No description available.

The purpose of this dissertation is to explore the creation of a cervical cancer health prevention infographic, geared toward African American women ages 30 to 65, to be potentially used to raise health literacy and influence positive behaviors towards practicing prevention measures—ultimately preventing unnecessary deaths. This dissertation also produced a cervical cancer health prevention infographic prototype for African American Women ages 30 to 65 to be further tested and implemented within future health communication campaigns. Cervical Cancer is both preventable and treatable (if diagnosed during early stages); therefore the amount of individuals dying from the cancer should be minimal. Still, African American Women in this study’s target health population are dying from Cervical Cancer the most. Existing research highlights that social determinants of health (like income, education and literacy) play varying roles as barriers to prevention (Baldwin, 1996; J. L. Davis et al., 2013; Egbert & Parrott, 2001; Ford et al., 2013; McKinnon, Harper, & Moore, 2011; Sung, Alema-Mensah, & Blumenthal, 2002; Williams & Templin, 2013). . This dissertation specifically focuses on targeting the potential to increase health literacy on Cervical Cancer to potentially positively influence prevention uptake. Drawing upon fields like health communication, visual communication and social science research, this research endeavor presents an interdisciplinary approach to potentially solving health communication issue within an at-risk population. The theoretical framework in guiding infographic production for this dissertation was the Health Belief Model, which is widely used in health communication research to assess failure of prevention uptake (du Pré, 2014; Glanz et al., 2005; Maibach & Parrott, 1995; Rosenstock, 2000). The Health Belief Model in conjunction with existing literature regarding health literacy, cultural stigma and relevance in communication campaigns geared toward African American Women ages 30 to 65, infographic content was created and presented to study participants via six interactive focus groups. The focus group methodology of qualitative research allowed for 17 study participants to confidentially engage in dialogue with peers concerning the issue at hand while also helping to create the content hierarchy, enhance and suggest visuals, colors and themes of the proposed infographic. Iterative data analysis approaches allow for constant assessment of study outcomes and themes. This study produces theoretical, practical and methodological implications for future research on the lacking area of scholarly literature. Findings from this dissertation suggest a need to (1) test the proposed infographic for potential national health campaign usage, (2) a need for more long-term collaborative community efforts for continual population access in research on Cervical Cancer prevention, and (3) future assessment of a newer form of focus group research that focuses on incorporation smaller participant groups for increased hands-on interactivity.

Little is known about breast health behaviors in Afro-Caribbean women (ACW) residing in the United States, as they are often included in the collective group of African American women (AAW). The objective of this study was to determine the influence of a spiritually-guided intervention on breast health self-care (BHSC) attitudes in ACW residing in southeastern Florida using a concurrent triangulation mixed methods design. One hundred and seventeen women were recruited from three local south Florida Caribbean churches. Inclusion criteria included: (a) self-identification as Afro-Caribbean, (b) female aged 30 years or older, (c) living in the United States for at least 1 year, (d) able to provide informed consent, (e) able to speak and read English at the 8th grade level, and (f) no previous history of breast cancer. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

