背景:乳腺癌是美国最常见的癌症,也是美国印第安人妇女死亡的第二大原因。美洲印第安人妇女的乳腺癌筛查率低于其他种族群体,乳腺癌死亡率和生存率的差异仍然存在。为了满足这一关键需求,文化上适当的,可访问,个性化干预是必要的,以促进美国印度女性的乳腺癌筛查。这项研究使用移动健康原则为偏远地区的美洲印度女性开发了基于移动网络应用的乳房X线照片干预(wMammogram),北部平原的农村社区。
目的:本研究旨在评估乳房X光片干预的可行性和有效性,旨在激励美洲印第安人妇女接受乳腺癌筛查,与对照组相比,他收到了一本教育手册。
方法:在随机对照试验设计中使用基于社区的参与式研究(CBPR)原则和多管齐下的招募策略,我们开发了wMammogram干预措施。这项研究涉及122名年龄在40至70岁之间的美洲印第安人妇女,他们被随机分配到干预组(n=62)或对照组(n=60)。干预组中的人通过移动网络应用程序收到个性化和文化上适当的消息,而对照组的人收到了一本教育手册。我们测量了诸如乳房X光检查之类的结果,打算在干预后接受乳腺癌筛查,以及参与者对干预的满意度和接受度。
结果:在6个月的随访中,接受wMammogram干预的女性比例(26/62,42%;P=.009)比对照组(12/60,20%)明显更高。wMammogram干预组,与对照组相比,报告对干预措施感知效果的评分明显更高(t120=-5.22;P<.001),知识的增加(t120=-4.75;P<.001),和对干预的满意度(t120=-3.61;P<.001)。此外,与小册子组相比,干预组表示更愿意在将来到期时接受乳房X光检查(62/62,100%vs51/60,85%),并且更愿意向朋友推荐接受的干预(61/62,98.4%vs54/60,90%),差异有统计学意义.
结论:这项研究显示了wMammogram干预措施的可行性和有效性,以促进偏远地区的美洲印第安人妇女的乳腺癌筛查,农村社区设置。研究结果表明,随着技术的进步和移动设备的普及,移动网络应用程序可以作为一种有价值的健康干预工具,它建立在低成本技术的基础上,增强预防保健的可及性和可持续性,以帮助减少难以接触到的美洲印第安人人群的乳房健康差距。
背景:ClinicalTrials.govNCT05530603;https://clinicaltrials.gov/ct2/show/NCT05530603。
BACKGROUND: Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This
study used mobile health principles to develop a mobile web app-based
mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains.
OBJECTIVE: This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure.
METHODS: Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled
trial design, we developed the wMammogram intervention. This
study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as
mammogram receipt, intention to receive breast cancer screening after the intervention, and participants\' satisfaction with and acceptance of the intervention.
RESULTS: A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a
mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences.
CONCLUSIONS: This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations.
BACKGROUND: ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.