Perception of cervical cancer screening among Immigrant African women residing in Houston, Texas Esther I. Orji M.Ed., University of Lagos, 2002 B. Ed, Abia State University, 1998 A.C. E. University of Benin, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2016 Disparities in cervical cancer screening participation still exist especially among immigrant and minority women compared to non immigrant populations. Research investigators through multiple studies have explored reasons for non participation in cervical cancer screening among immigrant and minority women. However, there was limited research specifically on how immigrant women of African descent could be empowered to overcome barriers associated with cervical cancer screening in Houston Texas. The purpose of this study was to explore and understand the perceptions of factors which are barriers to perform cervical cancer screening tests among immigrant women of African descent, as well as their beliefs on preventive medicine, and how immigrant women could be empowered in order to overcome barriers associated with cervical cancer screening. The theoretical framework was based on the health belief model. The participants for the study were 20 immigrant women of African descent aged 21-65. A semi-structured interview schedule which comprised of open ended questions was used to collect data on the perspectives of immigrant women towards cervical cancer screening. Data was transcribed verbatim and analyzed thematically. The social change implications of the study can be that immigrant women could be more encouraged to seek access to the appropriate state of the art in cervical cancer screening which could contribute in reducing mortality, morbidity rate, and costs associated with cervical cancer.

Current ACS guidelines recommend routine screening for cancer (ACS, 2002). Motivation to adhere to guidelines may be different for individuals with and without a family history of melanoma (Jonna, et al., 1998). Prior research examining the relationship between family history and skin cancer detection behaviors (Berwick et al., 1996; Friedman et al., 1993; Oliveria et al., 1999) have failed to utilize a theoretical framework to derive hypotheses. The purpose of the present study was to examine the utility of Protection Motivation Theory (PMT) in explaining intentions to engage in skin cancer screening (SCS) and skin self-examination (SSE). In addition, the present study explored whether PMT variables explained the relationship between having a family history of melanoma and SCS/SSE intentions. The research design was cross-sectional with 101 participants in the positive family history group and 80 participants in the negative family history group. Using a standardized, self-report measure, participants were assessed on demographic characteristics, melanoma risk factors, PMT variables, family history, and SCS/SSE behaviors and intentions. Statistical analyses included descriptive statistics, chi square for categorical variables, t-tests for continuous variables, correlational analyses, and multiple regression analyses. The majority of participants (N = 181) were Caucasian (97%) and female (59%). As expected, findings indicated that greater perceived vulnerability, self-efficacy, and response efficacy were associated with greater SCS intentions (p greater or less than .0001). Additionally, greater self-efficacy and response efficacy were associated with greater SSE intention (p greater or less than .01). Additionally, positive family history individuals reported greater perceived vulnerability, greater self-efficacy, and less perceived severity than negative family history individuals (p greater or less than .01). Individuals with a family history of melanoma also had greater SCS intentions and were more likely to have a healthcare provider who recommended SCS. Finally, perceived vulnerability and self-efficacy partially mediated the relationship between group status and SCS intentions. The present study confirms and extends prior research on psychological factors associated with SCS/SSE intentions and on individuals with a family history of melanoma. Clinical implications and future directions are discussed.