O câncer de mama é a neoplasia maligna mais prevalente entre as mulheres no mundo e representa 23% de todos os cânceres femininos. Buscou-se avaliar a implementação de um programa de rastreamento mamográfico para as mulheres que vivem na área de Barretos usando uma unidade móvel (UM) e uma unidade fixa (UF). Um total de 54.238 mulheres com idade entre 40 a 69 anos reside nesta área e são elegíveis para a participação no programa. Os dados epidemiológicos das mulheres foram examinadas entre 01 de abril de 2003 e 31 de março de 2005. A análise estatística foi constituída pela avaliação das freqüências dos parâmetros clínicos e as características do tumor usando o teste de Qui-quadrado com correção de Bonferroni, com valor de confiança de p<0,05. Um total de 17.964 mulheres (media de 51 anos de idade) foram efetivamente examinadas por mamografia, o que representou 33,1% de todas as mulheres elegíveis (18,6 exames por dia na UF e 26,3 na UM). Setenta e seis casos foram diagnosticados como câncer de mama (41, ou 54%, no UM), o que representa 4,2 casos de câncer de mama para cada 1.000 exames. Foi observada diferença significativa na detecção de câncer entre mulheres com idade entre 50-59 e 60-69 anos (p<0,001) e com idade entre 40-49 e 60-69 anos (p<0,001). Não foram observadas diferenças entre 40 a 49 e 50-59 anos (p = 0,164). O programa de rastreamento mamografico é viável no território nacional e os resultados preliminares são animadores / Breast cancer is the most prevalent malignancy among women worldwide and enrolls 23% of all female cancers. We sought to evaluate the implementation of a screening program for women who living in Barretos county area using a mobile unit (MU) and a fixed unit (FU). A total of 54,238 women aged 40 to 69 years is living in this area and are eligible for breast screening. Epidemiologic-based data supported the study design and the women were examined from April 01, 2003 to March 31, 2005. Statistical analysis supported the evaluation of clinical parameters frequencies and tumor characteristics using Chi-test and Bonferroni correction test, with confidence value of p<0,05. Overall of 17,964 women (media of 51 years old) were effectively examined by mammogram which represented 33,1% of all eligible women (18,6 in RA and 26,3 exams in MU per day). Seventy-six cases were diagnosed as breast cancer (41, or 54%, at MU), which represents 4,2 cases of breast cancer for each 1.000 exams. It was observed significant difference of cancer detection between women aged 50 to 59 and 60 to 69 yrs (p<0, 001) and between women aged 40 to 49 and 60 to 69 yrs (p<0,001). No differences were observed between aged 40 to 49 and 50 to 59 yrs (p=0,164). The program for mammogram screening is feasible to be implementing in Brazil territory and the preliminary results are encouraging

Introdução: O câncer do colo do útero é um problema de saúde publica, é uma importante causa de morbidade e mortalidade em mulheres de todo mundo. O rastreamento com a citologia de Papanicolaou, quando realizado periodicamente demonstrou ser eficaz na redução de incidência e mortalidade em países desenvolvidos. O rastreamento com unidade móvel de prevenção é uma estratégia para o diagnóstico precoce do câncer do colo do útero. Objetivo: Avaliar os resultados do programa de rastreamento com busca ativa e unidade móvel na detecção precoce do câncer do colo do útero na população das zonas urbana e rural de Barretos. Casuística e Métodos: Estudo retrospectivo, descritivo, com 16.849 mulheres na zona urbana e 1.055 na zona rural de Barretos. O projeto inclui visitas domiciliares repetidas de um profissional de saúde da unidade móvel do Hospital de Câncer de Barretos (HCB), entrevista e coleta de Papanicolaou. Mulheres com diagnóstico citológico de ASC-US, ASC-H, lesões intraepiteliais e carcinoma invasivo, foram convocadas para colposcopia e todas as mulheres com histopatológico de carcinoma foram tratadas e permanecem em seguimento no HCB. Os resultados deste programa foram comparados com dados do registro sobre câncer do colo do útero do Departamento Regional de Saúde V (DRS-V) e da Fundação Oncocentro de São Paulo (FOSP), do mesmo período. Resultados: Na zona urbana 10.350 (61,4%) mulheres foram examinadas e realizaram o exame de Papanicolaou, com taxa de cobertura de 62,9% nas mulheres em idade alvo (25 a 60 anos) do programa brasileiro. Foram identificados 35 casos de carcinoma, sendo 77,1% de carcinoma espinocelular in situ. A idade média foi 41,9 anos, 81,4% das mulheres examinadas eram das classes socioeconômicas D e E, e 88,6% apresentavam exame prévio de Papanicolaou. Na zona rural, 1.055 (100%) mulheres foram entrevistadas, examinadas e realizaram o exame de Papanicolaou, com taxa de cobertura de 74,4% na idade alvo. Foram identificados 6 casos de carcinoma, sendo 83,3% de carcinoma espinocelular