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Biomedical subjects

V L Champion

Publications and source records attributed to V L Champion.

At least 19 recordsLinked to original sources
PubMed2004

Do benefits and barriers differ by stage of adoption for colorectal cancer screening?

In 2003, over 148,300 people were expected to be diagnosed and 56,000 to die from colorectal cancer (CRC). First-degree relatives (FDRs) of people with colon cancer have a two- to eight-fold increased risk for CRC. Despite evidence that screening is effective, adherence with screening recommendations in this at-risk population is low. This study's purposes were to (1) identify perceived benefits and barriers of fecal occult blood testing (FOBT), sigmoidoscopy and colonoscopy, and (2) compare demographic characteristics and perceived benefits and barriers by stage of adoption for CRC screening. Participating FDRs (n = 257) completed a 40-min structured telephone interview. Despite high rates of agreement with the benefits of screening, most FDRs were not contemplating being screened. Of those 50 and older, most were in precontemplation for FOBT, sigmoidoscopy and colonoscopy. Older age was related to stage for FOBT and sigmoidoscopy, but not colonoscopy. Lack of provider recommendation also was related to stage. Consistent with theoretical predictions, precontemplators had (1) higher rates of endorsement of specific barriers to screening and (2) lower rates of endorsement of benefits than contemplators or actors. For morbidity and mortality reduction, participation in routine, periodic screening is imperative. These findings can guide development of screening-promoting interventions.

Age Factors↗
PubMed2001

Examining the boundaries of tailoring: the utility of tailoring versus targeting mammography interventions for two distinct populations.

Health messages can be generic, targeted to population subsets or tailored for individual recipients. There has been little examination of which populations need tailored interventions or whether tailored and targeted interventions differ in important ways. We used data from a mammography intervention study in two distinct populations to simulate a comparison of individually tailored versus targeted interventions. Tailored intervention content was based on individual recipients' interview responses. Targeted intervention content was based on composite group responses. For more than 60% in each population group, about two-thirds of tailored message content was a good match with content of the targeted intervention generated by composite group responses; roughly one-third of the content was 'not a good' fit for their intervention needs. Tailored interventions for more than 80% of subjects in each population differed in at least some way from those generated for all other population group members. This simulation is a first step in quantifying the contribution of individual tailoring over group targeting. Future research should examine whether a targeted intervention that is mostly a 'good' match results in behavioral outcomes similar to those of individually tailored interventions and whether particular differences in tailored versus targeted interventions yield significantly more favorable intervention outcomes.

Breast Neoplasms↗
PubMed2001

Improving depressive symptoms among caregivers of patients with cancer: results of a randomized clinical trial.

PURPOSE/OBJECTIVES: Determine the impact of a 16-week supportive nursing intervention on caregivers of patients with newly diagnosed cancer. DESIGN: Randomized clinical trial. SETTING: Two midwestern cancer treatment sites. SAMPLE: Caregivers of newly diagnosed patients. Patients' mean age was 55.73 years; 55% had breast cancer, and 76% were female. Caregivers' mean age was 52.44 years, and 50% were female. 125 dyads consented to participate; 89 dyads completed the study. METHODS: A nursing intervention was delivered to the experimental group that emphasized symptom monitoring/management, education, emotional support, coordination of services, and caregiver preparation to care. Nurses made a total of nine contacts, five in person and four by telephone, over 16 weeks. Centers for Epidemiological Studies-Depression (CES-D) and a symptom inventory were used. Medical record audits were conducted retrospectively. MAIN RESEARCH VARIABLES: Patient and caregiver depression scores and patient symptom experience. FINDINGS: Baseline caregiver depression and the number of patient symptoms at baseline, 9, and 24 weeks were significant predictors of caregiver depression at 9 and 24 weeks. However, no main effect of the experimental condition existed on caregiver depression. At the final observation, a nonsignificant inverse relationship was found between the number of interventions and depression scores for caregivers. CONCLUSIONS: The intervention appeared to be more effective in slowing the rate of deterioration of depressive symptoms than in decreasing levels of depression in this sample of caregivers. Determining the effectiveness of this intervention in decreasing caregiver depression was difficult because caregivers with higher levels of depression were more likely to withdraw from the study. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be vigilant in monitoring caregivers for signs of depression and must intervene to provide emotional support and make appropriate referrals for follow-up care to promote positive outcomes for patients and caregivers.

