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1.
ABSTRACT

Family cancer history (FCH) can shape prevention and early detection behaviors to decrease cancer risk. However, many individuals are unaware of increased risk for cancers based on family patterns. For some African-American communities, communication about FCH is rare and barriers have not been well studied. To optimize the use of FCH, it is crucial to understand how patients gather and share FCH with relatives and healthcare providers. We conducted four focus groups (n = 40) and seven key informant interviews (n = 9) to investigate knowledge, experiences, and barriers/promoters of FCH in the East Baltimore African-American community. Thematic analysis identified 14 distinct themes across six communication domains: participants’ understanding of FCH, past FCH communication with family and providers, barriers to FCH communication, promoters of FCH communication, suggestions for future communication, and community health priorities. FCH was most often defined by narratives of family cancer experiences, and the majority of participants had shared little FCH with family members. Five psychosocial domains were commonly reported as barriers to sharing FCH: fear/denial, pride/dignity, selflessness/self-sacrifice, cancer fatalism, and distrust/skepticism of medical care. Diagnosis/death and caregiving/social support promoted FCH communication and encouraged cancer prevention behaviors such as screening. Although most participants had experienced cancer in their families, communication about FCH was low and psychosocial barriers were common. Understanding these communication domains in minority populations is crucial to developing interventions to address disparities in cancer prevention and control, particularly where effective screening and care recommendations exist for those with positive family histories.  相似文献   

2.
Black women face the greatest breast cancer mortality burden of any racial or ethnic group in the United States. Breast cancer disparity is particularly pronounced in Chicago, where Black women were 62 percent more likely to die of breast cancer than their White counterparts in 2007. No work to date has examined views of disparity among a population living in the context of a large, well-documented, and grave health disparity. We examined (1) awareness of breast cancer disparities among Black women in Chicago; and (2) Black women’s perceptions of the causes of breast cancer disparity. Four focus groups with Black women were held in Chicago. Participants completed a brief survey about their views of breast cancer prior to the group discussion. In response to the survey question, “In your opinion, who is more likely to die from breast cancer?” 51 % of participants believed all women have the same chance of dying from breast cancer. In focus group discussions, participants placed responsibility for disparity on individual behaviors and community culture. Participants believed that disparity resulted from Black women’s lack of awareness of cancer screening and their failure to be screened or treated for breast cancer. The majority of participants were unaware of breast cancer mortality disparities. Moreover, while health researchers and professionals believe disparity in Chicago results from healthcare system inequalities, Black women largely viewed breast cancer disparity as a consequence of individual behaviors, knowledge and attitudes.  相似文献   

3.
Building on social science research examining the relationship between genetic knowledge, identity and the family this paper takes the cultural context of Cuba as a site for critical ethnographic engagement. The paper makes use of research working with a range of Cuban public and genetic professionals as part of a collaborative research project exploring the social and cultural context of health beliefs about breast cancer. It illuminates the contrasting ways in which genomic knowledge linked to an increased risk of breast cancer is perceived, communicated, and acted upon. It is argued that the particular meaning and significance of genetic risk linked to breast cancer in this context must be examined in relation to long standing institutional practices relating to public health care provision. The focus on 'the family' in the provision of Cuban health provides a particularly viable foundation for the expansion of what is described as 'community genetics', including the collation of family history details for common complex diseases such as breast cancer. Nevertheless specific public perceptions of risk related to breast cancer and the difficulties of discussing a diagnosis of cancer openly in the family point to the very specific challenges for the translation and application of predictive interventions in Cuba. In summary the dynamic interrelationship between public health, perceptions of risk or health beliefs about the causes of the disease and attitudes towards cancer diagnosis within the family point to both continuities and discontinuities in the way that genomic interventions linked to breast cancer are unfolding as part of a dynamic yet still ostensibly socialist project of health care in Cuba.  相似文献   

4.
Projects to reduce disparities in cancer treatment and research include collaborative partnerships and multiple strategies to promote community awareness, education, and engagement. This is especially needed in underserved areas such as the Mississippi Delta where more women are diagnosed at regional and distant stages of breast cancer. The purpose for this project was to increase the relatively low screening rate for African American women in the Mississippi Delta through a partnership between the Mississippi Network for Cancer Control and Prevention at The University of Southern Mississippi, The Fannie Lou Hamer Cancer Foundation and the Mississippi State Department of Health to decrease health disparities in breast cancer through increased awareness on self-early detection methods, leveraging resources to provide mammography screenings, and adequate follow-up with services and treatment for abnormal findings. Through this collaborative effort, over 500 women in three rural Mississippi Delta counties were identified, provided community education on early self-detection, and given appointments for mammography screenings within one fiscal year.  相似文献   