in situ. A idade média foi de 39,8 anos, 86,7% nas classes socioeconômicas D e E, e 81,0% das mulheres apresentavam exame de Papanicolaou prévio. Analisamos os dados do programa de rastreamento do HCB e comparamos com os dados, em relação ao estadiamento, da DRS-V e FOSP, no mesmo período. Está análise mostrou que houve uma prevalência de lesões in situ em relação às invasivas no programa de rastreamento do HCB quando comparado à DRS-V (p=0,005) e à FOSP (p<0,001). Conclusões: O rastreamento com busca ativa e unidade móvel é um método efetivo no diagnóstico precoce do câncer do colo do útero / Introduction: Uterine cervical cancer is a public health problem and an important cause of morbidity and mortality among women worldwide. Screening using the Papanicolaou cytological test, when done repeatedly, has been shown to be effective for reducing the incidence and mortality of this disease in developed countries. Screening with an active search using a mobile unit is a strategy for early diagnosis of uterine cervical cancer. Objective: To evaluate the results from a screening program with an active search using a mobile unit for early detection of uterine cervical cancer among the populations in the urban and rural zones of Barretos. Sample and Methods: This was a retrospective descriptive study on 16,849 women in the urban zone and 1,055 in the rural zone of Barretos. The project included repeated home visits by a healthcare professional from the mobile unit of Barretos Cancer Hospital (HCB), interviews and collection of Papanicolaou smears. Women with a cytological diagnosis of ASC-US, ASC-H, intraepithelial lesions and invasive carcinoma were called in for colposcopy examinations. All the women with a histopathological diagnosis of carcinoma were treated and remained under follow-up by HCB. The results were compared with data from the uterine cervical cancer records of the Fifth Regional Health Department (DRS-V) and the Oncocenter Foundation of São Paulo (FOSP), covering the same period. Results: From the urban zone, 10,350 Papanicolaou smears (61.4%) were collected, with a coverage rate of 62.9% of the women at the target age for the Brazilian program. There were 35 cases of carcinoma, of which 77.1% were in situ squamous cell carcinoma. The womens mean age was 41.9 years; 81.4% were in socioeconomic classes D and E; and 88.6% had had a previous Papanicolaou examination. In the rural zone, 1,055 Papanicolaou smears (100.0%) were collected, with a coverage rate of 74.4% of the women at the target age. There were six cases of carcinoma, of which 83.3% were in situ squamous cell carcinoma. The womens mean age was 39.8 years; 86.7% were in socioeconomic classes D and E; and 81.0% had had a previous Papanicolaou examination. We analyzed the data from the HCB screening program in comparison with the staging data from DRS-V and FOSP, over the same period. There were statistically significant differences in the proportions of in situ and invasive carcinoma found in the HCB screening program in relation to DRS-V (p = 0.0046) and in relation to FOSP (p < 0.001). This analysis showed that there was higher prevalence of in situ lesions than of invasive lesions in the HCB screening program. Conclusions: Screening with an active search using a mobile unit is an effective method for early diagnosis of uterine cervical cancer

Introdução: O câncer de mama é um problema de saúde publica, sendo a maior causa de morbidade e mortalidade de câncer em mulheres de todo mundo. O rastreamento mamográfico mostrou-se efetivo na redução na mortalidade por câncer de mama em países desenvolvidos, entretanto ainda não é consenso a idade de início do rastreamento mamográfico. Objetivo: Verificar o impacto do rastreamento mamográfico em mulheres entre 40-49 anos na região de Barretos. Casuística e métodos: Este é um estudo observacional transversal que incluíram mulheres assintomáticas com idade entre 40-69 anos que foram submetidas a rastreamento mamográfico entre os anos de 2003 a 2007. As mulheres com exames classificadas pelo sistema BI-RADS em zero, quatro ou cinco foram convocados para investigação. Foram descritas as freqüências absolutas e relativas das variáveis e suas diferenças analisadas pelo teste de qui-quadrado sendo escolhido o nível de significância p <0,05. Foi realizado análise de regressão logística para avaliar o risco de câncer de mama em relação à