Feminine Gender Role and Illness Behavior in Irritable Bowel Syndrome

The purpose of this study was to investigate the relationship between aspects of the feminine gender role and modes of illness behavior in patients with irritable bowel syndrome (IBS). Fifty IBS patients (34 women and 16 men) completed the Personal Attributes Questionnaire (PAQ), which assesses aspects of gender role, and the Illness Behavior Questionnaire (IBQ), which assesses components of illness behavior. The Communal Femininity subscale of the PAQ, which is characterized by traits of servility and subordination, showed a significant positive correlation with the Disease Conviction subscale of the IBQ, which is characterized by symptom preoccupation and rejection of physician reassurance (r = .55; p < .001). The Communal Femininity subscale of the PAQ also correlated positively with the General Hypochondriasis subscale of the IBQ, which is characterized by a high level of anxiety over one's state of health (r = .55; p < .001). These results suggest that characteristics of the feminine gender role, such as the nurturing of others before oneself, may influence the experience of physical symptoms by contributing to a heightened focus on physiological cues and by increasing levels of psychosocial stress.     

Peer Reviewed: Collaboration to Increase Colorectal Cancer Screening Among Low-Income Uninsured Patients

Background

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. CRC screening allows for prevention through the removal of precancerous lesions and early detection of cancer.

Community Context

Ride for Life Alaska (RFL), a nonprofit organization that raises funds to fight cancer, and the Anchorage Neighborhood Health Center (ANHC), which is Alaska''s largest community health center, joined efforts to provide CRC screening and outreach to an ethnically diverse group of low-income underinsured or uninsured patients residing in and around Anchorage, Alaska.

Methods

RFL and ANHC worked with gastroenterologists, medical practices, and pathology services to contribute pro bono and reduced-fee services for CRC screening. Information to patients was distributed through signs in the clinic, flyers, and the ANHC website.

Outcomes

CRC screening was increased in this population. During 2007-2009, there were 2,561 immunochemical fecal occult blood tests given to patients, and 1,558 were completed (61%); 24% were positive. Sixteen gastroenterologists, 4 medical practices, and 2 laboratories provided 111 follow-up colonoscopies and pathology services to patients identified through the CRC screening program who did not have other funding resources available for follow-up care.

Interpretation

This program provides a model for leveraging scarce screening resources by drawing on multiple partners to increase CRC screening. Recommendations for those seeking to initiate similar programs are to have memoranda of agreement in place and a clear scope of work for all participating people and organizations to avoid delays in program implementation; hire a screening care coordinator to manage patient care and collaborate with medical practices; and identify program champions who have the energy and persistence to craft such partnerships.     

Colorectal Cancer Screening Among Chinese American Immigrants

The purpose of this study was to examine the factors determining fecal occult blood test (FOBT) uptake in Chinese American immigrants. This study used a prospective, cross-sectional design with convenience sampling. An educational session on colorectal cancer screening (CRS) was provided to the participants during a health fair, and each participant was offered a no-cost FOBT kit. Data was collected over two consecutive years during three different health fairs. A questionnaire was used to collect demographic data. A total of 113 participants were recruited and 72% of them returned the FOBT kit. There was a significant association between having a primary-care physician (PCP) and having CRS in the past, even after controlling for age, gender and the length of time in the US (P = .009). Participants who visited a doctor for health maintenance were less likely to participate in the FOBT, compared to participants who never visited a doctor or who only visited a doctor when they were sick (P = .001). The length of time in the US had a significant effect on having a PCP (P = .002). However, having a PCP or having CRS in the past was not associated with participating in the screening and so was feeling at risk for CRC. In fact, 49% of Chinese women and 45% of Chinese men felt no risk of CRC. Future research and interventions that address knowledge deficits and focus on recent immigrants and their access to health care may have the potential to increase CRS among Chinese American immigrants.     

