Title: Knowledge, Cancer Fatalism and Spirituality as Predictors of Breast Cancer Screening Practices for A
1Knowledge, Cancer Fatalism and Spirituality as
Predictors ofBreast Cancer Screening Practices
forAfrican American and Caucasian Women
- Staci T. Anderson, PhD, RN
- April 11, 2008
2Background
- 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
3Breast Cancer IncidenceAge-Adjusted (per 100,000)
(National Center for Health Statistics, 2006)
4Survival Rates
5-Year Relative Survival Rates
- (National Center for Health Statistics, 2006)
Percentage of Women
5Trends in Mortality Rates
Age-Adjusted Rates
Per 100,000
(National Center for Health Statistics, 2006)
6Louisiana Trends
(per 100,000)
Per 100,000
(NCI SEER State Cancer Profile, 2006)
7Mammography Screening Trends
- (Centers for Disease Control and Prevention, 2005)
8Breast Cancer Screening
- Barriers
- Structural Barriers
- Organizational
- Psychological
- Facilitators
- Health Insurance
- Source of Health Care
- Physician Recommendation
9Problem 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.
10Purpose
- 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.
11Significance
- 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.
12Study 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
13Research 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.
14Research 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.
15Methodology
- Study Design
- Multicorrelational cross-sectional research
design - Sampling
- Non-probability convenience sample
- Inclusion/exclusion criteria
- Instruments
16Measurements
- Breast Cancer Knowledge Test (BCK) (McCance et
al., 1990) - Measures knowledge of detection and screening
practices - Higher scores associated with greater knowledge
- Demographic Questionnaire
17Demographic 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
18Demographic 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
19Breast Cancer Screening Practices
20Breast Cancer Knowledge
21H1 There is a positive relationship between
breast cancer knowledge and breast cancer
screening practices in AA women.
X2 1.816 df 1 p .178
22H2 There is a positive relationship between
breast cancer knowledge and breast cancer
screening practices in Caucasian women.
X2 .065 df 1 p .799
23H3 Breast cancer knowledge is a predictor of
breast cancer screening practices in AA women.
Total variance explained 6.0 variance
unexplained 94.0.
24H4 Breast cancer knowledge is a predictor of
breast cancer screening practices in Caucasian
women.
Total variance explained 0.0 variance
unexplained 100.0.
25Discussion/Conclusions
- Breast Cancer Screening Practices
- Breast Cancer Knowledge
- No significant relationship found
- Caucasian women had higher mean scores
- Demographics
- Income
- Education
- Health Resources
26Implications
- Nursing Research
- Nursing Practice
- Nursing Education
- Health Wellness Model
- Health Policy
- Policy Initiatives
- Funding for Research
27Limitations
- Use of self-report data
- Non-probability convenience sample
- Recruitment settings
- Variability of study participants
28Recommendations
- 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
29