Systematic Review of Mammography Screening Educational Interventions for Hispanic Women in the United States

Abstract

In the United States (U.S.), Hispanics experience breast cancer disparities. Breast cancer is the leading cause of cancer-related death among Hispanic women, and Hispanic women receive mammography screening at lower rates than some other ethnic groups. This low rate of screening mammography is associated with increased risk for possible late-stage diagnosis and lower survival rates. Educational interventions could play a role in increasing screening mammography rates among Hispanic women. This systematic review synthesized the current literature on educational interventions to increase mammography screening among Hispanic women. The review included studies published between May 2003 and September 2017 with experimental and quasi-experimental interventions to increase mammography screening among Hispanics in the U.S. Five studies out of an initial 269 studies met inclusion criteria for the review. All studies employed an interpersonal intervention strategy with community health workers, or promotoras, to deliver the mammography screening intervention. For each study, odds ratios (OR) were calculated to estimate intervention effectiveness based on similar follow-up time periods. The study ORs resulted in a narrow range between 1.02 and 2.18, indicating a low to moderate intervention effect for these types of interpersonal cancer education interventions. The summary OR for the random effects model was 1.67 (CI 1.24-2.26). Hispanics exhibit lower levels of adherence to screening mammography than non-Hispanic whites. Interpersonal cancer education interventions such as the use of promotoras may help to mediate the impact of barriers to receiving a mammogram such as low health literacy, deficits in knowledge about the benefits of screening, and low awareness of the availability of screening services.

Relationship of health literacy with utilization of health-care services in a general Japanese population

“…Educational interventions about health literacy have been developed to improve health-related behavior, including cancer screening (Van den Broucke et al, 2014; Crowley et al, 2013). One review has suggested that such interventions help mediate the impact of barriers to undergoing cancer screening, such as low health literacy (Luque et al, 2018). One Japanese report found that health education designed to impart knowledge and interpersonal skills may improve health literacy beyond functional health literacy (Ishikawa et al, 2018); however, in Japan, there are few educational opportunities to support health management with respect to health literacy.…”

The impact of translated reminder letters and phone calls on mammography screening booking rates: Two randomised controlled trials

“…Generally, rates of cancer screening for migrants to Australia are slightly lower than the Australian born population [14][15][16]. There is also some evidence of a socioeconomic gradient in screening [17][18][19], and while this is not conclusive [20], studies have identified patterns of more advanced disease at diagnosis among diverse cultural or lower socioeconomic groups [21][22][23]. It is therefore important to target strategies to improve uptake of screening among these at-risk groups.…”

An overview of reviews on strategies to reduce health inequalities

“…Regarding the category of “where care is provided and changes in the healthcare environment,” several reviews included interventions that focused on improving access to healthcare services by connecting healthcare professionals to work or educational institutions, or directly to the homes of vulnerable populations with geographic difficulties or who had been displaced, to provide access health care [ 43 – 45 ]. In this context, subjects such as healthy eating in the school environment in low-income countries [ 36 ], assessment and rapid testing for the human immunodeficiency virus in street dwellers or disadvantaged women [ 19 , 46 ], medical visits for detection of colorectal, breast and cervical cancer [ 47 – 51 ], and informed advocacy measures in the community to promote cardiovascular disease protective factors [ 27 , 52 ] had positive effects when implemented in places where there are concentrations of disadvantaged groups, thus improving access to health care.…”