Analysis of Variance↗
PubMed1999

Revised susceptibility, benefits, and barriers scale for mammography screening.

The purpose of this research was to revise scales measuring perceived susceptibility to breast cancer and perceived benefits and barriers to mammography utilization. A total of 618 women age 50 and over who were enrolled in a large intervention study participated in data collection. Scales were revised beginning with focus group input. Analyses included internal consistency reliability, test-retest reliability, factor analysis, confirmatory analysis, and known groups techniques to test construct validity. Internal consistency ranged from .75 to .88, and test reliabilities from .59 to .72. Construct validity was confirmed with exploratory and confirmatory factor analyses, as well as known group techniques. Overall these scales represent an improvement in those previously reported.

Breast Neoplasms↗
PubMed1999

Cost-effectiveness comparison of five interventions to increase mammography screening.

BACKGROUND: Mammography is the primary method used for breast cancer screening. However, compliance with recommended screening practices is still below acceptable levels. This study examined the cost-effectiveness of five combinations of physician recommendation and telephone or in-person individualized counseling strategies for increasing compliance with mammography. METHODS: There were 808 participants who were randomly assigned to one of six groups. A logistic regression model with compliance as the dependent variable and group as the independent variable was used to test for significant differences and a ratio of cost to improvement in mammogram compliance evaluated the cost-effectiveness. RESULTS: Three of the interventions (in-person, telephone plus letter, and in-person plus letter) had significantly better compliance rates compared with the control, physician letter, or telephone alone. However, when considering costs, only one emerged as the superior strategy. The cost-effectiveness ratios for the five interventions show that telephone-plus-letter is the most cost-effective strategy, achieving a 35.6% mammography compliance at a marginal cost of $0.78 per 1% increase in women screened. CONCLUSIONS: A tailored phone prompt and physician reminder is an effective and economical intervention to increase mammography. Future research should confirm this finding and address its applicability to practice.

Aged↗
PubMed1999

Mammography adherence and beliefs in a sample of low-income African American women.

The purpose of this article is to describe the relation of perceptions of perceived breast cancer risks and perceived benefits and barriers to mammography and stage of mammography adherence in a convenience sample of low-income African American women. The theoretical framework of the Health Belief Model and the Transtheoretical Model were used to identify concepts and stage of mammography adherence. Data were obtained in waiting rooms of multipurpose centers. Scores for susceptibility and benefits were lowest for those who were in (a) precontemplation (had not thought about having a mammogram); as compared to (b) contemplation (had thought about having a mammogram, but not yet acted); (c) action (had a mammogram as recommended by the American Cancer Society); and (d) relapse (had a mammogram in the past, but overdue). Barriers scores were highest for those who had not had a mammogram (precontemplators and contemplators). In addition, individual barriers were significantly lower for women in action. Results have implications for interventions to increase screening in low-income African American women.

Journal Article↗
PubMed1998

Validity of self-reported mammography in low-income African-American women.

BACKGROUND: Mammography screening reduces mortality by 25% to 30% in women aged 50 to 69. Because mammography screening is often used less frequently than the recommended guidelines, many descriptive and intervention studies are underway to increase use of this important screening tool. Assessment of intervention effect is dependent on valid measurement of mammography use. Although several studies have shown a close correspondence between self-report and medical records, most had few minority participants. METHODS: The purpose of this report was to compare self-reported mammography and medical records of mammography status in a low-income African-American sample. A total of 229 low-income (at 150% of poverty or below) African-American women were interviewed regarding breast cancer screening. Response categories that assessed last mammogram were "within the last 12 months," "13-24 months," and "over 24 months," as well as date and location of last mammogram. Self-reported mammography was compared with medical records at the facility named by respondents. RESULTS: Comparison with self-report showed that only 49% to 60% of reported mammography use could be verified within categories. CONCLUSION: Self-report alone may not provide accurate rates of mammography compliance. Further research is necessary with ethnic and low-income women.

