Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review

Abstract

BackgroundRacial minority populations face an increased burden relative to cancer interventions. Compared to Caucasians, the cancer screening rate is substantially lower among African American, Asian American, Latinx American, and American Indian/Alaska Native populations. Barriers such as low health literacy, lack of health insurance, and miscommunication between patients and providers have been identified as important factors that result in low screening rates among minority adults. This study was to identify interventions targeting racial minority adults 40 years of age or older that were effective in increasing cancer screening uptake rates. MethodsA systematic review of articles published in and after January 2009 was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Twenty-six published studies of cancer screening intervention tested with minority adults were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed, and Scopus databases. ResultsThirteen (50%) of the studies utilized lay community health workers to increase cancer awareness and knowledge and to encourage screening. These methods took place over the telephone, at community education sessions, or within the context of personalized patient navigation support. The intervention programs utilized culturally relevant materials as well as spoken and written information in the targeted population's native language. Various intervention designs resulted in statistically significant increases in cancer screening adherence. However, we found no intervention that consistently elevated cancer screening rates across all racial/ethnic minority adults. ConclusionsThe finding suggests that highly segmented interventions are needed in order to improve cancer screening among various racial/ethnic minority adults.

The effect of high blood pressure-health literacy, self-management behavior, self-efficacy and social support on the health-related quality of life of Kazakh hypertension patients in a low-income rural area of China: a structural equation model

“…High Blood Pressure-Health Literacy (HBP-HL) refers to the ability of hypertensive patients to acquire, understand, and deal with hypertension-related knowledge as well as the medical services needed to control diseases [ 15 ]. Previous studies have indicated HBP-HL as a powerful indicator for predicting the health status of people, which is highly correlated with morbidity, mortality, life expectancy, and HRQoL of people with hypertension [ 16 ], especially in ethnic minorities [ 17 , 18 ]. Low health literacy usually leads to a series of negative health outcomes [ 19 ].…”

The Effect of Health Literacy, Self-management Behavior, Self-efficacy and Social Support on the Health-related Quality of Life of Kazakh Hypertension Patients in a Low-income Rural Area of China: a structural Equation Model

“…High Blood Pressure-Health Literacy (HBP-HL) refers to the ability of hypertensive patients to acquire, understand, and deal with hypertension-related knowledge as well as the medical services needed to control diseases [11] . Previous studies have indicated HBP-HL as a powerful indicator for predicting the health status of people, which is highly correlated with morbidity, mortality, life expectancy, and HRQoL of people with hypertension [12] , especially in ethnic minorities [13][14] . Low health literacy usually leads to a series of negative health outcomes [15] .…”

Explaining Correlates of Cervical Cancer Screening among Minority Women in the United States

“…Referring to the G*power 3.1.9.7 software (linear multiple regression: fixed model, R 2 increase), a minimal number of 154 participants was required to reach significance when considering the following statistical parameters: type I error α = 5%, power 1-β = 95%, a moderate effect size f 2 = 0.15, and a total number of variables N = 15 to be integrated in the multivariable regression analysis [37,38]. Given the lack of consensus in the sample size recommendations for the Structural Equation Modelling (SEM), we used Kline (2015) criteria that had 20 observations (participants) for each estimated parameter in the model, with a typical size of N = 200, among models using the maximum likelihood method [39]. However, recently, several studies recommended a sample size which would vary from 50 to 400 participants [40][41][42].…”

“…However, many of these studies did not use theory in their interventions. Those that did use theory drew from social cognitive theory, the health belief model, the transtheoretical model, the social support model, elaboration theory, or multiple theories [39][40][41][42]. In sum, there are limited studies to increase cervical cancer screening among minority women and only a few of these interventions among minority women utilized theory.…”