Biomedical subjects

Regina Otero-Sabogal

Publications and source records attributed to Regina Otero-Sabogal.

7 recordsLinked to original sources

PubMed2006

Ethnic differences in decisional balance and stages of mammography adoption.

Behavioral theories developed through research with mainstream, English-speaking populations have been applied to ethnically diverse and underserved communities in the effort to eliminate disparities in early breast cancer detection. This study tests the validity of the transtheoretical model (TTM) decisional balance measure and the application of the TTM stages of change in a multiethnic, multilingual sample. A random sample of 1,463 Filipino, Latino, African American, Chinese, and White women aged 40 to 74 completed a phone survey of mammography beliefs and practices. Consistent with the TTM and independent of ethnicity, decisional balance was associated with mammography stage in all five ethnic groups when controlling for socioeconomic and other factors. In addition, having private insurance and a regular physician and being a long-time resident in the United States were positively associated with mammography maintenance. The application of the TTM for mammography is supported in a multiethnic and multilingual sample.

Adult↗

PubMed2006

Improving rescreening in community clinics: does a system approach work?

Community clinics provide inadequate breast cancer screening services to low-income, racially- and ethnically-diverse communities. This study develops and evaluates the effectiveness of multifaceted organizational system interventions--operational assessments, tracking systems, reminder calls, tailored education, physician prompts and a tailored counseling call--on mammography rescreening rates within three community clinics. We used the Chronic Care Model and Put Prevention Into Practice framework to redesign breast screening delivery services within the California Cancer Detection Programs: Every Woman Counts (CDP:EWC), community clinic settings. We used a quasi-experimental design with a random selection of 400 patients at pre-intervention. To establish a post-intervention clinic's rescreening rate a new comparable cross-sectional random sample of 347 women was drawn. Measures A chart abstraction instrument was used to establish clinics' rescreening rates. Subjects participants at pre and post-intervention were low-income women 50 years of age and older who had received normal mammography results and had not been diagnosed with breast cancer in the last five years. General linear mixed model analysis revealed significant improvements for the organizational system redesign condition [pre-intervention rescreening rate: 32.1 percent v. post-intervention rescreening rate 50.2 percent, (p < .001)]. For the organizational system redesign plus tailored counseling call condition, there was maintenance in the rescreening rate following the intervention [pre-intervention: 44.4 percent v. post-intervention: 45.1 percent, (p > 0.05)]. Multilevel interventions directed at redesigning community clinics primary care breast cancer screening services, can improve mammography rescreening rates.

Aged↗

PubMed2004

Patient and clinical site factors associated with rescreening behavior among older multiethnic, low-income women.

PURPOSE: Our goal was to identify factors predictive of mammography rescreening within 18 months of baseline screening in multiethnic, low-income older women. DESIGN AND METHODS: We interviewed a cross-sectional survey of staff of 102 randomly selected clinics that provided screening and diagnostic services. We also surveyed a random sample of 391 older women served by these clinics to retrospectively assess their experiences of the screening process. RESULTS: We found that 59% of the sample returned for a repeat mammogram. Education level and the belief it is important to get an annual mammogram were significant patient-level predictors of rescreening. Offering pap smears and using hands-on demonstrations with breast models were significant clinic-level variables predictive of rescreening. Of note, among the variables that did not prove significant in the final model were those reflecting ethnicity and income. IMPLICATIONS: Individual and health-care-delivery-system factors play important roles in the obtaining of regular mammograms by low-income women. These findings highlight the importance of both factors in improving rescreening rates among older women.

Age Factors↗

PubMed2004

Mammography rescreening among women of diverse ethnicities: patient, provider, and health care system factors.

This study identified patient, provider, and health care system factors that influenced mammography rescreening among non-insured, racial/ethnic minority women. Data were collected using a stratified-clustered random sample survey of 1,050 women of five racial/ethnic groups (Latina, Chinese, Filipina, African American, and Caucasian) and 102 primary care clinical sites. Women received screening services through two no-cost screening programs in California. Chi-square tests were used to assess bivariate associations and multiple logistic regressions were used to compute adjusted odds ratios and 95% confidence intervals. Mammography rescreening was associated with living in the United States longer; having higher education levels, better health care access, a history of breast problems, and favorable perceptions of mammography; obtaining regular Pap screening and hormone replacement therapy; having had better communication with clinicians; and attending clinics that conducted in-reach activities. This study suggests that simply removing financial barriers is not enough to improve mammography rescreening among underserved women.

Aged↗

PubMed2003

Increasing ethnic diversity in cancer control research: description and impact of a model training program.

BACKGROUND: There is little ethnic diversity at the doctoral level among researchers in cancer control. The Minority Training Program in Cancer Control Research is designed to encourage underrepresented master's level health science students to pursue doctoral training and careers in research. METHODS: Program components include an annual 5-day summer institute, internships, and doctoral incentive awards. Intention to pursue doctoral training is measured before and after participation. Doctoral applications and enrollment are tracked through annual surveys. RESULTS: Seventy students participated during the first three years, 1999-2001. Intention to apply increased significantly for each class (year one, p %lt; 0.001; year two, p = 0.042; year three, p = 0.006). Thirty-one percent of participants have either enrolled in doctoral programs (n= 10) or report plans to apply in the next one to two years (n = 9). Over half of these students indicated that the MTPCCR had a positive influence on their plans. CONCLUSIONS: A targeted training program encourages under-represented students to pursue doctoral degrees and thus has the potential to increase ethnic diversity in public health research.

Biomedical Research↗

PubMedDate not supplied

The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer.

BACKGROUND: A disproportionate number of women diagnosed with cervical cancer are from low-income and/or ethnically diverse groups. This study was designed to evaluate the effectiveness of an outreach and counseling intervention at improving the rate of follow-up of abnormal Pap smears among women at Alameda County Medical Center, Oakland, CA. METHODS: Between September 1, 1999 and August 31, 2001, 348 women with abnormal Pap test results were randomly assigned to intervention or usual care. The main outcome was rate of follow-up. RESULTS: The intervention produced a significant increase in the rate of follow-up visits within 6 months. Women in the intervention group were much more likely to obtain timely follow-up at Highland Hospital than were those in the control group (61% vs. 32%, P = 0.001). The intervention was equally effective when delivered to women in the control group who had no follow-up by 6 months. Overall, we were able to contact 90% of women in the intervention group. CONCLUSIONS: An outreach intervention is highly effective at increasing follow-up of abnormal Pap smears in a public hospital setting. Institutions offering cervical cancer screening to low-income, high-risk women should consider the use of outreach workers to reduce loss to follow-up.

Adolescent↗

PubMedDate not supplied

Timely follow-up among multicultural women with abnormal mammograms.

OBJECTIVE: To examine factors influencing time from screening to final diagnosis among multicultural women with abnormal mammograms using the precede-proceed model. METHODS: Staff of 58 clinics and a sample of 436 women served by these clinics were interviewed and their medical records examined. RESULTS: Longer duration from screening to diagnosis was associated with speaking Spanish and having clinic staff make appointments. Ease of access to health care, provision of early morning screening services and higher levels of patient anxiety shortened the time to diagnosis. CONCLUSION: The precede-proceed model is useful in delineating personal and structural factors that affect timely diagnosis.

Aged↗