idade. Resultados: 27.133 mulheres com idades entre 40-69 foram selecionadas, 52% (14.082) das mamografias foram feitas em mulheres de 40 a 49 anos. Foram detectados 132 casos de câncer de mama em mulheres de 40 a 69 anos sendo 49 casos entre mulheres de 40 a 49. A estimativa de risco de câncer de mama entre mulheres de 40 e 49 anos (OR 0,43 [IC95% 0,28 - 0,66]) foi significativamente menor do que entre 60-69 anos. Dos casos de câncer de mama em mulheres de 40 a 49 anos 55% eram iniciais (Estádio Clínico 0-I) enquanto que no período anterior ao rastreamento eram 13%. Conclusões: O rastreamento mamográfico realizado na Região de Barretos mostrou menor risco de câncer de mama nas mulheres de 40 a 49 anos em relação às mulheres entre 60 e 69 anos. O estudo mostrou ainda que o rastreamento aumentou o número de casos iniciais (Estádio Clínico 0-I) entre as mulheres de 40 e 49 anos em relação ao período anterior ao rastreamento / Introduction: Breast cancer is a public health problem, being the major cause of morbidity and mortality of cancer in women worldwide. The mammographic screening was effective in reducing mortality from breast cancer in developed countries, but consensus is not yet the age of onset of mammographic screening. Objective: Investigate the impact of mammographic screening in women aged 40-49 years in Barretos region. Methods: This is a cross sectional observational study that included asymptomatic women aged 40-69 years who underwent screening mammography between the years 2003 to 2007. Women with tests classified by the BI-RADS at zero, four or five were summoned for investigation. We described the absolute and relative frequencies of the variables and their differences were analyzed by chi-square was chosen significance level p <0.05. Was performed logistic regression analysis to assess the risk of breast cancer in relation to age. Results: 27,133 women aged 40-69 were selected, 52% (14 082) of mammograms were performed in women 40 to 49 years. We detected 132 cases of breast cancer in women aged 40 to 69 years with 49 cases among women 40 to 49. The estimated risk of breast cancer among women between 40 and 49 years (OR 0.43 [95% CI 0.28 to 0.66]) was significantly lower than 60-69 years. Cases of breast cancer in women aged 40 to 49 years 55% were early (clinical stage 0-I) while in the period prior to screening was 13%. Conclusions: The screening mammography performed in the region Barrie showed a lower risk of breast cancer in women aged 40 to 49 years for women between 60 and 69 years. The study also showed that screening increased the number of initial cases (clinical stage 0-I) among women aged 40 to 49 years in the period prior to screening

Introdução: O câncer do colo do útero é um problema de saúde publica, é uma importante causa de morbidade e mortalidade em mulheres de todo mundo. O rastreamento com a citologia de Papanicolaou, quando realizado periodicamente demonstrou ser eficaz na redução de incidência e mortalidade em países desenvolvidos. O rastreamento com unidade móvel de prevenção é uma estratégia para o diagnóstico precoce do câncer do colo do útero. Objetivo: Avaliar os resultados do programa de rastreamento com busca ativa e unidade móvel na detecção precoce do câncer do colo do útero na população das zonas urbana e rural de Barretos. Casuística e Métodos: Estudo retrospectivo, descritivo, com 16.849 mulheres na zona urbana e 1.055 na zona rural de Barretos. O projeto inclui visitas domiciliares repetidas de um profissional de saúde da unidade móvel do Hospital de Câncer de Barretos (HCB), entrevista e coleta de Papanicolaou. Mulheres com diagnóstico citológico de ASC-US, ASC-H, lesões intraepiteliais e carcinoma invasivo, foram convocadas para colposcopia e todas as mulheres com histopatológico de carcinoma foram tratadas e permanecem em seguimento no HCB. Os resultados deste programa foram comparados com dados do registro sobre câncer do colo do útero do Departamento Regional de Saúde V (DRS-V) e da Fundação Oncocentro de São Paulo (FOSP), do mesmo período. Resultados: Na zona urbana 10.350 (61,4%) mulheres foram examinadas e realizaram o exame de Papanicolaou, com taxa de cobertura de 62,9% nas mulheres em idade alvo (25 a 60 anos) do programa brasileiro. Foram identificados 35 casos de carcinoma, sendo 77,1% de carcinoma espinocelular in situ. A idade média foi 41,9 anos, 81,4% das mulheres examinadas eram das classes