Gender Differences and Risk of Arrest Among Offenders with Serious Mental Illness

Despite the increasing number of men and women with serious mental illness (SMI) incarcerated in America's jails, little research exists on the role gender may play in arrest among persons with SMI. This study examined correlates of arrests among offenders with SMI, specifically the role of gender. County criminal justice records, as well as county and statewide social service archival databases, were used to identify jail inmates with SMI in a large urban county in Florida. Of the 3,769 inmates identified, 41% were female. This study identified three distinct classes of male and female offenders within which persons had similar trajectories of arrests over the 4-year study period representing those with minimal, low, and high arrest rates. Findings suggest some important differences between women and men in risk factors for re-arrests. Attention to these factors may improve the ability to prevent future recidivism among men and women with SMI.     

The Combined Influence of Psychosocial Factors on Illness Behavior Among Women

Distinctions in illness behavior for women, such as use of health services, may result from gender-specific biological risks for disease but could also be explained by the relationships among social, psychological, and behavioral factors. The purpose of this study was to determine if illness behavior in women might be related to associations among social support satisfaction, perceived health status, coping skills, and perceived stress. Data were collected November–December 2005 from 205 female college students through self-report using questionnaires. Structural equation modeling was used to test relationships among psychosocial factors. The final model revealed associations between psychosocial factors and illness behavior for women along two paths. First, high perceived stress and poor perceived health status were associated with more reported illness behavior. Second, greater use of total coping skills, greater social support satisfaction, and good perceived health status were associated with less reported illness behavior. Consideration of multiple health-related factors may provide a more complete picture of how psychosocial factors are related to illness behavior for women. Specifically, interactions among stress, coping, social support, and perceived health status may be important to women’s health. Our results suggest that interventions should focus on skill-building and strategies to improve self-perception of health.     

青少年性知识态度和行为的性别差异

目的　系统分析中学生性知识、态度及行为的性别差异 ,为开展青少年性教育提供一定的参考依据。　方法对陕西省西乡县高中一、二年级的学生进行问卷调查。　结果　男生知识总分高于女生。男女生知识获得的主要途径基本相同 ,大多数来自医学书刊和生理卫生课。男生知识来源较女生广泛 ,尤其来源于录像和街头广告明显多于女生 ;女生知识来源于家庭明显多于男生。除了在中学生谈恋爱上男女均持较宽容的态度外 ,在其它性态度上 ,男生明显比女生开放。男女生性行为的发生率无显著性差异 ( 4 .5 %和 2 .4 % ) ,但其它与性有关的行为男生多于女生。　结论　青少年在性知识、态度和行为以及对性教育的需求上确实存在性别上的差异 ,在对青少年进行性教育的过程中应考虑到这一点     

Correlates of Colorectal Cancer Screening Among Residents of Ohio Appalachia

There is an excess burden of colorectal cancer (CRC) in the Appalachian region of the United States, which could be reduced by increased uptake of CRC screening tests. Thus, we examined correlates of screening among Appalachian residents at average-risk for CRC. Using a population-based sample, we conducted interviews with and obtained medical records of Appalachian Ohio residents 51–75 years between September 2009 and April 2010. Using multivariable logistic regression, we identified correlates of being within CRC screening guidelines by medical records. About half of participants were within CRC screening guidelines. Participants who were older (OR = 1.04, 95 % CI 1.01, 1.07), had higher income ($30,000–$60,000, OR = 1.92, 95 % CI 1.29, 2.86; ≥$60,000, OR = 1.80, 95 % CI 1.19, 2.72), a primary care provider (OR = 4.22, 95 % CI 1.33, 13.39), a recent check-up (OR = 2.37, 95 % CI 1.12, 4.99), had been encouraged to be screened (OR = 1.57, 95 % CI 1.11, 2.22), had been recommended by their doctor to be screened (OR = 6.68, 95 % CI 3.87, 11.52), or asked their doctor to order a screening test (OR = 2.24, 95 % CI 1.36, 3.69) had higher odds of being screened within guidelines in multivariable analysis. Findings suggest that access to and utilization of healthcare services, social influence, and patient–provider communication were the major factors associated with CRC screening. Researchers and healthcare providers should develop and implement strategies targeting these barriers/facilitators to improve CRC screening rates and reduce the CRC burden among residents of Appalachia.     