5.
Ethnic minorities who live in socioeconomically disenfranchised communities suffer disproportionately from many health problems including cancer. In an effort to reduce these disparities, many health-care practitioners and scholars have promoted "culturally competent" health education efforts. One component of culturally competent education is a grounded knowledge base. To obtain knowledge about the cancer-related ideas of members of one African American community, researchers conducted focus groups with public housing residents and used the findings to develop a five-part television news series about breast, prostate, and cervix cancers. We found that participants gathered information from the folk, popular, and professional health sectors and constructed their cancer-related ideas from this information. Furthermore, experiences of racism, sexism, and classism colored their beliefs and behaviors regarding the prevention, detection, and treatment of common cancers. For this community "cancer" represents a giant screen upon which individual fears and societal ethnic, political, and economic tensions are projected.  相似文献   

6.
7.
Ethnic minorities who live in socioeconomically disenfranchised communities suffer disproportionately from many health problems including cancer. In an effort to reduce these disparities, many health-care practitioners and scholars have promoted “culturally competent” health education efforts. One component of culturally competent eudcation is a grounded knowledge base. To obtain knowledge about the cancer-related ideas of members of one African American community, researchers conducted focus groups with public housing residents and used the findings to develop a five-part television news series about breast, prostate, and cervix cancers. We found that participants gathered information from the folk, popular, and professional health sectors and constructed their cancer-related ideas from this information. Furthermore, experiences of racism, sexism, and classism colored their beliefs and behaviors regarding the prevention, detection, and treatment of common cancers. For this community “cancer” represents a giant screen upon which individual fears and societal ethnic, political, and economic tensions are projected.  相似文献   

8.
9.
Minority and foreign-born women report lower rates of mammograms compared to non-Hispanic white, U.S.-born women, even though they have increased risk for developing breast cancer. We examine disparities in mammography across breast cancer risk groups and determine whether disparities are explained by socioeconomic factors. Propensity score methodology was used to classify individuals from the 2000, 2005, and 2010 National Health Interview Survey according to their risk for developing breast cancer. Logistic regression models were used to predict the likelihood of mammography. Compared to non-Hispanic white women, Mexicans, Asians and “other” racial/ethnic origins were less likely to have undergone a mammogram. After controlling for breast cancer risk, socioeconomic status and health care resources, Mexican, Cuban, Dominican, Central American, Black, and foreign-born women had an increased likelihood of receiving a mammogram. Using propensity scores makes an important contribution to the literature on sub-population differences in the use of mammography by addressing the confounding risk of breast cancer. While other factors related to ethnicity or culture may account for lower breast cancer screening rates in Asian and Mexican women, these findings highlight the need to consider risk, in addition to socioeconomic factors, that may pose barriers to screening in determining mammography disparities.  相似文献   

10.
OBJECTIVES: The purposes of this study were (1) to identify disparities between adults with developmental disabilities and non-disabled adults in health and medical care, and (2) to compare this pattern of disparities to the pattern of disparities between adults with other disabilities and adults without disabilities. METHODS: The authors compared data on health status, health risk behaviors, chronic health conditions, and utilization of medical care across three groups of adults: No Disability, Disability, and Developmental Disability. Data sources were the 2001 North Carolina Behavioral Risk Factor Surveillance System and the North Carolina National Core Indicators survey. RESULTS: Adults with developmental disabilities were more likely to lead sedentary lifestyles and seven times as likely to report inadequate emotional support, compared with adults without disabilities. Adults with disabilities and developmental disabilities were significantly more likely to report being in fair or poor health than adults without disabilities. Similar rates of tobacco use and overweight/obesity were reported. Adults with developmental disabilities had a similar or greater risk of having four of five chronic health conditions compared with non-disabled adults. Significant medical care utilization disparities were found for breast and cervical cancer screening as well as for oral health care. Adults with developmental disabilities presented a unique risk for inadequate emotional support and low utilization of breast and cervical cancer screenings. CONCLUSIONS: Significant disparities in health and medical care utilization were found for adults with developmental disabilities relative to non-disabled adults. The National Core Indicators protocol offers a sound methodology to gather much-needed surveillance information on the health status, health risk behaviors, and medical care utilization of adults with developmental disabilities. Health promotion efforts must be specifically designed for this population.  相似文献   

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