Latinas and breast cancer outcomes: population-based sampling, ethnic identity, and acculturation assessment.
Latinas and breast cancer outcomes: population-based sampling, ethnic identity, and acculturation assessment.
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DOI：
10.1158/1055-9965.epi-09-0238
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Katz SJ
中科院分区：
文献类型：
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作者：
Hamilton AS;Hofer TP;Hawley ST;Morrell D;Leventhal M;Deapen D;Salem B;Katz SJ
患有乳腺癌的拉丁裔和非裔美国人，特别是那些社会经济地位和文化适应程度较低的人，在评估治疗满意度、决策和生活质量的研究中代表性不足。一项研究旨在从这些亚群中招募大量具有代表性的样本。2005-2006年，洛杉矶SEER登记处通过快速病例确定（RCA）选择了事件病例，对拉丁裔和非裔美国人进行了过采样。在确诊后5-6个月，向患者邮寄一份调查问卷和10美元的奖励；未受访者通过电话联系。采用多变量分析评估可能的反应偏倚。RCA对西班牙裔的定义通过自我报告得到了验证。拉丁裔受访者采用SASH文化适应指数。选取1,698例符合条件的乳腺癌病例，其中1,223例参与，有效率为72.0%，不同种族/民族差异不大。年龄、种族/民族和临床因素与反应无关；然而，与非受访者相比，受访者中已婚和来自较高社会经济地位的人口普查区的可能性略高。RCA对西班牙裔身份的定义具有高度敏感性（94.6%）和特异性（90.0%）。较低的文化适应程度与拉丁裔较低的教育水平和识字率有关。由于使用了RCA、激励、广泛的电话随访、母语为西班牙语的采访者和重点调查问卷，所有亚组的高回复率得以实现。低适应指数类别确定了一个高度脆弱的亚群。这个代表问题更大的亚群体的大样本将为制定更好的干预措施以帮助这些妇女提供基础。
Latinas and African-Americans with breast cancer, especially those of lower socioeconomic status and acculturation, have been underrepresented in studies assessing treatment satisfaction, decision making and quality of life. A study was designed to recruit a large and representative sample of these subgroups. Incident cases were selected by Rapid Case Ascertainment (RCA) by the Los Angeles SEER Registry in 2005-2006, with oversampling of Latinas and African-Americans. Patients were mailed a questionnaire and $10 incentive 5-6 months after diagnosis; non-respondents were contacted by telephone. Multivariate analysis was used to assess possible response bias. The RCA definition of Hispanic origin was validated by self reports. The SASH acculturation index for Latina respondents was used. 1,698 eligible breast cancer cases were selected and 1,223 participated for a response rate of 72.0%, which varied little by race/ethnicity. Age, race/ethnicity, and clinical factors were not associated with response; however respondents were slightly more likely to be married and from higher socioeconomic status census tracts than non-respondents. The RCA definition of Hispanic identity was highly sensitive (94.6%) and specific (90.0%). Lower acculturation was associated with lower education and literacy among Latinas. High response rates among all subgroups were achieved due to use of RCA, an incentive, extensive telephone follow-up, a native Spanish speaking interviewer, and a focused questionnaire. The low acculturation index category identified a highly vulnerable subgroup. This large sample representing subgroups with greater problems will provide a basis for developing better interventions to assist these women.