Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico.
Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico.
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DOI：
10.1111/jrh.12202
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Wheeler CM
中科院分区：
文献类型：
--
作者：
McDonald YJ;Goldberg DW;Scarinci IC;Castle PE;Cuzick J;Robertson M;Wheeler CM
多重内在和结构性障碍，包括地理，可能会阻止妇女从事宫颈癌预防保健，如筛查，诊断性阴道镜检查和切除癌前治疗程序。按农村和非农村地区分层的地理可及性在很大程度上是未知的，以获得必要的服务，整个宫颈癌预防保健连续。新墨西哥州（2010-2012年）的医疗保健机构数据由新墨西哥州人乳头瘤病毒Pap登记处（NMHPVPR）提供，NMHPVPR是美国首个基于人群的全州宫颈癌筛查登记处。旅行距离和时间之间的人口加权的人口普查区质心最近的设施提供筛查，诊断和切除治疗服务进行了检查，使用邻近分析农村和非农村人口普查区。使用Mann-Whitney检验（P <0.05）来确定差异是否显著，并使用Cohen's r来测量效果。在所有宫颈癌预防保健服务和年份中，与非农村地区相比，居住在农村地区的妇女有更大的地理可及性负担（4.4 km vs 2.5 km，4.9 min vs 3.0 min）;阴道镜检查9.9 km vs 4.2 km，10.4 min vs 4.9 min;癌前病变治疗服务分别为14.8公里和6.6公里，14.4分钟和7.4分钟，P均<0.001）。宫颈癌预防工作的改进应涉及在各个设施内提供全方位筛查、诊断和癌前治疗服务的潜在好处。在监测和建议服务基础设施的变化（例如，移动的与砖和砂浆）时，区分农村和非农村地区的可及性和评估至关重要。
Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar).
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影响因子：
4.9
作者：
Goldberg, Daniel W.;Wilson, John P.;Cockburn, Myles G.
通讯作者：
Cockburn, Myles G.
影响因子：
158.5
作者：
Baker, DW;Sudano, JJ;Dor, A
通讯作者：
Dor, A
DOI：
10.1046/j.1523-5394.1998.006006325.x
发表时间：
1998-11-01
期刊：
CANCER PRACTICE
影响因子：
--
作者：
Gulitz, E;Bustillo-Hernandez, M;Kent, EB
通讯作者：
Kent, EB
影响因子：
6.2
作者：
SMART, CR
通讯作者：
SMART, CR
影响因子：
7.2
作者：
Benard, Vicki B.;Coughlin, Steven S.;Richardson, Lisa C.
通讯作者：
Richardson, Lisa C.