ethnic minority women prefer strong recommendations to be screened for cancer 2017 laura a. v. marlow学术.pdf

该【ethnic minority women prefer strong recommendations to be screened for cancer 2017 laura a. v. marlow学术 】是由【探春文档】上传分享，文档一共【8】页，该文档可以免费在线阅读，需要了解更多关于【ethnic minority women prefer strong recommendations to be screened for cancer 2017 laura a. v. marlow学术 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。(2017)17:-017-4093-*,?AbstractBackground:’:Womenaged30–60yearsfromIndian,Pakistani,Bangladeshi,Caribbean,AfricanandwhiteBritishbackgrounds(n=pletedface-to-faceinterviewswithamulti-:i)mendationfromtheNationalHealthService(NHS)togoforscreening,ii)AstatementthattheNHSthinksyoushouldgoforscreening,butit’suptoyoutodecide,iii):Preferencesvariedbyethnicity(χ2(5)=,p<.001).Allethnicminoritygroupshadapreferenceforamendationtobescreened(53–86%acrossethnicgroupsvs31%whiteBritish).Socio-demographicfactors(maritalstatus,educationandemployment),ulturation(mainlanguageandmigrationstatus),mendationpreferences(χ2(5)=(3)=,respectively,bothp<.001),-:mendationtoparticipateincancerscreeningappearstobeimportantforethnicminoritywomen,particularlynon-:Screening,Race,Ethnicity,Inequalities,mendation,LiteracyBackgroundinvestmentoftimeandeffortinreachingafullyin-Increasingly,peopleareencouragedtotakeanactiveformedscreeningdecisioncouldbeburdensomeforroleintheirhealthcaremanagement[1–3]includingsomepeople[6].Complicatingthisfurthertherearenu-makinginformeddecisionsaboutpreventivehealthsuchmerousaspectsofinformeddecisionmaking,forex-ascancerscreening[4]wheretheimportanceofampletheimportanceofscreeningdecisionsbeingpersonalchoiceaboutwhethertoparticipateisnowconsistentwithpreferencesandvalues,theneedforde-highlightedinpolicy[5].However,informationrequiredliberationaboutprosandconsofparticipatinginscreen-tofullyunderstandtherisksandbenefitsofscreeningingandaimstoreducedecisionalconflict[7].plexandithasbeenarguedthattheOnefacetofinformeddecisionmakingis‘roleprefer-ence’,theextenttowhichpotentialserviceusersprefertotakeanactiveroleintheirhealthcaremanagement*Correspondence:l.******@?Deceasedversusdeferringthedecision-men-CancerResearchUKHealthBehaviourResearchCentre,Departmentofdationofahealthcareprovider(sometimesreferredtoasEpidemiology&PublicHealth,UCL,GowerStreet,LondonWC1E6BT,UK?TheAuthor(s).(/licenses/by//),whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedyougiveappropriatecredittotheoriginalauthor(s)andthesource,providealinktomonslicense,(/publicdomain/zero//)appliestothedatamadeavailableinthisarticle,(2017)17:164Page2of8intellectualoutsourcing)[6,8–10].-havelookedatpreferencesfordecision-makinginthedationforscreening:Itmaybeperceivedasmitigatingcontextofmedicalcare,withanumberofUSstudiessug-burden(-gestingthatsomeethnicminoritygroupsprefertoleavetionandmitigatingdecisionalconflict)buttheremaydecisionsaboutmedicalcareuptotheirdoctor[24,25].alsobeconcernsregardingapparentcoerciveness[6].NotspeakingEnglishhasbeenassociatedwithlessdesireThisisimportantincontextsliketheUK,whichhaveatoparticipateinmedicalcaredecisions[26].Although“one-size-fits-all”municationversuscon-providinginformationontheharmsandbenefitsoftextsliketheUSwhicharemoreamenableto“sharedscreeningisessential,paniedwithadecision-making”duringaface-to--aphysician[11].a-mendationvsIDMinthenizedcancerscreeningprograms(suchasintheUK),in-,-(basedonageandgender)atregularin-qualitativestudyindicatedthatwomenpreferredarec-tervals(usuallyevery3–5years)toparticipateinommendationtoattendmammographyscreeningalong-[12].-basedstudyofolderForbreastscreeningwomenaresentaninvitationtoat-adults’attitudestocolorectalcancerscreeningwhichtendforapre-setmammographyappointmentatalocalmendation,clinicandforcervicalscreeningwomenaresentaninvi-alongsideinformationonbenefitsandharms[13].tationtocontacttheirhealthcareproviderandmakeanTherearelikelytobearangeofpreferencesforappointmentforasampletobetaken(usuallybyanurseinvolvementindecisionmaking,butsomegroups,par-practitioner).asionaGPmayraisethetopicofticularlythosewithlimitedcapabilitytoprocessthecancerscreeningduringaconsultationaboutanothercomplexinformationinvolved;forexamplebecauseofhealthissueiftheycanseeonthepatientsrecordsthathavinglowerliteracyandnumeracyskills[14,15],(thewidersurveyofwomenaged30–,womenwereeligibleforcervicalscreeningandsomeofcommunicateneedswithhealthprofessionals,andthem(thoseaged50–60years)werealsoeligibleforunderstandhealth-relatedinformation[16]--mendationmaking[17].Arecentreviewlookingatassociationsbe-variedbyethnicityandifsocio-demographicfactors,in-ulturation,Englishproficiencyorhealthdecisionmakinginthecontextofcolorectalcancersug-[18].InastudyofAustralianadultsDatawerecollectedbyEthnicFocus,amarketresearchwithlowliteracy,panythatusesquotasamplingtorecruitpartici-increasedparticipants’knowledgebutresultedinre-,missionedEthnicFocustorecruit720womengainingmoreinformationpeoplebelievedtherisksdidaged30–60yearsfromIndian,Pakistani,Bangladeshi,notoutweighthebenefitsandshowingthatimprove-African,CaribbeanandWhiteBritishbackgrounds(120paniedbyin-womenfromeachethnicgroup).creasesinscreeningparticipation[19].EthnicminoritystatushasbeenassociatedwithpoorerSamplinghealthliteracy[20,21].whichcouldmakeitdifficultforEthnicFocusmaintainsalistofsamplingpointsbasedpeoplefromethnicminoritybackgroundstoreadandoncensusinformationabouttheconcentrationsofdif-interpretscreeninginvitationsandthewritteninforma-ferentethnicminoritygroupswithineachpost-codesec-,[22,23].Insuchasituationtheindividualfacedpoints(n=35)wererandomlyselectedandinspectedtowithascreeningdecisionmaypreferastrongproviderensuretheyrepresentedareasofhigh,(2017)17:-maternityleave,doinganyotherwork,retired,student,lingualinterviewersvisitedpropertieswithineachsam-lookingafterthehomeorfamily,long-termsickordis-plingpointlookingforeligibleparticipants(determinedabled,other).Thesequestionswerealltakenfromthebyage,genderandethnicity).Ifaneligibleparticipant2011UKCensus[27],amandatorysurveyofallUKresi-livedinahousehold,,withwomencontactaneligibleparticipantbeforetheywerecountedasked‘Whatisyourethnicgroup?’andoffered18re-asanon--sponseoptionsunderfivemajorheadings(White,,Mixedormultipleethnicgroups,Black/mitteebe-African/Caribbean/BlackBritish,Otherethnicgroup).,mainlanguagespoken,andultur-femalemulti--ofwomen[28].Questionsweretakenfromthe2011searchteambutwasfullybriefedabouttheaimsofthecensusquestions[27].,wesubtractedtheiryearofarrivalfromtheyearlanguagespriortodatacollectionandcheckedforcon--’syearofarrivalintheUKandcurrentage,werecarriedoutinthewoman’:bornintheUK;migrated<18yearsold;waspartofawiderstudywithafocusonattitudestomigrated≥(fullquestionnairemainlanguageas‘English’or‘other’.availableonrequest).EnglishproficiencymendationpreferencesWomenwhoreportedamainlanguageotherthanmendationswereEnglishwereasked“howwellcanyou:i)readEnglish,assessedusingasingleitemwiththreeresponseoptions:andii)speakEnglish(responseoptions:verywell/well/“Imagineyouwerebeinginvitedtogoforcancerscreen-notwell/notatall).-speakEnglishandweretakenfromtheUK-,wouldyouprefer:)mendationfromtheNHStogoforscreening;ii)AstatementthattheNHSthinksyouHealthliteracyshouldgoforscreeningbutthatit’suptoyoutodecide;Thesurveyformatmeantassessmentofhealthliteracyiii)mendation–it’suptoyoutodecideusingavalidatedtoolwasnotpossible(thesetoolstakewhetherornottogoforscreening”.pleteandhavenotmen-beentranslatedandvalidatedintothelanguageswedationinthecontextofcolorectalcancerscreening[13].needed).Instead,twosingleitemswereadaptedfromNoinformationwasprovidedaboutcancerscreeningtheEuropeanHealthLiteracyProject[29]assessingself--municatewiththeGP:“?”andwomen’spreconceivedviewsaboutthevoluntarynatureself-prehendwrittenhealthmaterials:ofscreeningintheUK.“Howeasydoyoufindittounderstandleafletsandlettersaboutyourhealth?”ResponseoptionsforbothSocio-demographicfactorsquestionswere:veryeasy/fairlyeasy/fairlydifficult/veryWomenwereasked‘Whatisyourage?’(openresponsedifficult).Questionswereaskedtoallwomenregardlessbox),Whatisyourmaritalstatus?(Single,Married,-Cohabiting,Divorcedorseparated,Widowed),Whatiscausewefelttheybesttappedaspectsrelevanttohowthehighesteducationalqualificationyouhaveobtained?screeninginvitationsaresent(aswrittenmaterials)or(Noformalqualifications,O-levels,ONCorBTec,A-howconcernsmightbediscussed(withaGP).levelsorhighers,highereducationbelowdegree,degreeorhigher,stillstudying,other)and‘Areyoucurrently…’Analyses(Workingasanemployee,self-employedorfreelance,mendationpreferenceswereexaminedindividu-workinginthefamilybusiness,(2017)17:164Page4of8preferencefora“mendation”(responseop-)versus“it’suptoyou”(responseoptioniioriii).preferencesvariedbyethnicity(χ2(5)=,p<.001)Logisticregressionanalyseswerefirstusedtoexplorewithwomenfromeachoftheethnicminoritygroupstheinfluenceofethnicity,migrationstatusandmainlan-().consideredtheroleofothersocio-demographicvariablesThedifferencewassmallestforCaribbeanwomenandself-municatewiththeGP(OR=,95%CI:-,beforeandBritishwomen),andmostpronouncedforBangladeshiafteradj