农村妇女更青睐哪种乳腺癌筛查方案?中国江苏的离散选择实验。

IF 3.4 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Yanjun Sun, Yiping Wang, Huiying Zhang, Zhiqing Hu, Yuhao Ma, Yuan He
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引用次数: 0

摘要

背景:中国鼓励 35-64 岁的农村妇女免费完成乳腺癌筛查(BCS)。然而,要达到令人满意的乳腺癌筛查率是一项挑战。本研究测量了农村妇女的偏好和偏好异质性,以制定提高乳腺癌筛查参与率的策略:方法:在中国江苏省通过面对面访谈的便利抽样方式进行了一项带有离散选择实验(DCE)的横断面调查。通过系统的文献综述、先前对中国农村妇女BCS意向的研究、对农村妇女(13人)、医务人员(4人)和医疗管理人员(2人)的深入访谈以及对现实可行政策的了解,确定了DCE的六个属性。D-efficient 设计使用 Ngene 1.3.0 生成。使用 Stata 18.0 中的混合对数模型(MXL)来估计属性水平对农村妇女偏好的主要影响。此外,还估算了相对重要性和使用 BCS 服务的意愿(WTU)。异质性偏好通过潜类模型(LCM)进行分析。社会人口状况用于预测类别成员的特征。还计算了不同等级的 WTU:共招募了 451 名 35-64 岁的农村妇女。MXL 结果显示,筛查间隔(SI)是农村妇女使用 BCS 服务的最重要因素,其次是筛查水平、医务人员的态度、获取知识和信息的途径、推荐筛查的人以及用于筛查的时间(TSS)。农村妇女更倾向于选择 TSS 较短的 BCS 服务;通过多种途径获取知识和信息;较短的 SI;医务人员或村、社区工作人员及其他人员的推荐;医务人员的热情;在现场工作时间较长的医务人员。LCM 的偏好异质性分析确定了 "过程驱动 "和 "效率驱动 "两个类别:结论:如果服务符合妇女的偏好,乳腺癌筛查的接受率会更高。对于中国农村妇女来说,筛查间隔是最重要的因素,她们更倾向于每年进行一次筛查,而不是间隔更长的时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What Breast Cancer Screening Program do Rural Women Prefer? A Discrete Choice Experiment in Jiangsu, China.

Background: Chinese rural women aged 35-64 years are encouraged to complete breast cancer screening (BCS) free of charge. However, it is challenging to reach a satisfying BCS uptake rate. In this study, rural women's preferences and preferences heterogeneity were measured for the development of strategies to enhance participation in BCS.

Methods: A cross-sectional survey with a discrete choice experiment (DCE) was conducted via convenience sampling via face-to-face interviews in Jiangsu, China. Six DCE attributes were identified through a systematic literature review; our previous study of Chinese rural women's BCS intentions; a qualitative work involving in-depth interviews with rural women (n = 13), medical staff (n = 4), and health care managers (n = 2); and knowledge of realistic and actionable policy. The D-efficient design was generated using Ngene 1.3.0. A mixed logit model (MXL) in Stata 18.0 was used to estimate the main effect of attribute levels on rural women's preferences. The relative importance and willingness to utilize BCS services (WTU) were also estimated. The heterogeneous preferences were analyzed by a latent class model (LCM). Sociodemographic status was used to predict the characteristics of class membership. The WTU for different classes was also calculated.

Results: A total of 451 rural women, aged 35-64 years, were recruited. The MXL results revealed that the screening interval (SI) was the most important attribute for rural women with regard to utilizing BCS services, followed by the level of screening, the attitude of medical staff, ways to get knowledge and information, people who recommend screening, and time spent on screening (TSS). Rural women preferred a BCS service with a shorter TSS; access to knowledge and information through multiple approaches; a shorter SI; a recommendation from medical staff or workers from the village or community, and others; the enthusiasm of medical staff; and medical staff with longer tenures in the field. Two classes named "process driven" and "efficiency driven" were identified by the preference heterogeneity analysis of the LCM.

Conclusion: There is a higher uptake of breast cancer screening when services are tailored to women's preferences. The screening interval was the most important attribute for rural women in China with a preference for a yearly screening interval versus longer intervals.

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来源期刊
Patient-Patient Centered Outcomes Research
Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-
CiteScore
6.60
自引率
8.30%
发文量
44
审稿时长
>12 weeks
期刊介绍: The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.
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