Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
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宫颈癌风险和进入：利用三种统计工具评估南佛罗里达州的海地妇女。
DOI：
10.1371/journal.pone.0254089
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Kobetz E
中科院分区：
文献类型：
--
作者：
Moise RK;Balise R;Ragin C;Kobetz E
尽管美国宫颈癌发病率的下降可归因于卫生政策，但移民妇女，特别是海地妇女，因检测和治疗延迟而承受着不成比例的疾病负担。然而，在这一人群中，风险预测和获取动态在很大程度上仍未得到充分探索和解决。本研究旨在评估未接受筛查的海地妇女患宫颈癌的风险和可及性。该样本从两项研究中提取并合并，包括美国最大的海地人聚居地南佛罗里达州的n = 346名高危海地妇女（年龄在30-65岁之间，过去三年未接受筛查）。采用三种方法（逻辑回归[LR]、分类与回归树[CART]和随机森林[RF]）评估筛查史与社会人口学变量之间的关系。LR结果显示，报告美国国籍（OR = 3.22, 95%CI = 1.52-6.84）、接受常规护理（OR = 2.11, 95%CI = 1.04-4.30）、在美国居住较长时间（OR = 1.01, 95%CI = 1.00-1.03）的女性更有可能报告以前的筛查。CART的结果返回的准确率为0.75，树最初分为非公民妇女，然后是在美国居住43年或更少，没有获得常规护理的妇女。RF模型将美国年限、公民身份和获得常规护理的机会确定为最重要的变量，表明基尼指数的最大平均下降。模型是。79的准确率（95% CI = 0.74-0.84）。这项多管齐下的分析确定了以前没有记录的海地妇女进行健康筛查的障碍。由于在进入美国卫生系统方面存在障碍，没有公民身份或被认为无法获得常规护理的美国新移民患疾病的风险可能更高。
Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30–65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52–6.84), access to routine care (OR = 2.11, 95%CI = 1.04–4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00–1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74–0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.
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影响因子：
15.8
作者：
Farmer PE;Nizeye B;Stulac S;Keshavjee S
通讯作者：
Keshavjee S
影响因子：
12.7
作者：
Kobetz, Erin;Menard, Janelle;Auguste, Pascale Denize
通讯作者：
Auguste, Pascale Denize
影响因子：
12.7
作者：
Abraído-Lanza, AF;Dohrenwend, BP;Turner, JB
通讯作者：
Turner, JB
影响因子：
2.5
作者：
Carrasquillo O;McCann S;Amofah A;Pierre L;Rodriguez B;Alonzo Y;Ilangovan K;Gonzalez M;Trevil D;Byrne MM;Koru-Sengul T;Kobetz E
通讯作者：
Kobetz E
影响因子：
6.2
作者：
Basen-Engquist, K;Paskett, ED;Bodurka, DC
通讯作者：
Bodurka, DC