Longitudinal predictors of nonadherence to maintenance of mammography.
Longitudinal predictors of nonadherence to maintenance of mammography.
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DOI：
10.1158/1055-9965.epi-09-1120
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发表时间：
2010-04
期刊：
影响因子：
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通讯作者：
Rimer BK
中科院分区：
文献类型：
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作者：
Gierisch JM;Earp JA;Brewer NT;Rimer BK
定期坚持乳房x光检查，也称为乳房x光检查的维持，可以降低乳腺癌的发病率和死亡率。然而，乳房x光检查的维持是罕见的，很少有人知道为什么女性不保持定期的筛查计划。我们调查了不坚持服药的女性的纵向预测因素。参与者是在研究入组前8 - 9个月进行乳房x光筛查的参保妇女（n= 1493）。数据收集于2003年至2008年。我们使用离散事件历史分析来模拟连续三个年度筛查间隔（+ 2个月）的乳房x光检查维持不依从性。大多数（54%）妇女在三年内没有坚持筛查。没有坚持检查的女性更有可能年龄在40到49岁之间，认为自己的健康状况尚可或较差，对上一次乳房x光检查经历不太满意，报告有一个或多个进行乳房x光检查的障碍，对下次进行乳房x光检查缺乏完全的信心（自我效能较低），或者行为意愿较弱。不坚持服药的几率随着时间的推移而降低。虽然在增加接受乳房x光检查的妇女比例方面取得了很大进展，但大多数妇女仍然没有长期定期使用乳房x光检查。我们的发现为未来乳房x光检查维持干预的目标提供了见解。
Regular adherence to screening mammography, also known as maintenance of mammography, reduces breast cancer morbidity and mortality. However, mammography maintenance is uncommon, and little is know about why women do not maintain regular screening schedules. We investigated longitudinal predictors of women not maintaining adherence. Participants were insured women enrolled in an intervention trial who had screening mammograms eight to nine months prior to study enrollment (n=1,493). Data were collected from 2003 to 2008. We used discrete event history analysis to model non-adherence to mammography maintenance over three successive annual screening intervals (+ 2 months). Most (54%) women did not maintain screening adherence over three years. Women who did not maintain adherence were more likely to be aged 40 to 49, rate their health fair or poor, be less satisfied with their last mammography experiences, report one or more barriers to getting mammograms, be less than completely confident about getting their next mammograms (lower self-efficacy), or have weaker behavioral intentions. The odds of not maintaining adherence decreased over time. While great strides have been achieved in increasing the proportion of women who have received mammograms, most women still are not maintaining regular mammography use over time. Our findings provide insights into targets for future mammography maintenance interventions.