Title from PDF of title page. / Document formatted into pages; contains 117 pages. / Thesis (Ph.D.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT Current ACS guidelines recommend routine screening for cancer (ACS, 2002). Motivation to adhere to guidelines may be different for individuals with and without a family history of melanoma (Jonna, et al., 1998). Prior research examining the relationship between family history and skin cancer detection behaviors (Berwick et al., 1996; Friedman et al., 1993; Oliveria et al., 1999) have failed to utilize a theoretical framework to derive hypotheses. The purpose of the present study was to examine the utility of Protection Motivation Theory (PMT) in explaining intentions to engage in skin cancer screening (SCS) and skin self-examination (SSE). In addition, the present study explored whether PMT variables explained the relationship between having a family history of melanoma and SCS/SSE intentions. / ABSTRACT: The research design was cross-sectional with 101 participants in the positive family history group and 80 participants in the negative family history group. Using a standardized, self-report measure, participants were assessed on demographic characteristics, melanoma risk factors, PMT variables, family history, and SCS/SSE behaviors and intentions. Statistical analyses included descriptive statistics, chi square for categorical variables, t-tests for continuous variables, correlational analyses, and multiple regression analyses. The majority of participants (N = 181) were Caucasian (97%) and female (59%). As expected, findings indicated that greater perceived vulnerability, self-efficacy, and response efficacy were associated with greater SCS intentions (p greater or less than .0001). Additionally, greater self-efficacy and response efficacy were associated with greater SSE intention (p greater or less than .01). / ABSTRACT: Additionally, positive family history individuals reported greater perceived vulnerability, greater self-efficacy, and less perceived severity than negative family history individuals (p greater or less than .01). Individuals with a family history of melanoma also had greater SCS intentions and were more likely to have a healthcare provider who recommended SCS. Finally, perceived vulnerability and self-efficacy partially mediated the relationship between group status and SCS intentions. The present study confirms and extends prior research on psychological factors associated with SCS/SSE intentions and on individuals with a family history of melanoma. Clinical implications and future directions are discussed. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

There is a dearth of validated self-efficacy (SE) measures in the field of preventive oncology. The objective of this study is to describe the development and validation of a measure to assess patients' perceived ability to obtain the recommended care following an abnormality suspicious for breast cancer. Guided by a social cognitive theory framework, a 51-item measure was developed to explore perceived capability to obtain follow up care under a number of barriers. A multi-step process was utilized to assess the instrument's psychometric properties. First, cognitive validity assessments with experts were conducted, and these aided in the wording refinement of several items. An exploratory factor analysis was performed, and a 4-factor solution emerged containing factors related to barriers to care such as costs, transportation, structural and communication barriers. Reliability analyses were conducted for the total scale and subscales. Then, relationships between theoretically-related constructs were explored to assess convergent validity (self-efficacy and outcome expectations, perceived control), and divergent validity (self-efficacy and depression). Findings provide evidence of both convergent and discriminant validity. This multi-step process aided in the reduction of the scale to 12 validated and reliable items.

No description available.

La problématique du transport de la donnée médicale, de surcroît nominative, comporte de nombreuses contraintes, qu’elles soient d’ordre technique, légale ou encore relationnelle. Les nouvelles technologies, issues particulièrement des grilles informatiques, permettent d’offrir une nouvelle approche au partage de l’information. En effet, le développement des intergiciels de grilles, notamment ceux issus du projet européen EGEE, ont permis d’ouvrir de nouvelles perspectives pour l’accès distribué aux données. Les principales contraintes d’un système de partage de données médicales, outre les besoins en termes de sécurité, proviennent de la façon de recueillir et d’accéder à l’information. En effet, la collecte, le déplacement, la concentration et la gestion de la donnée, se fait habituellement sur le modèle client-serveur traditionnel et se heurte à de nombreuses problématiques de propriété, de contrôle, de mise à jour, de disponibilité ou encore de dimensionnement des systèmes. La méthodologie proposée dans cette thèse utilise une autre philosophie dans la façon d’accéder à l’information. En utilisant toute la couche de contrôle d’accès et de sécurité des grilles informatiques, couplée aux méthodes d’authentification robuste des utilisateurs, un accès décentralisé aux données médicales est proposé. Ainsi, le principal avantage est de permettre aux fournisseurs de données de garder le contrôle sur leurs informations et ainsi de s’affranchir de la gestion des données médicales, le système étant capable d’aller directement chercher la donnée à la source.L’utilisation de cette approche n’est cependant pas complètement transparente et tous les mécanismes d’identification des patients et de rapprochement d’identités (data linkage) doivent être complètement repensés et réécris afin d’être compatibles avec un système distribué de gestion de bases de données. Le projet RSCA (Réseau Sentinelle Cancer Auvergne – www.e-sentinelle.org) constitue le cadre d’application de ce travail. Il a pour objectif de mutualiser les sources de données auvergnates sur le dépistage organisé des cancers du sein et du côlon. Les objectifs sont multiples : permettre, tout en respectant les lois en vigueur, d’échanger des données cancer entre acteurs médicaux et, dans un second temps, offrir un support à l’analyse statistique et épidémiologique. / Nominative medical data exchange is a growing challenge containing numerous technical, legislative or relationship barriers. New advanced technologies, in the particular field of grid computing, offer a new approach to handle medical data exchange. The development of the gLite grid middleware within the EGEE project opened new perspectives in distributed data access and database federation. The main requirements of a medical data exchange system, except the high level of security, come from the way to collect and provide data. The original client-server model of computing has many drawbacks regarding data ownership, updates, control, availability and scalability. The method described in this dissertation uses another philosophy in accessing medical data. Using the grid security layer and a robust user access authentication and control system, we build up a dedicated grid network able to federate distributed medical databases. In this way, data owners keep control over the data they produce.This approach is therefore not totally straightforward, especially for patient identification and medical data linkage which is an open problem even in centralized medical systems. A new method is then proposed to handle these specific issues in a highly distributed environment. The Sentinelle project (RSCA) constitutes the applicative framework of this project in the field of cancer screening in French Auvergne region. The first objective is to allow anatomic pathology reports exchange between laboratories and screening structures compliant with pathologists’ requirements and legal issues. Then, the second goal is to provide a framework for epidemiologists to access high quality medical data for statistical studies and global epidemiology.

