Age and breast cancer screening among Latina women

该研究旨在理清年龄、社会经济地位（SES）和种族，特别是文化适应对乳腺癌筛查测试的影响。各种研究证明拉丁裔（西班牙裔）和非拉丁裔白人妇女在乳腺癌发病率和死亡率以及生存率方面存在差异。几项研究表明，老年拉丁裔妇女接受的乳腺癌筛查试验少于非拉丁裔白人，这可能是观察到的乳腺癌死亡率和存活率差异的部分原因。对文化适应（移民群体接受主流文化的价值观、信仰和行为的过程）的研究表明，拉美文化价值观可能与筛查减少有关。其他研究表明，社会经济地位和其他结构因素解释了筛查的差异。本研究将通过测试年龄、文化和社会经济地位因素对癌症筛查影响的理论模型，以及这些影响的中介机制，对拉丁裔妇女乳腺癌筛查的文献有重要贡献。利用1992年全国健康访谈调查的癌症控制补充资料，这项研究将检查三种筛查行为：最近的临床乳房检查和乳房x光检查，以及乳房自我检查的频率。以下研究问题将被解决：(1)年龄、文化适应和癌症筛查之间的关系是什么？(2)在控制年龄和社会经济地位变量的情况下，文化适应是否与乳腺癌筛查行为相关？(3)癌症知识、对癌症生存机会的信念、质量和保健在多大程度上调解了文化适应、社会经济地位和癌症筛查之间的关系？(4)年龄对筛查行为是否有直接影响？很少有研究测试了涉及年龄、文化适应、社会地位和筛查之间关系的中介过程。此外，据我们所知，没有发表的研究在具有全国代表性的美国拉丁裔妇女样本中测试了调解模型。

The study aims to disentangle the effects of age, socioeconomic status (SES) and ethniclty , specifically, acculturation, on breast cancer screening tests. Various studies document disparities between Latina (Hispanic) and non- Latina white women in incidence and mortality rates of breast cancer, as well as survival rates. Several studies indicate that older Latina women receive fewer breast cancer screening tests than non-Latina whites, possibly accounting for some of the observed differences in breast cancer mortality and survival rates. Research on acculturation (the process by which immigrant groups espouse the values, beliefs and behaviors of a dominant culture), suggests that Latino cultural values may be associated with decreased screening. Other research indicates that SES and other structural factors account for differences in screening. The proposed study will significantly contribute to the literature on breast cancer screening among Latina women by testing a theoretical model on the effects of age, cultural and socioeconomic status factors on cancer screening, as well as mechanisms that mediate these effects. Using data from the Cancer Control Supplement of the 1992 National Health Interview Survey, the study will examine three screening behaviors: recent clinical breast examination and mammography, and frequency of breast self-examination. The following research questions will be addressed: (1) What is the relationship between age, acculturation and cancer screening?; (2) Is acculturation related to breast cancer screening behaviors even when controlling for age and socioeconomic status variables?; (3) To what extent do cancer knowledge, beliefs about the chances of survival of cancer, and quality &health care mediate the relationships between acculturation, SES and cancer screening?; and (4) Does age have a direct effect on screening behaviors? Few studies have tested mediating processes involved in the relationship between age, acculturation, SES, and screening. Furthermore, we know of no published studies which have tested mediation models among a nationally representative sample of Latina women in the United States.