Biomedical subjects

Jo Anne Earp

Publications and source records attributed to Jo Anne Earp.

3 recordsLinked to original sources

PubMed2002

Disparities in mammography screening in rural areas: analysis of county differences in North Carolina.

The extent to which targeted mammography programs have impacted women in rural areas is not well defined. We investigated mammography screening rates among 843 women age 50 and over from a population-based sample in four predominantly rural eastern North Carolina counties. We examined age, race, education level, county of residence, health insurance, and the self-reported completion of mammography in the past year using contingency tables and logistic regression. African American females aged 65 years or older had the lowest reported mammography rates (42%), while white females aged 50 to 64 had the highest rates (58%). Uninsured women and those with less education were less likely to have received a mammogram. Logistic regression demonstrated that age, education, and health insurance were significant predictors of mammography completion. A county-level analysis revealed that three counties had similar rates and one county had substantially lower rates. A higher-than-expected rate of screening-mammography completion among African American women was noted in one predominantly rural county served by a breast cancer screening program. Logistic regression analysis confirmed that county was a significant predictor for mammography completion. In separate regressions run by race, county remained a significant predictor for African American women but not for white women. Differences in mammography screening appear to persist in some predominantly rural areas and are related to age, race, education, and health insurance. Programs that target hard-to-reach women with efforts tailored specifically to their needs may be effective in reducing persistent racial differences.

Black or African American↗

PubMed2002

Do clinic-based STD data reflect community patterns?

Sexually transmitted disease (STD) interventions in communities are often based on studies conducted in STD clinics. Clinic-based studies are relatively easy to conduct, but they do not include all people at risk for STDs in the community. Although it is widely believed that clinic-based data present a biased picture of the community, the differences between clinical and community perspectives seldom have been quantified. The Sexually Transmitted Epidemic Prevention (STEP) Project included in-depth standardized interviews administered in an STD clinic and the neighbourhoods of the same town. The populations could be quantitatively compared on some questions. The two samples yielded similar estimates of the proportions using condoms, the average age at first intercourse, and the proportion sexually abused as a child. Risky sexual behaviours were more common in the clinic population, however, and the community sample was more socio-economically stable. Clinic-based data may be useful for targeting high risk people in the community but less useful for reaching those at lower risk. The utility of clinic-based studies for community-based interventions may be enhanced by collecting extra information from clinic patients with lower risk profiles.

Adolescent↗

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↗