A l'ère des multithérapies antirétrovirales, le poids des manifestations de l'infection VIH sur la morbi/mortalité s'est allégé alors que d'autres pathologies pèsent de plus en plus sur l'état de santé des personnes vivant avec le VIH (PvVIH). Le recours au dépistage des cancers et la prise en charge des facteurs de risque cardiovasculaire liés au mode de vie (tabac, alcool, inactivité physique, obésité) sont deux importantes composantes dans la prévention de ces comorbidités chez les PvVIH. A partir des données de l'enquête ANRS-Vespa2, nous avons montré que le recours au dépistage des cancers n'était pas moindre chez les PvVIH que dans la population générale. Cependant, le dépistage annuel du cancer du col de l'utérus n'était pas optimal, et le dépistage du cancer colorectal demeurait faible. Un faible niveau d'éducation et l'immunodépression étaient associés à un moindre recours au dépistage des cancers gynécologiques. D'autre part, plus de la moitié des PvVIH présentait au moins un facteur de risque cardiovasculaire. Les usagers de drogues et les hommes ayant des rapports sexuels avec des hommes étaient particulièrement sujets aux addictions, cumulant fréquemment ces facteurs, et les immigrées d'Afrique sub-Saharienne étaient surtout exposées à l'obésité et l'inactivité physique. Ces comportements étaient liés à la situation sociale et aux caractéristiques de la maladie VIH. Cette thèse permet de mieux appréhender la fréquence et les facteurs associés à ces comportements de santé au sein des groupes de la population séropositive, et de proposer des pistes pour améliorer la prévention des comorbidités afin de contribuer à en limiter le poids sur la santé des PvVIH. / In the era of combined antiretroviral therapy, the burden of HIV-related morbidity/mortality has decreased while other health conditions are of growing concern among HIV-infected people. Cancer screening uptake and management of behavioral risk factors for cardiovascular disease (tobacco smoking, alcohol intake, lack of physical activity, obesity) are two major components in the prevention of those comorbidities among HIV-infected people. Analysis of data from the ANRS-Vespa2 survey showed that levels of cancer screening uptake were not lower among HIV-infected people compared to the general population. However, the level of cervical cancer screening uptake within the past year was suboptimal and the level of colorectal cancer screening uptake was low. Low educational attainment and immunodepression were correlated with a lower level of screening uptake for gynecological cancers. Furthermore, more than half of the HIV-infected population was exposed to at least one behavioral cardiovascular risk factor. Intravenous drug users and men who have sex with men were particularly prone to addictive behaviors (and lack of physical activity) and risk factors were often combined. Sub-Saharan African migrant women were mainly exposed to obesity and insufficient physical activity. Those behaviors were associated with social status and certain characteristics of the HIV-infection. This thesis allows to better understand the frequency and correlates of those health behaviors among the various sub-groups of people living with HIV and provides evidence to improve the prevention of comorbidities in order to reduce their burden on the health of those living with HIV.