Colorectal Cancer Screening Among Korean Americans: A Systematic Review

The incidence of colorectal cancer (CRC) among Korean Americans (KAs) has increased in recent years, even as the rate in nearly ever other population group in the United States has decreased. Reversing this trend will require improving screening rates, but a variety of sociocultural factors may inhibit this goal. We conducted a systematic review of the published literature on cancer screening among KAs, and identified thirteen eligible studies that examined CRC screening. KAs have CRC screening rates that are significantly lower than the national average. Only about one in four KAs ages 50 and older reports having ever had a fecal ocult blood test (FOBT) and only about 40 % have ever had a sigmoidoscopy or colonoscopy. KA adults are also significantly less likely than the general US population to say they have heard of FOBT, sigmoidoscopy, or colonoscopy. In the KA population, screening rates are higher among adults with higher socioeconomic status, greater acculturation to the United States, more cancer knowledge, more social support, and better access to healthcare services. Improving cultural and financial access to health education and healthcare services may increase CRC screening among KAs and reduce the incidence of the disease.     

The Influence of Gender on Colorectal Cancer Knowledge,Screening Intention,Perceived Risk and Worry Among African Americans in South Florida

The aim of this study was to examine if gender differences exist for colorectal cancer (CRC) knowledge, intention to screen, perceived risk and cancer worry among African Americans for CRC. African American males and females (N = 336) aged 45 years or older living in southeast Florida were recruited to participate in a cross-sectional survey that assessed intentions to screen as well as CRC knowledge, cancer worry, perceived risk. No significant differences were found between men and women in their intention to screen for CRC or in their worry about cancer. Results did suggest that men and women differed significantly about their understanding of CRC knowledge. Findings also showed that there were differences in perceived risk between genders, with female study participants possessing lower levels of risk than men. Study results suggest that future interventions need to ensure that females understand their risk for CRC and understand the benefits associated with CRC screening. Findings also suggest that interventions promoting CRC screening may need to be tailored if increased participation in CRC screening is to be achieved for women.     

Assessing Colorectal Cancer Knowledge Among Puerto Rican Hispanics: Implications for Cancer Prevention and Control

In Puerto Rico, colorectal cancer (CRC) incidence and mortality rates are increasing. Moreover, adherence rates to CRC screening (52.2%) are still below the goals (70.5%) established by Healthy People 2020. Lack of knowledge is described as a significant barrier to adherence to CRC screening. The aim of this study was to assess CRC knowledge and screening rates among Puerto Rican Hispanics. Participants aged 40–85 years were recruited from the internal medicine outpatient clinics at the University of Puerto Rico. Demographic characteristics and knowledge about CRC, including risk factors and CRC screening tests, were obtained through face-to-face interviews. A mean CRC knowledge score was calculated based on correct responses to 13 validated questions. Mean knowledge scores were evaluated according to demographic characteristics using the Wilcoxon-Mann-Whitney test. A total of 101 participants were recruited with mean age of 63 (±10.6) years. Fifty-eight (58%) of participants were females, 59% reported ≥12 years of education, and 71% reported ever screening for CRC. The mean CRC knowledge score was significantly lower (p?<?0.05) among participants with lower annual family income, those who had never received a recommendation for CRC screening by a healthcare provider, and those who had no history of CRC screening. Knowledge about CRC must be improved in Puerto Rico. Efforts must be made to promote and develop culturally appropriate CRC educational strategies. Future studies should focus on identifying other barriers and factors that may limit CRC screening in the Puerto Rican Hispanic population.