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How does social integration influence breast cancer control among urban African-American women? Results from a cross-sectional survey
Journal article   Open access   Peer reviewed

How does social integration influence breast cancer control among urban African-American women? Results from a cross-sectional survey

Ann Carroll Klassen and Carmen Washington
BMC women's health, v 8(1), pp 4-4
06 Feb 2008
PMID: 18254967
url
https://doi.org/10.1186/1472-6874-8-4View
Published, Version of Record (VoR) Open

Abstract

Women's Health Cross-Sectional Studies Humans Middle Aged Social Support Patient Acceptance of Health Care - statistics & numerical data Urban Health Health Knowledge, Attitudes, Practice Breast Neoplasms - prevention & control African Continental Ancestry Group - statistics & numerical data Baltimore - ethnology Aged, 80 and over Female Surveys and Questionnaires Aged Breast Neoplasms - diagnostic imaging Mammography - utilization Breast Neoplasms - ethnology
Although social integration is a well-established influence on health, less is known about how the specific types of social connection (social roles, social networks, and social support) influence knowledge, attitudes, and practices for specific prevention goals, and how to utilize these influences in interventions with priority populations. This research examined the prevalence of social roles, networks and support among 576 urban African-American women age 45-93 in East Baltimore, Maryland, and the association of these social factors with breast cancer related knowledge, attitudes, and practices. Using data from 1997-1998 in-home interviews, we developed indices of six possible social roles, social networks of family, neighborhood and church, and instrumental and emotional social support. In multivariate models adjusting for age, education, and medical care, we examined the association of each social influence on breast cancer knowledge, attitudes, screening recency and intention, and treatment preferences. We found substantial variation in social integration among these women, with social integration positively associated with overall health and well-being. Social roles and networks were positively associated with screening knowledge, and emotional support and church networks were positively associated with attitudes conducive to early detection and treatment. In regard to screening behaviors, family networks were associated with both screening recency and intention. Women with greater church networks and emotional support held more conservative attitudes towards lumpectomy, reconstruction, and clinical trials. Overall, social integration is a positive influence on breast cancer control and should be utilized where possible in interventions, including identifying surrogate mechanisms for support for subgroups without existing social resources.

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