How does social integration influence breast cancer control among urban African-American women? Results from a cross-sectional survey.
How does social integration influence breast cancer control among urban African-American women? Results from a cross-sectional survey.
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DOI：
10.1186/1472-6874-8-4
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发表时间：
2008-02-06
期刊：
影响因子：
--
通讯作者：
Washington C
中科院分区：
文献类型：
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作者：
Klassen AC;Washington C
虽然社会融合是一个公认的影响健康，但很少有人知道的具体类型的社会联系（社会角色，社交网络，社会支持）如何影响知识，态度和具体的预防目标的做法，以及如何利用这些影响力的干预措施与重点人群。本研究调查了马里兰州东巴尔的摩576名年龄在45-93岁的城市非裔美国妇女的社会角色、网络和支持的流行情况，以及这些社会因素与乳腺癌相关知识、态度和行为的关联。利用1997-1998年的家庭访谈数据，我们开发了六种可能的社会角色，家庭、邻里和教会的社交网络，以及工具性和情感性社会支持指数。在调整年龄，教育和医疗保健的多变量模型中，我们研究了每种社会影响对乳腺癌知识，态度，筛查最近和意图以及治疗偏好的关联。我们发现这些妇女的社会融合存在很大差异，社会融合与整体健康和福祉呈正相关。社会角色和网络与筛查知识呈正相关，情感支持和教会网络与有利于早期发现和治疗的态度呈正相关。在筛查行为方面，家庭网络与筛查近因性和筛查意向均相关。拥有更大教会网络和情感支持的女性对乳房肿瘤切除术、重建和临床试验持更保守的态度。总体而言，社会融合对乳腺癌控制有积极影响，应尽可能在干预措施中加以利用，包括确定替代机制，为没有现有社会资源的亚群体提供支持。
Although social integration is a well-established influence on health, less is known about how the specific types of social connection (social roles, social networks, and social support) influence knowledge, attitudes, and practices for specific prevention goals, and how to utilize these influences in interventions with priority populations. This research examined the prevalence of social roles, networks and support among 576 urban African-American women age 45–93 in East Baltimore, Maryland, and the association of these social factors with breast cancer related knowledge, attitudes, and practices. Using data from 1997–1998 in-home interviews, we developed indices of six possible social roles, social networks of family, neighborhood and church, and instrumental and emotional social support. In multivariate models adjusting for age, education, and medical care, we examined the association of each social influence on breast cancer knowledge, attitudes, screening recency and intention, and treatment preferences. We found substantial variation in social integration among these women, with social integration positively associated with overall health and well-being. Social roles and networks were positively associated with screening knowledge, and emotional support and church networks were positively associated with attitudes conducive to early detection and treatment. In regard to screening behaviors, family networks were associated with both screening recency and intention. Women with greater church networks and emotional support held more conservative attitudes towards lumpectomy, reconstruction, and clinical trials. Overall, social integration is a positive influence on breast cancer control and should be utilized where possible in interventions, including identifying surrogate mechanisms for support for subgroups without existing social resources.