socioeconômicas D e E, e 88,6% apresentavam exame prévio de Papanicolaou. Na zona rural, 1.055 (100%) mulheres foram entrevistadas, examinadas e realizaram o exame de Papanicolaou, com taxa de cobertura de 74,4% na idade alvo. Foram identificados 6 casos de carcinoma, sendo 83,3% de carcinoma espinocelular in situ. A idade média foi de 39,8 anos, 86,7% nas classes socioeconômicas D e E, e 81,0% das mulheres apresentavam exame de Papanicolaou prévio. Analisamos os dados do programa de rastreamento do HCB e comparamos com os dados, em relação ao estadiamento, da DRS-V e FOSP, no mesmo período. Está análise mostrou que houve uma prevalência de lesões in situ em relação às invasivas no programa de rastreamento do HCB quando comparado à DRS-V (p=0,005) e à FOSP (p<0,001). Conclusões: O rastreamento com busca ativa e unidade móvel é um método efetivo no diagnóstico precoce do câncer do colo do útero / Introduction: Uterine cervical cancer is a public health problem and an important cause of morbidity and mortality among women worldwide. Screening using the Papanicolaou cytological test, when done repeatedly, has been shown to be effective for reducing the incidence and mortality of this disease in developed countries. Screening with an active search using a mobile unit is a strategy for early diagnosis of uterine cervical cancer. Objective: To evaluate the results from a screening program with an active search using a mobile unit for early detection of uterine cervical cancer among the populations in the urban and rural zones of Barretos. Sample and Methods: This was a retrospective descriptive study on 16,849 women in the urban zone and 1,055 in the rural zone of Barretos. The project included repeated home visits by a healthcare professional from the mobile unit of Barretos Cancer Hospital (HCB), interviews and collection of Papanicolaou smears. Women with a cytological diagnosis of ASC-US, ASC-H, intraepithelial lesions and invasive carcinoma were called in for colposcopy examinations. All the women with a histopathological diagnosis of carcinoma were treated and remained under follow-up by HCB. The results were compared with data from the uterine cervical cancer records of the Fifth Regional Health Department (DRS-V) and the Oncocenter Foundation of São Paulo (FOSP), covering the same period. Results: From the urban zone, 10,350 Papanicolaou smears (61.4%) were collected, with a coverage rate of 62.9% of the women at the target age for the Brazilian program. There were 35 cases of carcinoma, of which 77.1% were in situ squamous cell carcinoma. The womens mean age was 41.9 years; 81.4% were in socioeconomic classes D and E; and 88.6% had had a previous Papanicolaou examination. In the rural zone, 1,055 Papanicolaou smears (100.0%) were collected, with a coverage rate of 74.4% of the women at the target age. There were six cases of carcinoma, of which 83.3% were in situ squamous cell carcinoma. The womens mean age was 39.8 years; 86.7% were in socioeconomic classes D and E; and 81.0% had had a previous Papanicolaou examination. We analyzed the data from the HCB screening program in comparison with the staging data from DRS-V and FOSP, over the same period. There were statistically significant differences in the proportions of in situ and invasive carcinoma found in the HCB screening program in relation to DRS-V (p = 0.0046) and in relation to FOSP (p < 0.001). This analysis showed that there was higher prevalence of in situ lesions than of invasive lesions in the HCB screening program. Conclusions: Screening with an active search using a mobile unit is an effective method for early diagnosis of uterine cervical cancer

Introdução: O câncer de mama é um problema de saúde publica, sendo a maior causa de morbidade e mortalidade de câncer em mulheres de todo mundo. O rastreamento mamográfico mostrou-se efetivo na redução na mortalidade por câncer de mama em países desenvolvidos, entretanto ainda não é consenso a idade de início do rastreamento mamográfico. Objetivo: Verificar o impacto do rastreamento mamográfico em mulheres entre 40-49 anos na região de Barretos. Casuística e métodos: Este é um estudo observacional transversal que incluíram mulheres assintomáticas com idade entre 40-69 anos que foram submetidas a rastreamento mamográfico entre os anos de 2003 a 2007. As mulheres com exames classificadas pelo sistema BI-RADS em zero, quatro ou cinco foram convocados