Attitudinal and socio-structural determinants of cervical cancer screening and HPV vaccination uptake: a quantitative multivariate analysis
Titelübersetzung:Einstellung und soziostrukturelle Determinanten zu Gebärmutterkrebs-Screening und HP-Virus-Schutzimpfung: eine quantitativ-multivariate Analyse
Autor/in:
Kuitto, Kati; Pickel, Susanne; Neumann, Henning; Jahn, Detlef; Metelmann, Hans-Robert
Quelle: Journal of Public Health, 18 (2010) 2, S 179-188
Details
Inhalt: Aim: The introduction of the human papillomavirus (HPV) vaccine enables for the first time in the history of cancer prevention the possibility of combating the major cause of a cancer even before its onset. The secondary prevention measure of cervical cancer screening has thus been complemented by a primary prevention measure. The aim of this study is to analyse the determinants of uptake of preventive measures against cervical cancer as a basis for comparing the determinants of screening attendance with those of HPV vaccination attendance. Subject and methods: A population-based representative survey comprising 760 randomly selected women aged 14 to 65 was performed in the German federal state of Mecklenburg-Western Pomerania. Prevention behaviour, attitudes towards cervical cancer screening and HPV vaccination, and knowledge about cervical cancer and HPV were investigated by means of a structured questionnaire. Descriptive analyses and multivariate logistic regression analyses were conducted to identify the determinants of screening and HPV vaccine uptake. Results: Attendance both at screening and at HPV vaccination was best predicted by attitudinal factors. Positive connotations of cancer prevention measures and utility expectations, fear of cancer and high subjective risk perception were conducive to attendance at screening and HPV vaccination. Screening attendance was less regular among women of lower socioeconomic status. In contrast, HPV vaccination uptake was higher for young women with lower educational attainment and lower social class. Knowledge did not impact prevention behaviour significantly. There is no trade-off between screening and vaccination attendance; the vast majority of respondents was aware of the necessity of regular screening attendance even when vaccinated against HPV. Conclusions: Uptake rates for existing primary and secondary prevention measures against cervical cancer can be enhanced by fostering perceptions of utility and positive connotations of regular screening and becoming vaccinated against HPV. Elderly women in particular should be encouraged to attend screening by means of a recall system. Given the low overall level of knowledge about cervical cancer and its risk factors, there is a need for education about the necessity and utility of prevention to reach women of all social classes.
Schlagwörter:Gesundheit; vaccination; Prävention; risk; cancer; determinants; preventive medical examination; prevention; sozioökonomische Faktoren; Federal Republic of Germany; Vorsorgeuntersuchung; Mecklenburg-Western Pomerania; Gesundheitsvorsorge; Gesundheitsverhalten; knowledge; attitude; Risiko; health care; Krankheit; socioeconomic factors; woman; Mecklenburg-Vorpommern; Krebs; Impfung; Determinanten; health behavior; Risikoabschätzung; health; illness; Wissen; risk assessment; Einstellung; Cervical cancer prevention; Cervical screening; HPV vaccination; Attitudes; Socio-structural determinants; soziostrukturelle Faktoren
SSOAR Kategorie:Gesundheitspolitik
Dokumenttyp:Zeitschriftenaufsatz
Immigrant women's perceptions and experiences of health care services: insights from a focus group study
Titelübersetzung:Wahrnehmungen und Erfahrungen von Migrantinnen mit dem Gesundheitswesen in Portugal: Erkenntnisse aus einer Fokus-Gruppen-Studie
Autor/in:
Dias, Sónia; Gama, Ana; Rocha, Cristianne
Quelle: Journal of Public Health, 18 (2010) 5, S 489-496
Details
Inhalt: Aim: This study aimed to describe perceptions and experiences related to access and utilization of health care services of African and Brazilian immigrant women in Portugal. Subjects and methods: Six focus groups were conducted with 35 African and Brazilian women with low income and living in Lisbon, chosen through purposive sampling. Content analysis was undertaken through identification of themes and categories. Results: African and Brazilian women expressed different perceptions and patterns of use of health care services. Most participants pointed out several barriers to access and utilization of services related to legal issues, economic constraints or health professionals' attitudes. Conclusion: These results highlight the challenges to providing health care within a multicultural setting and the need to assure the provision of integrated and comprehensive health care services. Improving access to general health care is essential in order to minimize disadvantages from vulnerable subgroups, like immigrant women. Supporting better integration into the health system may lead to improved health outcomes.
