The evaluation and follow-up of abnormal mammography screening has not bee studied for possible ethnic and income group differences in timeliness and type of diagnostic tests. We propose to conduct a cohort study of 1000 women, 40 to 79 years of age, without previous breast cancer, and from four ethnic groups (white, African American, Latina, Chinese) with abnormal mammography examination defined as an examination interpreted as having a new abnormality by the radiologist and requiring a follow-up examination in less than one year. We plan to conduct baseline telephone interviews to compare demographics, patient perceptions about the process of care, access to health care variables, clinical assessments, expectations from their primary clinician, out-of-pocket expenses, and other predictor variables indicated by our conceptual framework, within three months after the index abnormal screening mammography. The main outcomes to be evaluated include time to first diagnostic test, time to resolution or final disposition, intention to adhere, intention to continue screening, interval mammography screening, anxiety, and functional status. We will then conduct follow-up interviews at 12 and 24 months after the index examination to address whether predictor variables affect timely adherence with evaluation of abnormal mammography, intention to continue screening, interval mammography, satisfaction with care, out- of-pocket costs, anxiety, and functional well-being. The cohort design will permit an evaluation of the effect that changes in health care systems may have on these outcomes in these women. Finally, we will develop and pilot test intervention strategies with 150 women to promote the efficient resolution of abnormalities on screening mammography and to reduce potential adverse effects on functional status of these women.
| Pérez-Stable, Eliseo J; Afable-Munsuz, Aimee; Kaplan, Celia Patricia et al. (2013) Factors influencing time to diagnosis after abnormal mammography in diverse women. J Womens Health (Larchmt) 22:159-66 |
| Stewart, Susan L; Rakowski, William; Pasick, Rena J (2009) Behavioral constructs and mammography in five ethnic groups. Health Educ Behav 36:36S-54S |
| Otero-Sabogal, Regina; Stewart, Susan; Shema, Sarah J et al. (2007) Ethnic differences in decisional balance and stages of mammography adoption. Health Educ Behav 34:278-96 |
| Wagner, Todd H; Engelstad, Linda P; McPhee, Stephen J et al. (2007) The costs of an outreach intervention for low-income women with abnormal Pap smears. Prev Chronic Dis 4:A11 |
| Alderete, Ethel; Juarbe, Teresa C; Kaplan, Celia Patricia et al. (2006) Depressive symptoms among women with an abnormal mammogram. Psychooncology 15:66-78 |
| Juarbe, Teresa C; Kaplan, Celia Patricia; Somkin, Carol P et al. (2005) Are risk factors for breast cancer associated with follow-up procedures in diverse women with abnormal mammography? Cancer Causes Control 16:245-53 |
| Karliner, Leah S; Patricia Kaplan, Celia; Juarbe, Teresa et al. (2005) Poor patient comprehension of abnormal mammography results. J Gen Intern Med 20:432-7 |
| Engelstad, Linda P; Stewart, Susan; Otero-Sabogal, Regina et al. (2005) The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer. Prev Med 41:741-8 |
| Somkin, Carol P; McPhee, Stephen J; Nguyen, Tung et al. (2004) The effect of access and satisfaction on regular mammogram and Papanicolaou test screening in a multiethnic population. Med Care 42:914-26 |
| Wagner, Todd H; Goldstein, Mary K (2004) Behavioral interventions and cost-effectiveness analysis. Prev Med 39:1208-14 |
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