Knowledge, Cancer Fatalism and Spirituality as Predictors of Breast Cancer Screening Practices for A

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Knowledge, Cancer Fatalism and Spirituality as
Predictors ofBreast Cancer Screening Practices
forAfrican American and Caucasian Women

• Staci T. Anderson, PhD, RN
• April 11, 2008

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Background

• Breast cancer is the 2nd most frequently
  diagnosed cancer in women.
• In 2007, an estimated 178,480 new cases of breast
  cancer will be diagnosed
• African American (AA) women die from breast
  cancer more than any other racial group
• Use of breast cancer screening practices
  influences mortality and survival rates

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Breast Cancer IncidenceAge-Adjusted (per 100,000)
(National Center for Health Statistics, 2006)
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Survival Rates
5-Year Relative Survival Rates

• (National Center for Health Statistics, 2006)

Percentage of Women
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Trends in Mortality Rates
Age-Adjusted Rates
Per 100,000
(National Center for Health Statistics, 2006)
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Louisiana Trends
(per 100,000)
Per 100,000
(NCI SEER State Cancer Profile, 2006)
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Mammography Screening Trends

• (Centers for Disease Control and Prevention, 2005)

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Breast Cancer Screening

• Barriers
• Structural Barriers
• Organizational
• Psychological
• Facilitators
• Health Insurance
• Source of Health Care
• Physician Recommendation

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Problem Statement

• Despite improvements in mammography screening
  rates, differences in breast cancer mortality and
  survival rates persist between AA and Caucasian
  women. Differences in utilization of breast
  cancer screening practices has been identified as
  a contributing factor to this phenomenon. Various
  complex and interrelated factors influence
  participation in breast cancer screening
  practices.

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Purpose

• To explore relationships between knowledge
  related to breast cancer screening and detection,
  cancer fatalism, spirituality and breast cancer
  screening practices in African American and
  Caucasian women.
• To determine the ability of these variables to
  predict breast cancer screening practices in
  African American and Caucasian women.

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Significance

• Findings could be used to develop more culturally
  specific educational interventions.
• Health care providers need to be aware of an
  individuals knowledge, perceptions, beliefs, and
  attitudes about breast cancer.

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Study Variables

• Breast Cancer Knowledge
• Cognitive information about breast cancer and
  breast cancer detection and screening practices
• Breast Cancer Screening Practices
• Methods used to detect breast cancer in persons
  who are asymptomatic.
• BSE
• CBE
• Mammogram

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Research Hypotheses

• H1 There is a positive relationship between
  breast cancer knowledge and breast cancer
  screening practices in AA women.
• H2 There is a positive relationship between
  breast cancer knowledge and breast cancer
  screening practices in Caucasian women.

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Research Hypotheses

• H3 Breast cancer knowledge is a predictor of
  breast cancer screening practices in AA women.
• H4 Breast cancer knowledge is a predictor of
  breast cancer screening practices in Caucasian
  women.

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Methodology

• Study Design
• Multicorrelational cross-sectional research
  design
• Sampling
• Non-probability convenience sample
• Inclusion/exclusion criteria
• Instruments

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Measurements

• Breast Cancer Knowledge Test (BCK) (McCance et
  al., 1990)
• Measures knowledge of detection and screening
  practices
• Higher scores associated with greater knowledge
• Demographic Questionnaire

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Demographic Characteristics

• Race 53.7 AA 46.3 Caucasian
• Age 44.7 12.8
• Marital Status 48.8 Married
• 63.6 Annual Income 50,000
• Education
• 37.7 College Graduate
• 18.5 Completed Graduate School

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Demographic Characteristics

• Health Resource Variables
• Health Insurance Coverage - 94.4
• Usual Source of Care 90.1
• Health History
• Family history of BC diagnosis (n 58)
• 43.1 Participates in BCSP
• Family history of BC death (n 28)
• 46.4 Participates in BCSP

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Breast Cancer Screening Practices
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Breast Cancer Knowledge
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H1 There is a positive relationship between
breast cancer knowledge and breast cancer
screening practices in AA women.
X2 1.816 df 1 p .178
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H2 There is a positive relationship between
breast cancer knowledge and breast cancer
screening practices in Caucasian women.
X2 .065 df 1 p .799
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H3 Breast cancer knowledge is a predictor of
breast cancer screening practices in AA women.
Total variance explained 6.0 variance
unexplained 94.0.
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H4 Breast cancer knowledge is a predictor of
breast cancer screening practices in Caucasian
women.
Total variance explained 0.0 variance
unexplained 100.0.
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Discussion/Conclusions

• Breast Cancer Screening Practices
• Breast Cancer Knowledge
• No significant relationship found
• Caucasian women had higher mean scores
• Demographics
• Income
• Education
• Health Resources

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Implications

• Nursing Research
• Nursing Practice
• Nursing Education
• Health Wellness Model
• Health Policy
• Policy Initiatives
• Funding for Research

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Limitations

• Use of self-report data
• Non-probability convenience sample
• Recruitment settings
• Variability of study participants

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Recommendations

• Study designed to determine breast cancer
  screening practices over time utilizing a larger
  and ethnically diverse sample
• Secondary analysis to determine if there are
  relationships between demographic variables,
  spirituality, and each method of breast cancer
  early detection
• Develop and test culturally specific
  interventions that focus on increasing breast
  health and breast cancer screening practices

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• THANK YOU!
• QUESTIONS?