To explore knowledge, attitudes, beliefs, and practices regarding breast cancer detection practic... more To explore knowledge, attitudes, beliefs, and practices regarding breast cancer detection practices among South Asian women. Descriptive exploratory design. Toronto, Ontario, Canada. 57 South Asian women, age 40 and over, who are first generation immigrants from India and Pakistan and speak one of the four languages identified for the study--Hindi, Punjabi, Gujarati, or Urdu. An interview guide was designed specifically for this study. It contained questions regarding knowledge, attitudes, beliefs, and practices about breast self-examination (BSE), clinical breast examination (CBE), and mammogram. In addition, questions assessing the variables of the Health Belief Model and health motivations also were included. The data were obtained during face-to-face interviews in the primary language of the participating woman. The interviews were transcribed and translated into English. 12% of the participants practiced BSE monthly, 49% had undergone at least one CBE during their lives, and 47% had never had a mammogram. The majority (54%) said they did not know very much about breast cancer. While 21% of the women said detecting cancer early was important, only 5% reported that cancer could be cured. Age, education, or mother tongue showed no statistically significant relationship with the breast health practice scores. However, proficiency with the English language (p = 0.009) and number of years in Canada (p = 0.009) had a significant relationship with the breast health practice scores. The significant explanatory factor for the variable breast health practices was a cue to action (p = 0.009). South Asian women with minimal knowledge of breast cancer did not engage in breast cancer detection practices. This segment of the population of immigrant women needs to be better informed about breast cancer and the benefits of breast cancer detection practices.
Breast cancer is the most common cancer among women in the United States. Knowledge of the descri... more Breast cancer is the most common cancer among women in the United States. Knowledge of the descriptive epidemiology of breast cancer is useful both in suggesting etiologic hypotheses and, if preventive measures can be identified, in delineating high-risk groups to be targeted for preventive efforts. Demographic risk factors include increasing age (in Western countries), being white for breast cancer diagnosed at age 45 years or more, being black for breast cancer diagnosed at less than 40 years of age, high socioeconomic status, having never married, being of the Jewish faith, urban residence, and residence in the northern (as compared with the southern) United States. Incidence rates are generally highest in North American and Northern European countries, intermediate in Southern and Eastern European and South American countries, and lowest in Asia and Africa. The most notable characteristic of the descriptive epidemiology of breast cancer in recent years is perhaps the rapidly increasing incidence rates in developing countries. Identification of specific reasons for these increasing rates would contribute substantially to our understanding of the epidemiology of breast cancer.
Awareness of hereditary breast cancer genetic testing, of breast cancer risk factors, and of incr... more Awareness of hereditary breast cancer genetic testing, of breast cancer risk factors, and of increased level of risk based on family history are necessary before women can seek out genetic services. The aim of this paper is to describe the relationships between family history of breast cancer and awareness of genetic testing, knowledge of breast cancer risk factors, and perceived lifetime risk of breast cancer. An anonymous survey was administered by mail to a random sample of 600 women, 200 from each of three breast cancer family history groups (none, intermediate, and strong), drawn from a population-based registry of 240,000 women enrolled in a mammography screening program in the Denver Metropolitan area in Colorado. Awareness of genetic testing for breast cancer risk assessment was found to be significantly associated with family history of breast cancer, increasing from 35% in the lowest family history risk group to 67% in the group with the strongest familial risk (p = 0.002). In all family history groups, nearly 70% of respondents viewed high-fat diet and smoking as being important in relation to breast cancer risk, but alcohol was seen as being only somewhat important or not important by almost half of all respondents. Having a mother or sister with breast cancer was reported as being extremely or very important by nearly all respondents, regardless of family history. As expected, perceived lifetime risk for developing breast cancer was associated with family history (p = 0.001), but the perception of the lifetime risk for breast cancer was much higher among all of the family history groups than their true risk. In conclusion, educational interventions are needed to heighten women's awareness of genetic testing, to clarify women's knowledge of breast cancer risk factors, especially alcohol, and to reassure many women that their actual breast cancer risk is lower than they might perceive.
The purpose of this study, theoretically based on the Health Belief Model, was to assess breast c... more The purpose of this study, theoretically based on the Health Belief Model, was to assess breast cancer perceptions, knowledge, and screening behavior of low-income, African-American women residing in public housing. One hundred twenty (120) randomly selected women were interviewed to determine their perceived susceptibility to breast cancer, perceived severity of the disease, perceived barriers to breast cancer screening, and perceived benefits of mammography. Knowledge about breast cancer causes, risk factors, symptoms, and screening was also assessed. Contingency tables and Student's t test were used to analyze the data. The results demonstrated that 80.7% of women aged 40 and older had a previous mammogram. Approximately 92% of women reported having a clinical breast examination, and 75.8% performed breast self-examination. Knowledge of breast cancer was poor among the women in this study. Most women did not perceive themselves or a particular racial or economic group to be more susceptible to breast cancer. Moreover, the women in the sample did not perceive breast cancer as a fatal disease. Overall, women in the sample endorsed the benefits of mammography and denied the relevance of commonly cited barriers to breast cancer screening. The constructs of the Health Belief Model were not significantly related to mammography or breast self-examination. However, perceived severity and perceived barriers were found to be significantly related to clinical breast examination. Rates of early detection behaviors in this sample are commendable. Future research should focus on actual determinants and facilitators of regular screening behavior within a theoretical framework that incorporates cultural, ethnic, and socioeconomic diversity.
Breast cancer is the most common form of cancer in American women across most ethnic groups. Alth... more Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds. We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship. Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al., 1996; Ries et al., 2000; Shinagawa, 2000). In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000).
