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Michele M David

Publications and source records attributed to Michele M David.

2 recordsLinked to original sources
PubMed2005

Mammography use.

OBJECTIVES: The goal of this study was to compare mammography use in Haitian women versus that of other racial/ethnic groups in the same neighborhoods and to identify factors associated with mammography use in subpopulations that are seldom studied. METHODS: A community-based, cross-sectional survey sampled a multiethnic group of inner-city women from eastern Massachusetts. Bivariate analyses and logistic regression models were used to predict lifetime and recent (within two years) mammography screening. RESULTS: Self-reported lifetime mammography use was similar for Haitian (82%), African-American (78%), Caribbean (81%) and Latina women (86%) but higher for white women (94%, p = 0.008). Mammography use in the past two years was also similar in all groups (66-82%, p = 0.41). In multivariate models, African-American (adjusted odds ratio [AOR]; 0.3; 95% CI 0.1-0.9) and Haitian women (AOR 0.3; 95% CI 0.1-0.9) had lower odds of lifetime mammography compared to white women. Factors independently related to lifetime and recent mammography included having a regular healthcare provider, greater knowledge of breast cancer screening; higher education, and private health insurance. CONCLUSIONS: Haitian women with a regular provider and knowledge of breast cancer screening reported recent mammography use similar to women from other racial/ethnic groups. The racial/ethnic patterns of mammography use in our study do not explain racial/ethnic differences in breast cancer stage or mortality.

Adult↗
PubMedDate not supplied

Pap smear rates among Haitian immigrant women in eastern Massachusetts.

OBJECTIVE: Given limited prior evidence of high rates of cervical cancer in Haitian immigrant women in the U.S., this study was designed to examine self-reported Pap smear screening rates for Haitian immigrant women and compare them to rates for women of other ethnicities. METHODS: Multi-ethnic women at least 40 years of age living in neighborhoods with large Haitian immigrant populations in eastern Massachusetts were surveyed in 2000-2002. Multivariate logistic regression analyses were used to examine the effect of demographic and health care characteristics on Pap smear rates. RESULTS: Overall, 81% (95% confidence interval 79%, 84%) of women in the study sample reported having had a Pap smear within three years. In unadjusted analyses, Pap smear rates differed by ethnicity (p=0.003), with women identified as Haitian having a lower crude Pap smear rate (78%) than women identified as African American (87%), English-speaking Caribbean (88%), or Latina (92%). Women identified as Haitian had a higher rate than women identified as non-Hispanic white (74%). Adjustment for differences in demographic factors known to predict Pap smear acquisition (age, marital status, education level, and household income) only partially accounted for the observed difference in Pap smear rates. However, adjustment for these variables as well as those related to health care access (single site for primary care, health insurance status, and physician gender) eliminated the ethnic difference in Pap smear rates. CONCLUSIONS: The lower crude Pap smear rate for Haitian immigrants relative to other women of color was in part due to differences in (1) utilization of a single source for primary care, (2) health insurance, and (3) care provided by female physicians. Public health programs, such as the cancer prevention programs currently utilized in eastern Massachusetts, may influence these factors. Thus, the relatively high Pap rate among women in this study may reflect the success of these programs. Public health and elected officials will need to consider closely how implementing or withdrawing these programs may impact immigrant and minority communities.

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