研究服务不足的中老年非裔美国人接受大肠癌筛查的情况和医疗服务提供者的建议。

IF 2.4 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Health Promotion Perspectives Pub Date : 2022-12-31 eCollection Date: 2022-01-01 DOI:10.34172/hpp.2022.52
Sharon Cobb, Tavonia Ekwegh, Edward Adinkrah, Hoorolnesa Ameli, Attallah Dillard, Lucy W Kibe, Mohsen Bazargan
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引用次数: 0

摘要

背景:本研究旨在确定未得到充分服务的中老年非裔美国人是否接受了结肠直肠癌(CRC)筛查(乙状结肠镜检查或结肠镜检查),以及是否得到了其提供者的推荐。此外,我们还研究了提供者推荐和接受 CRC 筛查的相关因素。研究方法74 名 55 岁及以上的非裔美国人参加了这次当地社区横断面调查。我们采用了逻辑回归的多变量技术。结果:每三名参与者中就有一人表示他们接受过癌症筛查:每三名参与者中就有一人表示从未接受过肠镜检查或结肠镜检查。超过 31% 的人表示,他们的医疗服务提供者从未建议他们进行 CRC 检查。然而,与未被建议进行这些检查的人相比,表示其医疗服务提供者建议进行乙状结肠镜/结肠镜检查的参与者接受这些检查的几率几乎是未被建议者的 49 倍(几率比 [OR]:48.9,95% 置信区间 [CI]:29.5-81.2)。我们的数据表明,非裔美国男性接受医疗服务提供者建议的可能性明显低于女性(OR:0.70,95% 置信区间:0.50-0.91)。此外,在控制了其他变量后,还有以下因素:1)居住安排(OR:1.44,95% CI:1.02-2.04);2)健康维护组织(HMO)成员资格(OR:1.84,95% CI:1.28-2.67);3)医疗服务提供者的数量(OR:1.15,95% CI:1.01-1.32);4)对获得医疗服务和医疗质量的满意度(OR:1.24,95% CI:1.03-1.51)、5)抑郁症状(OR:0.92,95% CI:0.86-0.98)和 6)胃肠道疾病(OR:1.73,95% CI:1.16-2.58)与接受乙状结肠镜或结肠镜检查有关。结论我们的研究结果表明,缺乏医疗服务提供者的建议是阻碍医疗服务不足的美国黑人老年人接受 CRC 筛查的主要障碍。此外,我们的数据还显示,获得 CRC 筛查与参与者的一些易感特征、对获得医疗服务的满意度和医疗服务质量以及身心健康之间存在显著关联。这些发现与非裔美国人在医疗保健方面的差异可追溯到四个主要因素的观点相一致:患者、医疗保健提供者、医疗保健系统和整个社会,并强调有必要建立理论驱动、文化敏感和具有成本效益的 CRC 筛查干预措施,以认识和解决这部分人群在癌症筛查方面遇到的限制因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans.

Background: The purpose of this study is to determine whether underserved middle-aged and older African Americans are receiving a colorectal cancer (CRC) screening test (sigmoidoscopy or colonoscopy) and if recommended by their provider. Additionally, we examined correlates of both provider recommendation and uptake of CRC screening. Methods: Seven hundred forty African American individuals, aged 55 and older, participated in this local community cross-sectional survey. We used a multivariate technique of logistic regression. Results: One out of three participants reported that they never received a sigmoidoscopy or colonoscopy for CRC screening. More than 31% indicted that their providers never suggested CRC testing. However, participants who indicated that their providers recommended sigmoidoscopy/colonoscopy were almost 49 times (odds ratio [OR]: 48.9, 95% confidence interval [CI]: 29.5-81.2) more likely to obtain it compared to their counterparts who were not advised to have these procedures. Our data suggest that African American men were significantly less likely than women to receive recommendations from their providers (OR: 0.70, 95% CI: 0.50-0.91). Furthermore, controlling for other variables, the following factors: 1) living arrangement (OR: 1.44, 95% CI: 1.02-2.04), 2) health maintenance organization (HMO) membership (OR: 1.84, 95% CI: 1.28-2.67), 3) number of providers (OR: 1.15, 95% CI: 1.01-1.32), 4) satisfaction with access to and quality of care (OR: 1.24, 95% CI: 1.03-1.51), 5) depressive symptoms (OR: 0.92, 95% CI: 0.86-0.98), and 6) gastrointestinal conditions (OR: 1.73, 95% CI: 1.16-2.58) were associated with obtaining a sigmoidoscopy or colonoscopy test. Conclusion: Our findings suggest that the absence of a provider recommendation is the primary barrier preventing underserved older African Americans from obtaining CRC screening. In addition, our data revealed significant association between obtaining CRC screening and some of the predisposing characteristics of participants, satisfaction with access to and quality of care, and physical and mental health. These findings are consistent with this notion that disparities in health care for African Americans can be traced back to four primary factors: patients, healthcare providers, the healthcare system, and society as a whole, and emphasize the need for establishing theory-driven, culturally-sensitive, and cost-effective CRC screening interventions that recognize and address the constraints to cancer screening experienced by this segment of population.

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来源期刊
Health Promotion Perspectives
Health Promotion Perspectives PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.10
自引率
2.30%
发文量
27
审稿时长
13 weeks
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