Behavioral and Psychological Impact of Returning Breast Density Results to Latinas

 描述（由申请人提供）：乳腺癌是西班牙裔妇女/拉丁裔妇女癌症死亡的主要原因。乳腺癌与乳房X线摄影乳腺密度（MBD）之间的关系越来越受到关注，因为致密的乳腺组织与乳房X线摄影的灵敏度降低、乳房X线摄影上的肿瘤掩盖和诊断延迟有关。大约50%的女性有致密的乳房，10-12%的拉丁美洲人有非常致密的组织。美国正在推进立法，要求妇女了解她们的乳房密度，如果她们有致密的乳房组织，她们可能会从额外的筛查测试中受益。在没有其他背景信息的情况下，向妇女提供关于其MBD及其对乳腺癌风险影响的通知可能会产生意想不到的后果，特别是在健康素养较低和资源有限的拉丁美洲人中。能够进行补充乳腺筛查的妇女和不太能够这样做的妇女之间出现差异的可能性也是一个重要的考虑因素。该提案将通过实施一项前瞻性的3组随机试验，包括2,000名40-74岁的拉丁美洲人参加筛查乳房X光检查，将常规护理与两种“教育增强”方法进行比较，以通知焦虑，知识和随后的乳房X光检查筛查依从性。我们的研究包括一套全面的心理措施，1年和2年的行为结果，以及定性调查和成本分析，以提高我们的理解教育干预的交付在实践中，其可转移到其他医疗保健设置。在新颁布的立法背景下，在为未投保或未投保的拉丁裔人提供乳房X光检查的社区环境中进行这项研究，将提供关键数据，为未来的政策提供信息。 并影响临床实践。

 DESCRIPTION (provided by applicant): Breast cancer is the leading cause of cancer mortality among Hispanic women/Latinas. Increasing attention has been given to the association between breast cancer and mammographic breast density (MBD), as dense breast tissue is associated with reduced sensitivity of mammograms, masking tumors on the mammogram, and delays in diagnosis. Approximately 50% of women have dense breasts, with 10-12% of Latinas having extremely dense tissue. Legislation is advancing in the U.S. that mandates women are informed of their breast density and that they may benefit from additional screening tests if they have dense breast tissue. The effect of providing women with notification about their MBD and its impact on breast cancer risk with no other contextual information may have unintended consequences, particularly among Latinas with lower health literacy and limited resources. The likelihood of disparities emerging between women who can pursue supplemental breast screening and women who are less able to do so is also an important consideration. This proposal will examine important outcomes among women of relative socioeconomic disadvantage by implementing a prospective, 3 group randomized trial including 2,000 Latinas 40-74 years of age attending screening mammography that compares usual care to two "educationally enhanced" approaches to notification on anxiety, knowledge, and subsequent mammography screening adherence. Our study includes a comprehensive set of psychological measures, 1- and 2-year behavioral outcomes as well as qualitative inquiry and cost analysis to enhance our understanding of an educational intervention's delivery in practice and its transferability to other health care settings. Conducting this study in the context of newly enacted legislation and in a community setting that provides mammography screening to Latinas who are under- or uninsured will provide critical data that can inform future policy at the state and national level and impact clinical practice.