If we gave away mammograms, who would get them? A neighborhood evaluation of a no-cost breast cancer screening program.
If we gave away mammograms, who would get them? A neighborhood evaluation of a no-cost breast cancer screening program.
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如果我们赠送乳房X光检查，谁会得到它们？
DOI：
10.1006/pmed.2001.0956
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发表时间：
2002
影响因子：
5.1
通讯作者：
Mandelblatt,Jeanne
中科院分区：
文献类型：
--
作者：
Klassen,AnnC;Smith,AnnLM;Meissner,HelenI;Zabora,James;Curbow,Barbara;Mandelblatt,Jeanne
背景低成本和免费乳房X光检查计划已成为增加低收入人群获得乳腺癌筛查机会的广泛策略。然而，缺乏对实施这些计划的社区中哪些人仍未筛查的严格评估。我们对马里兰州东巴尔的摩的非裔美国老年妇女进行了一项病例对照研究，将免费项目的参加者与不使用免费场所的朋友和邻居进行了比较。方法我们招募了 288 名 50 岁及以上、在约翰·霍普金斯医院参加过免费项目的女性来完成一次 11 小时 2 小时的家庭访谈，回答有关癌症和健康以及广泛的社会和心理问题的半结构化和开放式问题。对于每个案例，我们招募了一名 5 岁以内的朋友或邻居，未接受免费筛查，以完成类似的对照访谈。匹配的病例对照分析用于比较目标社区内的计划参加者和未参加者。结果至少使用过一次免费计划的女性在计划开始前的筛查结果通常比她们的社区对照要差，但在计划开始 3 年后，近期筛查历史更好。在多变量分析中，计划参加者年收入更有可能低于 10,000 美元（OR = 2.34，95% CI 1.55,3.61），更有可能生育更多孩子（OR = 1.13，95% CI 1.04,1.24），并且不太可能拥有健康保险（OR = 0.42，95% CI 1.55,3.61）。 0.25,0.68）。她们更有可能去看女性初级保健提供者（OR = 1.82，95% CI 1.24,2.70）并去看多个提供者（OR = 3.38，95% CI 1.52,8.60）。结论低成本筛查干预计划覆盖了原本可能无法接受筛查的女性。然而，在目标社区内，改善与特定类型初级保健提供者的伙伴关系可以惠及更多妇女。
BackgroundLow- and no-cost mammography programs have become a widespread strategy to increase access to breast cancer screening in low-income populations. However, rigorous evaluations of who remains unscreened in communities with these programs are lacking. We conducted a case-control study of African American older women in East Baltimore, Maryland, comparing attendees at a no-cost program to friends and neighbors not using no-cost venues.MethodsWe recruited 288 women ages 50 and older, who attended a no-cost program at Johns Hopkins Hospital, to complete a 11 2 h home interview, answering semistructured and open-ended questions about cancer and health and a wide range of social and psychological items. For each case, we recruited one friend or neighbor, within 5 years of age, not receiving no-cost screening, to complete a similar control interview. Matched case-control analyses were used to compare program attendees to nonattendees within the target community.ResultsWomen using the no-cost program at least once were generally more poorly screened than their neighborhood control prior to the program, but had better recent screening history 3 years after the program began. In multivariate analyses, program attendees were more likely to have <$10,000 annual income (OR = 2.34, 95% CI 1.55,3.61), more likely to have had more children (OR = 1.13, 95% CI 1.04,1.24), and less likely to have health insurance (OR = 0.42, 95% CI 0.25,0.68). They were more likely to see a female primary care provider (OR = 1.82, 95% CI 1.24,2.70) and to see multiple providers (OR = 3.38, 95% CI 1.52,8.60).ConclusionsLow-cost screening intervention programs reach women who might otherwise not receive screening. However, within target communities, improved partnerships with specific types of primary care providers could reach additional women.