Schlagwörter:perception; Afrikaner; Gesundheit; discrimination; health care delivery system; Wahrnehmung; Gesundheitswesen; African; Erfahrung; Diskriminierung; Migrant; Benchmarking; sozioökonomische Faktoren; Einwanderung; attitude; benchmarking; migrant; Krankheit; socioeconomic factors; comparison; woman; Portugal; Portugal; sociocultural factors; soziokulturelle Faktoren; immigration; health; Vergleich; illness; Einstellung; experience; Immigrant women; Perceptions; Experiences; Access and utilization of health care services
SSOAR Kategorie:Gesundheitspolitik, Migration
Dokumenttyp:Zeitschriftenaufsatz
Results from the National Strategy for improvement of iodine nutrition in Bulgaria: a study of children and pregnant women living in an iodine-deficient area
Autor/in:
Gatseva, Penka D.; Bivolarska, Anelia V.; Argirova, Mariana D.
Quelle: Journal of Public Health, 19 (2010) 3, S 237-240
Details
Inhalt: Background: A significant part of Bulgaria is considered an iodine-deficient area. The National Strategy for Prevention and Control of Iodine Deficiency Disorders (IDD) was developed in 1994, and regular surveys undertaken in 2000–2003 indicated a normalization of the iodine supply in the Bulgarian population, including some at-risk population groups (children, schoolchildren, pregnant women). Despite the results achieved, mandating periodic cohort surveys for tracking the elimination of iodine deficiency is necessary. Objective: The aim of this study was to evaluate the results of the the national strategy for improvement of iodine nutrition in children and pregnant women living in an iodine-deficient area in Bulgaria 15 years after its update. Subjects and methods: Study subjects were 73 children aged 9.21 ± 2.07 years (29 boys and 44 girls) and 16 pregnant women living in the town of Asenovgrad. Urinary iodine concentration was measured and used as an index of iodine intake. Results: The median urinary iodine of the inspected children was between 100–199 μg/l, which is an indicator of optimal iodine nutrition. Almost 1/3 of the children (31.5%) had iodine deficiency. The median urinary iodine concentration of the 16 pregnant women investigated was 127.0 μg/l, which is an indicator of insufficient iodine intake. Conclusion: Despite the normalization of the iodine supply in the past years in the at-risk population groups of children and pregnant women, a considerable portion of them still has iodine deficiency. Recommendations for improving health education and iodine nutrition in at-risk population groups were made.
Schlagwörter:Urinary iodine; Children; Pregnant women; Iodine nutrition
SSOAR Kategorie:Medizin, Sozialmedizin, Gesundheitspolitik
Dokumenttyp:Zeitschriftenaufsatz
Health-related quality of life of family caregivers - evidence from Hesse
Titelübersetzung:Gesundheitsbezogene Lebensqualität von pflegenden Familienangehörigen: Ergebnisse aus Hessen
Autor/in:
Rösler-Schidlack, Birgit; Stummer, Harald; Ostermann, Herwig
Quelle: Journal of Public Health, 19 (2010) 3, S 269-280
Details
Inhalt: Aim: The aim of this study was to analyse the health-related quality of life (HRQOL) of primary family caregivers in comparison to the reference values of the average population. Subjects and methods: Data collection took place in the Werra-Meißner district in 2009 with a response rate of 102 primary family caregivers of frail elderly people. The health-related quality of life was measured with the Short Form 36 health survey (SF 36) and compared with the German reference values. Results: Compared to the health values of the normative sample, primary caregivers show significantly lower rates in all dimensions of health-related quality of life. In particular, caregivers between the ages of 53 to 61 report extremely low health values. Caregiving women compared to non-caregiving women have highly significant differences in all subscales of the SF 36. Caregiving men also report highly significant differences to non-caregiving men in all dimensions of the SF 36 except for Physical Functioning and General Health (p < 0.01). Caregivers in general and especially caregiving women aged 53 to 61 (midlife) were identified as at-risk groups for poor health. The latter report lower vitality and well-being, which may be a consequence of both social isolation and social impacts from multiple role demands. Conclusion: The identified high-risk groups of family caregivers, caregivers in midlife and especially caregiving women in midlife, should be supported by social measures, e.g., training courses for family caregivers, particularly in their home setting, and various types of respite care in order to sustain their health.
Schlagwörter:psychische Belastung; Gesundheit; alter Mensch; family member; Lebensqualität; Hessen; risk; health consequences; Federal Republic of Germany; häusliche Pflege; nursing care for the elderly; psychological stress; quality of life; Auswirkung; Risiko; home care; Krankheit; Altenpflege; Hesse; impact; elderly; gesundheitliche Folgen; gender-specific factors; health; Familienangehöriger; illness; family caregiver; health-related quality of life; SF 36; gender differences
SSOAR Kategorie:Medizinsoziologie, Gesundheitspolitik
Dokumenttyp:Zeitschriftenaufsatz