Biomedical subjects

Holly F Mathews

Publications and source records attributed to Holly F Mathews.

5 recordsLinked to original sources

PubMed2002

Impacting cultural attitudes in African-American women to decrease breast cancer mortality.

BACKGROUND: Over the past decade breast cancer mortality has decreased 1% or 2% per year in white women, but not in African-American women. The resulting "mortality gap" is a serious national problem, and it must be a high priority to understand the reasons for it and develop solutions. METHODS: The literature is reviewed to elucidate reasons for the mortality gap and the current status of possible solutions to the problem. In addition, new results of large population-based surveys in North Carolina are presented that may shed light on the problem. RESULTS: The most important reason for the mortality gap is that African-American women tend to be diagnosed with more advanced stage breast cancer than white women. This is due both to lower utilization of screening mammography and to delayed presentation for women with palpable lumps. This is related both to socioeconomic factors that influence access to medical care and to cultural factors that tend to discourage women from seeking care early for breast problems. CONCLUSIONS: Understanding the cultural beliefs that influence patient behavior will greatly aid physicians in caring for their African-American patients, and ultimately may help reduce the racial gap in breast cancer mortality.

Adult↗

PubMed2002

Beliefs about and responses to childhood ear infections: a study of parents in eastern North Carolina.

Middle ear infection, also known as otitis media (OM), is a major public health problem among American children. Although clinical and epidemiological aspects of OM have been intensely studied, cultural factors that may be contributing to the problem of OM have received less attention. This article presents findings from an ethnographic study exploring beliefs about OM and responses to the illness among parents from eastern North Carolina. In-depth interviews were conducted with a convenience sample of nine mothers in order to learn more about parents' explanatory models of OM, the source of their beliefs, and how they respond to the illness. A survey instrument based on their statements was then constructed and administered to a convenience sample of 79 parents. The survey consisted of belief statements about OM, as well as questions pertaining to sources of beliefs, the home management of the disease, and the effects of the illness on families. A cultural consensus analysis of responses to belief statements indicates that parents shared a common model of OM. Beliefs about risks, symptoms, and causes of OM were similar to the current biomedical model of the illness, but their divergent beliefs about the diagnosis, prognosis and treatment of OM could lead to unnecessary use of health care services. Clinicians, family, and friends were reported to be important sources of information about OM. Parents also reported using similar home management strategies and care seeking behaviors to minimize the impact of the illness on their children and families. While these findings need to be replicated in studies with larger, more representative samples, this study suggest that ethnographic approaches may provide new insights into the cultural dimension of the problem of OM.

Attitude to Health↗

PubMed2002

Religious beliefs and breast cancer screening.

BACKGROUND: The mechanisms underlying a reported tendency for women who hold strong religious beliefs to seek medical help at more advanced stages of breast cancer are unknown. This study investigates further the effect of religious beliefs with other variables on breast cancer screening and the intended presentation of a self-discovered breast lump. METHODS: The study included 682 eastern North Carolina women aged 40 and over who were interviewed in their homes about religious and other beliefs about breast cancer, screening, and intended actions with a self-discovered breast lump. RESULTS: Principal components factor analysis results suggested that a majority of women believe that God works through doctors to cure breast cancer. We labeled this dimension "religious intervention with treatment." A minority believed that medical treatment was unnecessary because only God could cure breast cancer. We labeled this dimension "religious intervention in place of treatment." The first dimension correlated with self-reported mammography but not clinical breast examination or women's intention to delay presentation of a self-discovered breast lump. The second dimension, significantly more common in African American women who were less educated and older, correlated strongly with the intention to delay presentation of a self-discovered breast lump. CONCLUSIONS: Belief in "religious intervention in place of treatment" may help to explain why African American women delay presentation of palpable breast lumps, contributing to advanced-stage cancer diagnosis. We suggest that clinicians and clergy work together within the context of religious beliefs to enhance early detection and survival from breast cancer.

Adult↗

PubMed2002

Increasing use of mammography among older, rural African American women: results from a community trial.

OBJECTIVES: A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older. METHODS: A stratified random sample of 801 African American women completed baseline (1993-1994) and follow-up (1996-1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years. RESULTS: The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = -1, 14) in community-wide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by low-income women in comparison counties. Adjustment for potentially confounding characteristics did not change the results. CONCLUSIONS: A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.

Black or African American↗

PubMedDate not supplied

Differences in breast self-examination techniques between Caucasian and African American elderly women.

BACKGROUND: The efficacy of breast self-examination (BSE) is controversial, recommendations to women are mixed, and reported differences by race in BSE are contrary to what is expected. We attribute this, in part, to measurement error in studies assessing the effectiveness of BSE. We assess differences by race in self-reported BSE while controlling selected sociodemographic indicators, BSE training, embarrassment, and perceived competence. METHODS: Data are from personal interviews with 1011 women ages 50 and older, with approximately equal numbers of African Americans and Caucasians reporting that they examine their own breasts. RESULTS: African American women are more likely than Caucasians to report examining their breasts visually, whereas Caucasian women are more likely than African Americans to report tactile examination of breast tissue, consistent with recommended BSE procedure. CONCLUSIONS: BSE measures must be multidimensional to detect differences by race to guide interventions promoting self-detection of breast lumps, early presentation, and mortality reduction.

Black or African American↗