To explore knowledge, attitudes, beliefs, and practices regarding breast cancer detection practic... more To explore knowledge, attitudes, beliefs, and practices regarding breast cancer detection practices among South Asian women. Descriptive exploratory design. Toronto, Ontario, Canada. 57 South Asian women, age 40 and over, who are first generation immigrants from India and Pakistan and speak one of the four languages identified for the study--Hindi, Punjabi, Gujarati, or Urdu. An interview guide was designed specifically for this study. It contained questions regarding knowledge, attitudes, beliefs, and practices about breast self-examination (BSE), clinical breast examination (CBE), and mammogram. In addition, questions assessing the variables of the Health Belief Model and health motivations also were included. The data were obtained during face-to-face interviews in the primary language of the participating woman. The interviews were transcribed and translated into English. 12% of the participants practiced BSE monthly, 49% had undergone at least one CBE during their lives, and 47% had never had a mammogram. The majority (54%) said they did not know very much about breast cancer. While 21% of the women said detecting cancer early was important, only 5% reported that cancer could be cured. Age, education, or mother tongue showed no statistically significant relationship with the breast health practice scores. However, proficiency with the English language (p = 0.009) and number of years in Canada (p = 0.009) had a significant relationship with the breast health practice scores. The significant explanatory factor for the variable breast health practices was a cue to action (p = 0.009). South Asian women with minimal knowledge of breast cancer did not engage in breast cancer detection practices. This segment of the population of immigrant women needs to be better informed about breast cancer and the benefits of breast cancer detection practices.
Breast cancer is the most common cancer among women in the United States. Knowledge of the descri... more Breast cancer is the most common cancer among women in the United States. Knowledge of the descriptive epidemiology of breast cancer is useful both in suggesting etiologic hypotheses and, if preventive measures can be identified, in delineating high-risk groups to be targeted for preventive efforts. Demographic risk factors include increasing age (in Western countries), being white for breast cancer diagnosed at age 45 years or more, being black for breast cancer diagnosed at less than 40 years of age, high socioeconomic status, having never married, being of the Jewish faith, urban residence, and residence in the northern (as compared with the southern) United States. Incidence rates are generally highest in North American and Northern European countries, intermediate in Southern and Eastern European and South American countries, and lowest in Asia and Africa. The most notable characteristic of the descriptive epidemiology of breast cancer in recent years is perhaps the rapidly increasing incidence rates in developing countries. Identification of specific reasons for these increasing rates would contribute substantially to our understanding of the epidemiology of breast cancer.
Awareness of hereditary breast cancer genetic testing, of breast cancer risk factors, and of incr... more Awareness of hereditary breast cancer genetic testing, of breast cancer risk factors, and of increased level of risk based on family history are necessary before women can seek out genetic services. The aim of this paper is to describe the relationships between family history of breast cancer and awareness of genetic testing, knowledge of breast cancer risk factors, and perceived lifetime risk of breast cancer. An anonymous survey was administered by mail to a random sample of 600 women, 200 from each of three breast cancer family history groups (none, intermediate, and strong), drawn from a population-based registry of 240,000 women enrolled in a mammography screening program in the Denver Metropolitan area in Colorado. Awareness of genetic testing for breast cancer risk assessment was found to be significantly associated with family history of breast cancer, increasing from 35% in the lowest family history risk group to 67% in the group with the strongest familial risk (p = 0.002). In all family history groups, nearly 70% of respondents viewed high-fat diet and smoking as being important in relation to breast cancer risk, but alcohol was seen as being only somewhat important or not important by almost half of all respondents. Having a mother or sister with breast cancer was reported as being extremely or very important by nearly all respondents, regardless of family history. As expected, perceived lifetime risk for developing breast cancer was associated with family history (p = 0.001), but the perception of the lifetime risk for breast cancer was much higher among all of the family history groups than their true risk. In conclusion, educational interventions are needed to heighten women's awareness of genetic testing, to clarify women's knowledge of breast cancer risk factors, especially alcohol, and to reassure many women that their actual breast cancer risk is lower than they might perceive.
The purpose of this study, theoretically based on the Health Belief Model, was to assess breast c... more The purpose of this study, theoretically based on the Health Belief Model, was to assess breast cancer perceptions, knowledge, and screening behavior of low-income, African-American women residing in public housing. One hundred twenty (120) randomly selected women were interviewed to determine their perceived susceptibility to breast cancer, perceived severity of the disease, perceived barriers to breast cancer screening, and perceived benefits of mammography. Knowledge about breast cancer causes, risk factors, symptoms, and screening was also assessed. Contingency tables and Student's t test were used to analyze the data. The results demonstrated that 80.7% of women aged 40 and older had a previous mammogram. Approximately 92% of women reported having a clinical breast examination, and 75.8% performed breast self-examination. Knowledge of breast cancer was poor among the women in this study. Most women did not perceive themselves or a particular racial or economic group to be more susceptible to breast cancer. Moreover, the women in the sample did not perceive breast cancer as a fatal disease. Overall, women in the sample endorsed the benefits of mammography and denied the relevance of commonly cited barriers to breast cancer screening. The constructs of the Health Belief Model were not significantly related to mammography or breast self-examination. However, perceived severity and perceived barriers were found to be significantly related to clinical breast examination. Rates of early detection behaviors in this sample are commendable. Future research should focus on actual determinants and facilitators of regular screening behavior within a theoretical framework that incorporates cultural, ethnic, and socioeconomic diversity.
Breast cancer is the most common form of cancer in American women across most ethnic groups. Alth... more Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds. We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship. Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al., 1996; Ries et al., 2000; Shinagawa, 2000). In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000).
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