Exploring the role of acculturation on mammography utilization among Hispanic women in the United States Open Access
Rodriguez, Juan (Summer 2020)
Published
Abstract
Breast cancer is the leading cause of cancer-related death among Hispanic women in the U.S. While Hispanic women have lower mortality rates than non-Hispanic white women, Hispanic women are more likely to get diagnosed at later stages. Disparities in stage at diagnosis may be explained, in part, by lower levels of mammography use among Hispanic women. In order to develop interventions, there is interest in understanding if acculturation impacts mammography use among Hispanic women. This dissertation conducted a systematic literature review and two quantitative studies to explore the association between acculturation and mammography use among Hispanic women in the U.S.
The systematic review indicated that while research has been conducted to assess the role of acculturation on mammography utilization among Hispanic women, this research has almost exclusively focused on proxy measures of acculturation on immigration status and language utilization. While these studies have provided limited evidence, results suggest that among foreign-born women, non-U.S. citizens are less likely to be up-to-date with mammography screening. Quantitative exploration of the role of immigration status on mammography use among a national sample of Hispanic women indicated that while immigration status was not a significant predictor of recent mammography use, foreign-born non-U.S. citizens faced significantly greater odds of being rarely or never screened for breast cancer. Results also indicated that these same women were more likely to face significant barriers in accessing health care and had lower socioeconomic status.
An ecological study exploring mammography capacity in Hispanic communities in the U.S. found that counties with dense Hispanic communities and counties that have been traditional Hispanic settlement destinations have greater odds of having limited mammography capacity. In addition, these high Hispanic population density and limited mammography capacity counties tend to be rural, and have a larger proportion of their population who are non-U.S. citizens, uninsured, and are living below the poverty level than the average U.S. county. Ensuring Hispanic women have adequate access to mammography screening in the U.S. will require policy and health system interventions to ensure access to health care services for non-citizens and those living in rural areas.
Table of Contents
Table of Contents
Chapter One – Introduction........................................................................................................ 1
I. Background................................................................................................................................... 1
A. The Hispanic population of the United States................................................................................................................ 1
B. Hispanic Mortality Paradox........................................................................................................................................................... 4
C. Cancer Burden of the Hispanic Population........................................................................................................................... 6
D. Breast Cancer among Hispanic women.................................................................................................................................. 7
II. Literature Review...................................................................................................................... 10
A. Mammography use among Hispanic women in the U.S............................................................................................. 10
B. Hispanics as homogeneous population............................................................................................................................... 15
C. Conceptualization and measurement of acculturation.............................................................................................. 16
D. Contextual factors and mammography use....................................................................................................................... 18
III. Theoretical Approach.............................................................................................................. 22
IV. Significance and Aims of Research.......................................................................................... 36
V. References................................................................................................................................. 41
Chapter Two................................................................................................................................ 62
Exploring acculturation as a multi-dimensional measure in research on mammography utilization among Hispanic/Latina women in the U.S........................................................................................................................................................ 62
I. Introduction................................................................................................................................ 62
II. Methods.................................................................................................................................... 64
III. Results..................................................................................................................................... 67
IV. Discussion............................................................................................................................... 77
V. Tables and Figures.................................................................................................................... 84
VI. References.............................................................................................................................. 101
VII. Supplementary Materials..................................................................................................... 113
Chapter Three........................................................................................................................... 118
The role of immigration status on mammography use among Hispanic women in the U.S. 118
I. Introduction.............................................................................................................................. 118
II. Methods.................................................................................................................................. 122
III. Statistical Analysis................................................................................................................ 132
IV. Results................................................................................................................................... 136
V. Discussion............................................................................................................................... 146
VI. Tables and Figures................................................................................................................. 158
VII. References............................................................................................................................ 173
VIII. Supplementary Materials................................................................................................... 183
Chapter Four............................................................................................................................. 185
Mammography capacity in primarily Hispanic communities in the U.S........................... 185
I. Introduction.............................................................................................................................. 185
II. Methods.................................................................................................................................. 187
III. Statistical Analysis................................................................................................................ 191
IV. Results................................................................................................................................... 193
V. Discussion............................................................................................................................... 197
VI. Tables and Figures................................................................................................................. 203
VII. References............................................................................................................................ 215
VIII. Supplementary Materials................................................................................................... 224
Chapter Five - Conclusions..................................................................................................... 228
I. Main Findings.......................................................................................................................... 228
II. Evaluation of Research: Limitations and Strengths................................................................. 235
III. Implications for Public Health Research and Practice........................................................... 238
IV. Conclusions........................................................................................................................... 241
V. References............................................................................................................................... 242
About this Dissertation
School | |
---|---|
Department | |
Degree | |
Submission | |
Language |
|
Research Field | |
Keyword | |
Committee Chair / Thesis Advisor | |
Committee Members |
Primary PDF
Thumbnail | Title | Date Uploaded | Actions |
---|---|---|---|
|
Exploring the role of acculturation on mammography utilization among Hispanic women in the United States () | 2020-07-09 22:38:12 -0400 |
|
Supplemental Files
Thumbnail | Title | Date Uploaded | Actions |
---|