Abstract
Background: Women who are at increased risk of breast cancer (BC), are largely not accepting of chemoprevention therapies (CPTs). Further, proven behavioral constructs were not employed in previous studies that assessed the correlates of acceptance of CPTs. Thus, we used the Breast Cancer Risk Reduction Health Belief scale, a validated instrument for assessing the health-seeking behavior of women who were at increased risk of BC with respect to being willing to accept risk assessment, CPTs counseling, or the therapies.
Methods: Using the data from the Acceptance of Breast Cancer Chemoprevention Therapies Project, a cross-sectional telephone survey, we assessed the association of the sociodemographic, socioeconomic, knowledge of BC prevention and care strategies, health care access or utilization characteristics, and the factor-derived Health Belief Model constructs with the endpoints mentioned above (i.e. that had 5-point Likert style response options), in 265 consecutively recruited Caucasian (n=83), Latinas (n=73), African American (n=103) or unknown (n=6) women, who were of diverse socioeconomic backgrounds, and at increased risk of BC. Student's t tests, chi square, or multiple linear regression analyses were used to compare the covariates with the respective endpoints.
Results: Most participants were in the 50-69 years age group (66.4%), of African American race/ethnicity (39.8%), single (58%), or of lower socioeconomic status (i.e., they had a high school education or less [65.3%], earned < $30,000 per annum before taxation [75.2%], etc). A slight majority had only publicly sponsored health insurance (50.5%), most had a regular physician (87.5%), had had a mammogram (98.8%), or screened annually (60%). Following multiple linear regression analyses, being willing to accept risk assessment, correlated positively with perceived susceptibility to BC (p=.03), or having higher knowledge test scores (p<.01), and negatively with being an African American with only elementary education (p<.001). Being willing to accept CPTs counseling correlated positively with being highly motivated based on self efficacy, perceived benefits and positive family-related cues (p<.001), or perceiving BC as life threatening (p<.01), and negatively with being of African American race/ethnicity (p=.02), being high school educated (p=.01), having a history of BC in first-degree relatives (p=.03), or ≥3 current medications (p=.05). Being willing to accept CPTs correlated positively being highly motivated based on self efficacy, perceived benefits, and positive family-related cues (p<.0001), and negatively with having a regular physician (p<.01), a history of other cancer (p<.01), being of African American race/ethnicity (p=.01), current age (p=.02), or having annual mammograms (p=.05).
Conclusions: The correlates of the willingness to accept chemoprevention strategies differed by the specific strategies. Further, future interventions should be targeted towards not just the eligible women, but also their families, and their physicians, and should take into consideration pertinent behavioral constructs, personal and health care-related characteristics.
Impact: Through our results, we have laid a firm foundation for future tailored interventions to enhance informed decision making about BC CPTs.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):PR-08.
RSS Feeds