para investigação. Foram descritas as freqüências absolutas e relativas das variáveis e suas diferenças analisadas pelo teste de qui-quadrado sendo escolhido o nível de significância p <0,05. Foi realizado análise de regressão logística para avaliar o risco de câncer de mama em relação à idade. Resultados: 27.133 mulheres com idades entre 40-69 foram selecionadas, 52% (14.082) das mamografias foram feitas em mulheres de 40 a 49 anos. Foram detectados 132 casos de câncer de mama em mulheres de 40 a 69 anos sendo 49 casos entre mulheres de 40 a 49. A estimativa de risco de câncer de mama entre mulheres de 40 e 49 anos (OR 0,43 [IC95% 0,28 - 0,66]) foi significativamente menor do que entre 60-69 anos. Dos casos de câncer de mama em mulheres de 40 a 49 anos 55% eram iniciais (Estádio Clínico 0-I) enquanto que no período anterior ao rastreamento eram 13%. Conclusões: O rastreamento mamográfico realizado na Região de Barretos mostrou menor risco de câncer de mama nas mulheres de 40 a 49 anos em relação às mulheres entre 60 e 69 anos. O estudo mostrou ainda que o rastreamento aumentou o número de casos iniciais (Estádio Clínico 0-I) entre as mulheres de 40 e 49 anos em relação ao período anterior ao rastreamento / Introduction: Breast cancer is a public health problem, being the major cause of morbidity and mortality of cancer in women worldwide. The mammographic screening was effective in reducing mortality from breast cancer in developed countries, but consensus is not yet the age of onset of mammographic screening. Objective: Investigate the impact of mammographic screening in women aged 40-49 years in Barretos region. Methods: This is a cross sectional observational study that included asymptomatic women aged 40-69 years who underwent screening mammography between the years 2003 to 2007. Women with tests classified by the BI-RADS at zero, four or five were summoned for investigation. We described the absolute and relative frequencies of the variables and their differences were analyzed by chi-square was chosen significance level p <0.05. Was performed logistic regression analysis to assess the risk of breast cancer in relation to age. Results: 27,133 women aged 40-69 were selected, 52% (14 082) of mammograms were performed in women 40 to 49 years. We detected 132 cases of breast cancer in women aged 40 to 69 years with 49 cases among women 40 to 49. The estimated risk of breast cancer among women between 40 and 49 years (OR 0.43 [95% CI 0.28 to 0.66]) was significantly lower than 60-69 years. Cases of breast cancer in women aged 40 to 49 years 55% were early (clinical stage 0-I) while in the period prior to screening was 13%. Conclusions: The screening mammography performed in the region Barrie showed a lower risk of breast cancer in women aged 40 to 49 years for women between 60 and 69 years. The study also showed that screening increased the number of initial cases (clinical stage 0-I) among women aged 40 to 49 years in the period prior to screening

Breast cancer is a serious illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The purpose of this phenomenological study was to seek individual professed barriers to breast cancer screening among African American women to better understand why breast cancer continues to be one of the principal basis of mortality among African American women. The theoretical framework for this study was the behavioral model of health services use. Purposeful selection was used to invite 14 African American women to participate in the in-depth interview process. Interview data were transcribed and then coded for recurring themes and meaning. The findings of this study demonstrate that these women's perceived barriers to breast cancer screening were lack of information, a belief that genetics dictates who gets breast cancer, embarrassment, a norm of people not going for health checkups, the procedure of breast cancer screening, and fear. Participants noted that the improved method of mammography may promote utilization within the population. Breast cancer disparities among African American women may decline if healthcare providers promote awareness of the availability and accessibility of breast cancer prevention resources and if African American women understand the barriers to breast cancer prevention and change their own screening practices.

published_or_final_version / Public Health / Master / Master of Public Health