In Boston Massachusetts, Black and White women aged 50-74, experience limited access to breast cancer screening. The purpose of this quantitative study was to investigate whether there is a correlation between breast cancer screening access to personal healthcare providers among Black and White women, aged 50- 74, in Boston, MA. The study focused on whether there was a correlation between breast cancer screening access and socioeconomic status among women, and whether a correlation existed between breast cancer screening and their educational levels. The study was informed by the health belief psychological framework. The study consisted of secondary data from the Behavioral Risk Factor Surveillance System with a sample size of n =1815, 18 years and above. Exclusion criteria consisted of adults under age 40, women above age 74 diagnosed with cancer, and had mastectomies previously. A chi square test examined the relationship between the independent and dependent variables. The key results showed a significant relation between race and access to healthcare providers. The study also found a significant relationship between low income levels and limited access. The study results portrayed a nonsignificant relationship between breast cancer screening and educational levels among black and white women. The results concluded that access to healthcare providers was significant among the races as well as their income levels. The study contributes to social change by promoting awareness through education of individuals, communities, organizations and the society at large.

Thesis (MPH.) --University of Limpopo, 2015 / Background Cervical cancer is the 2nd most common cancer in women globally representing 13% of female cancers and accounting for 11% of the total cancer deaths (Ahmedin et al.2011). Several studies demonstrated the association between HIV and HPV. In Zimbabwe the prevalence of HIV/AIDS is high and cervical cancer is the leading cause of cancer deaths among women of all age groups. The aim of the study was to determine the knowledge, attitude and practices of HIV infected women on cervical cancer and cervical cancer screening at Musiso Hospital, Masvingo Province, Zimbabwe. Methods 208 self administered questionnaires were used with a 100 per cent response rate. Quantitative data were analysed using STATA statistical package version 12 for descriptive and inferential statistics. Chi-squared tests were done for hypothesis testing at 5 per cent level of significance and 95 per cent confidence level. Multiple variable logistic regressions models were also used to assess association between outcomes of interest and socio-demographic characteristics. All open ended questions were analysed using qualitative methods. Results Out of the 208 participants, 45 (21.6 per cent) respondents claimed to know what cervical cancer is. About 55.3 per cent said cervical cancer is preventable. The majority (92.8 per cent) did not know any screening tests. Just above three quarters (77.3 per cent) of the respondents believed they were at risk of having cervical cancer. About 9 per cent (18) of all participants had screened for cervical cancer before and 95.8 per cent respondents reported would like to screen for cervical cancer in the future. Conclusion HIV infected women at Musiso mission hospital were found to be having inadequate knowledge, positive attitude and inadequate practices on cervical cancer and cervical cancer screening. There is need to equip these women with knowledge on cervical cancer and cervical cancer screening to increase cervical cancer screening uptake. Key Concepts: knowledge, attitude, practice, screening, cervical cancer

Colorectal cancer is a serious malignant disease with an incidence of over 1.8 million new cases per year worldwide. There are about 8 000 patients diagnosed with CRC in the Czech Republic each year, and about half of them present with an advanced disease. Screening program identifies patients in the early stages of CRC resulting in overall better prognosis and survival. There is also a lack of biomarkers of early CRC detection and of response to treatment. The first aim of our project was to conduct a national multicentre prospective observational study to evaluate the impact of CRC screening within the framework of a Czech population screening programme. Between March 2013 and September 2015, a total of 265 patients were enrolled in 12 centres across the Czech Republic. Patients were divided into screening and control groups and compared for pathology status and clinical characteristics. Screening was defined as a primary screening colonoscopy or a colonoscopy after a positive FOBT in an average-risk population. The distribution of CRC stages was significantly favourable in the screening group compared with the control group (stages 0, I and II, 63% versus 43.3%; p <0.001). The presence of distant (M1) and local metastases (N1 and N2) was significantly less prevalent in the screening group (0%,...