The Impact of False Positive Mammography Results on Breast Cancer Screening Intention Among Black Women

Extensive research indicates that false-positive mammograms (FPM) have been associated with negative psychosocial and cancer-related beliefs, but only a handful of studies examine Black women’s reactions to this experience. Additionally, these studies do not investigate how organizational and provider-level factors in concert with individual patient characteristics shape Black women’s experiences and reactions to FPM results. The purpose of this study was to determine the impact of organizational, provider, and individual-level factors on the processes and outcomes associated with FPM results in Black women. This study had two specific aims: 1) To describe, using a mixed methods approach, the organizational and provider-level characteristics of mammography facilities and their impact on Black women’s FPM experiences and outcomes. 2) To determine, through quantitative methods, the relationship between receiving a FPM result and future mammography intention among Black women. Two phases of data collection were conducted as part of this study. Phase I began in March 2016 and concluded October 2016. Observations, key informant interviews, provider surveys, and analyses of screening and diagnostic data were used to describe the facility and provider-level characteristics of five mammography screening centers in the Columbia, South Carolina Metropolitan Statistical Area (MSA). Organizational and provider data collected during Phase I were linked to patient survey data collected during Phase II. The patient survey tool contained items that assessed demographic characteristics, breast cancer (BrCa) screening history, emotional states, coping behaviors, cancer-related beliefs and attitudes in Black women with FPM and normal results. Black women aged 40+, breast cancer free, who completed screening mammograms from January to August 2016 at one of the previously mentioned screening centers were eligible to participate. Women who received a FPM result were selected as cases, matched controls were selected from women screened on the same day and site but had normal mammograms. Patient surveys were administered from July 2016 to January 2017. Of the 132 patient surveys returned, 117 met the criteria for study inclusion. No facility, provider, or patient factors were associated with two types of satisfaction: general and provider interpersonal style. FPM status was one of several patient characteristics associated with lower levels of satisfaction with convenience and provider information communication. Facility and provider-level factors had negative and positive effects on satisfaction with provider competence. Satisfaction with the clinical environment was also influenced by facility characteristics. FPM status was only associated with a higher perception of barriers to mammography, and perceived barriers were associated with a lower intention to complete mammography. Afrocentric coping behaviors moderated the perception of mammography barriers for women with FPM results, weakening this relationship. A variety of organizational, provider, and individual-level patient factors were found to influence the processes and outcomes associated with FPM among Black women. Receipt of FPM results appear to have a detrimental effect on mammography satisfaction and intention in in Black women, but culturally-relevant behaviors such as collective coping strategies may reduce the negative effects of FPM status. Study results reinforce the need for incorporating culturally-appropriate theoretical influences and the operationalization of those influences to understand the contributions to racial inequities in BrCa burden

Using Facebook Advertisements for Women’s Health Research: Methodology and Outcomes of an Observational Study

BACKGROUND: Recruitment of diverse populations for health research studies remains a challenge. The COVID-19 pandemic has exacerbated these challenges by limiting in-person recruitment efforts and placing additional demands on potential participants. Social media, through the use of Facebook advertisements, has the potential to address recruitment challenges. However, existing reports are inconsistent with regard to the success of this strategy. Additionally, limited information is available about processes that can be used to increase the diversity of study participants. OBJECTIVE: A Qualtrics survey was fielded to ascertain women’s knowledge of and health care experiences related to breast density. This paper describes the process of using Facebook advertisements for recruitment and the effectiveness of various advertisement strategies. METHODS: Facebook advertisements were placed in 2 rounds between June and July 2020. During round 1, multiple combinations of headlines and interest terms were tested to determine the most cost-effective advertisement. The best performing advertisement was used in round 2 in combination with various strategies to enhance the diversity of the survey sample. Advertisement performance, cost, and survey respondent data were collected and examined. RESULTS: In round 1, a total of 45 advertisements with 5 different headlines were placed, and the average cost per link click for each headline ranged from US $0.12 to US$0.79. Of the 164 women recruited in round 1, in total 91.62% were eligible to complete the survey. Advertisements used during recruitment in round 2 resulted in an average cost per link click of US $0.11. During the second round, 478 women attempted the survey, and 87.44% were eligible to participate. The majority of survey respondents were White (80.41%), over the age of 55 years (63.94%), and highly educated (63.71%). CONCLUSIONS: Facebook advertisements can be used to recruit respondents for health research quickly, but this strategy may yield participants who are less racially diverse, more educated, and older than the general population. Researchers should consider recruiting participants through other methods in addition to creating Facebook advertisements targeting underrepresented populations

Economic Pressure and Intention to Complete Colorectal Cancer Screening: A Cross-Sectional Analysis Among U.S. Men

Although men’s lives can be saved by colorectal cancer (CRC) screening, its utilization remains below national averages among men from low-income households. However, income has not been consistently linked to men’s CRC screening intent. This study tested the hypothesis that men who perceive more economic pressure would have lower CRC screening intent. Cross-sectional data were collected via an online survey in February 2022. Men (aged 45–75 years) living in the U.S. (N = 499) reported their CRC screening intent (outcome) and their perception of their economic circumstances (predictors). Adjusted binary and ordinal logistic analyses were conducted. All analyses were conducted in March 2022. Men who perceived greater difficulty paying bills or affording the type of clothing or medical care they needed (i.e., economic strain) were less likely to have CRC screening intent (OR = 0.67, 95% CI: 0.49, 0.93). This association was no longer significant when prior screening behavior was accounted for (OR = 0.75, 95% CI: 0.52, 1.10). Contrary to our hypothesis, men who reported more financial cutbacks were more likely to report wanting to be screened for CRC within the next year (OR = 1.06, 95% CI: 1.01, 1.11). This is one of the first studies to demonstrate that men’s perceptions of their economic circumstances play a role in their intent to complete early-detection screening for CRC. Future research should consider men’s perceptions of their economic situation in addition to their annual income when aiming to close the gap between intent and CRC screening uptake

Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87024/1/j.1747-4949.2011.00654.x.pd

Reach and effectiveness of a centralized navigation program for patients with positive fecal immunochemical tests requiring follow-up colonoscopy

Completion rates for follow-up colonoscopies after an abnormal fecal immunochemical test (FIT) are suboptimal in federally qualified health center (FQHC) settings. We implemented a screening intervention that included mailed FIT outreach to North Carolina FQHC patients from June 2020 to September 2021 and centralized patient navigation to support patients with abnormal FITs in completing follow-up colonoscopy. We evaluated the reach and effectiveness of navigation using electronic medical record data and navigator call logs detailing interactions with patients. Reach assessments included the proportion of patients successfully contacted by phone and who agreed to participate in navigation, intensity of navigation provided (including types of barriers to colonoscopy identified and total navigation time), and differences in these measures by socio-demographic characteristics. Effectiveness outcomes included colonoscopy completion, timeliness of follow-up colonoscopy (i.e., within 9 months), and bowel prep adequacy. Among 514 patients who completed a mailed FIT, 38 patients had an abnormal result and were eligible for navigation. Of these, 26 (68%) accepted navigation, 7 (18%) declined, and 5 (13%) could not be contacted. Among navigated patients, 81% had informational needs, 38% had emotional barriers, 35% had financial barriers, 12% had transportation barriers, and 42% had multiple barriers to colonoscopy. Median navigation time was 48.5 min (range: 24–277 min). Colonoscopy completion differed across groups – 92% of those accepting navigation completed colonoscopy within 9 months, versus 43% for those declining navigation. We found that centralized navigation was widely accepted in FQHC patients with abnormal FIT, and was an effective strategy, resulting in high colonoscopy completion rates