaire assessing factors related to cervical cancer prevention/control. Ninety percent were African American, mean age 46.15 ± 10.65 years. Eighty-one percent had a Pap test <1 year ago. Low healthcare access was positively associated with having a Pap test <1 year ago, (Odds ratio [OR] 3.80; 95 % Confidence interval [CI] 1.34-10.78). About 36 % reported ≥2 Pap tests during the first year after HIV diagnosis. Lower educational attainment was positively associated with having ≥2 Pap tests, OR 3.22; CI 1.08-9.62. Thirty-five percent reported more frequent Pap tests after diagnosis. Lower income was moderately associated with more frequent Pap tests post-diagnosis, OR 2.47; CI .98-6.23. Findings highlight the successes of HIV initiatives targeting socio-economically disadvantaged women and provide evidence that health policy aimed at providing and expanding healthcare access for vulnerable WLH has beneficial health implications.
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Infecciones por VIH/complicaciones , Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Prueba de Papanicolaou/estadística & datos numéricos , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal/estadística & datos numéricos , Adulto , Negro o Afroamericano/estadística & datos numéricos , Anciano , Fármacos Anti-VIH/uso terapéutico , Discriminación en Psicología , Detección Precoz del Cáncer , Escolaridad , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Humanos , Persona de Mediana Edad , Pobreza , Estigma Social , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/etnología , Neoplasias del Cuello Uterino/prevención & control , Adulto JovenRESUMEN
OBJECTIVE: Mammography is the most effective method to detect breast cancer in its earliest stages, reducing the risk of breast cancer death. We investigated the relationship between accessibility of mammography services at Federally Qualified Health Centers (FQHCs) and mortality-to-incidence ratio (MIR) of breast cancer in each county in the United States. METHODS: County-level breast cancer mortality and incidence rates in 2006-2010 were used to estimate MIRs. We compared breast cancer MIRs based on the density and availability of FQHC delivery sites with or without mammography services both in the county and in the neighboring counties. RESULTS: The relationship between breast cancer MIRs and access to mammography services at FQHCs differed by race and county of residence. Breast cancer MIRs were lower in counties with mammography facilities or FQHC delivery sites than in counties without a mammography facility or FQHC delivery site. This trend was stronger in urban counties (p=0.01) and among whites (p=0.008). Counties with a high density of mammography facilities had lower breast cancer MIRs than other counties, specifically in urban counties (p=0.01) and among whites (p=0.01). Breast cancer MIR for blacks was the lowest in counties having mammography facilities; and was highest in counties without a mammography facility within the county or the neighboring counties (p=0.03). CONCLUSIONS: Mammography services provided at FQHCs may have a positive impact on breast cancer MIRs. Expansion of services provided at the FQHCs and placement of FQHCs in additional underserved areas might help to reduce cancer disparities in the United States.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Mamografía , Servicios Preventivos de Salud/organización & administración , Proveedores de Redes de Seguridad/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Neoplasias de la Mama/etnología , Neoplasias de la Mama/mortalidad , Femenino , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Incidencia , Área sin Atención Médica , Características de la Residencia , Población Rural , Factores Socioeconómicos , Estados Unidos/epidemiología , Población Urbana , Población Blanca/estadística & datos numéricosRESUMEN
The United States incarcerates more people per capita than any other nation. Studies have consistently demonstrated higher prevalence of serious mental illness among the incarcerated. Although health care may be available to individuals while incarcerated, research is needed to understand the context of health care coverage and mental health after incarceration. The purpose of this study is to estimate the point prevalence of psychological distress (PD) among young adults with incarceration experience, while comparing the prevalence to that of young adults in the general population. Additionally, this study characterizes the relationship between incarceration experience and PD, while also examining this association given an individual's health insurance coverage status among young adults. Lastly, we examine if other individual, contextual, and behavioral factors influences the relationship between incarceration experience and PD, in addition to their health insurance coverage status. This study utilizes data from the 2008 panel of the National Longitudinal Survey of Youth 97, a population based survey dataset from the U.S. Department of Labor. Andersen's Behavioral Model of Health Services Use provided the conceptual framework for the study. The Mental Health Index 5 (MHI-5) was used to determine PD or normal mental health. Chi-square testing and multivariate logistic regression were performed to examine incarceration experience in association to PD. The sample with incarceration experience reported almost double the proportion of PD (21%) compared to those without an incarceration experience (11%). Young adults who have been incarcerated reported greater odds of PD than those with no incarceration experience (COR 2.18; 95% CI, 1.68-2.83) and the association was diminished in the presence of health insurance status and model covariates. Future health prevention and health management efforts should consider the impact of health insurance coverage status, health behaviors, and life satisfaction on mental health status among young adults with incarceration experience.