Black or African American↗
PubMed1997

Attitudes about breast cancer and mammography: racial, income, and educational differences.

This study examined the effect of race, income, and education on perceived susceptibility to and control over breast cancer, perceived benefits of and barriers to mammography, and knowledge about breast cancer and mammography use, in addition to determining if predictors for mammography use differed between races. Self-reported mailed survey data were obtained from a convenience sample of 1083 church women (78% Caucasian, 22% African-American) > or = 50 years with no history of breast cancer. ANOVA identified higher susceptibility and lower knowledge scores for African-American women; higher knowledge scores for upper income women of both races; interactions between race and income for benefits and perceived control; and interactions between race and education for barriers. African-American women were more likely to regard fear of radiation as a barrier to mammography (OR = .34; CI = .20, .57) and were more likely to worry about getting breast cancer (OR = .50; CI = .30, .82). Caucasian women were more likely to regard cost as a barrier (OR = 2.36, CI = 1.27, 4.40). For both races, variables predictive of ever having a mammogram were perceived control (White: OR = .69, CI = .54, .88; Black: OR = .50, CI = .38, .92), perceived barriers (White: OR = .88, CI = .83, .95; Black: OR = .75, CI = .64, .88), and knowledge (White: OR = 1.18, CI = 1.04, 1.33; Black: OR = 1.28, CI = 1.02, 1.61). Perceived benefits was predictive only for Caucasians (OR = 1.71, CI = 1.42, 2.06). Racial differences in perceived barriers to mammography and findings about the knowledge differences related to race, income, and education provide direction for health education efforts. The significance of cost factors for Caucasian and low-income women suggest that access barriers remain despite increased use of mammography.

Black or African American↗
PubMed1997

Factors influencing effect of mammography screening in a university workplace.

The purpose of this study was to examine the relationship between theoretically identified variables and participation in mammography screening in a university workplace. A sample of 1093 women 50 and over returned a questionnaire following the offer of a free workplace breast cancer screening. Anderson's Behavioral Model of Health Services Use identified factors predisposing and enabling women to have mammograms. Predisposing variables included attitudes and experience related to mammography. Enabling variables included income, willingness to pay for mammography, health insurance coverage, and regular source of health care. Comparisons were made among: (i) those who were screened in the workplace, (ii) those who were screened elsewhere, and (iii) those who were not screened. Differences in perceived barriers, perceived benefits, practice of breast self-examination (BSE), and education surfaced. Results indicated, among other things, that women who were older, had no more than 12 years of education, had a family member with breast cancer, and were proficient with breast self-examination were more likely to have participated in the university work-site screening.

Breast Neoplasms↗
PubMed1996

Health beliefs and social influence in home safety practices of mothers with preschool children.

The purpose of this study was to determine relationships among health beliefs, social influence, and home injury proofing-behavior in 140 low-income mothers with preschool children. Data were collected through structured interviews and observations of safety hazards in subjects' homes. Regression analysis showed that the combination of health beliefs, social influence, demographic, and experiential variables accounted for 51% of the variance in hazard accessibility and 44% in hazard frequency. Self efficacy, previous injury experience, knowledge, age, and birth position of the children were significant predictors of home safety practices. Recommendations are offered for practice, research, and health policy.

Accidents, Home↗
PubMed1995

Results of a nurse-delivered intervention on proficiency and nodule detection with breast self-examination.

PURPOSE/OBJECTIVES: To determine group differences in breast self-examination (BSE) frequency, proficiency, and nodule detection as a result of belief and/or informational interventions. DESIGN: Prospective, randomized, experimental design using a control group and three intervention groups. Data on outcome measures were collected one year following intervention to determine intervention effect on BSE outcome measures. SAMPLE: Women without breast cancer ranging in age from 35-88 years. METHODS: Graduate research assistants conducted in-home interviews and completed intervention delivery and data collection using a standardized protocol for each experimental group. Interventions included counseling about beliefs regarding BSE and informational counseling with BSE demonstration. A second in-home interview was conducted one year after the intervention to determine its effect on BSE outcome measures. MAIN RESEARCH VARIABLES: Self-recorded frequency, observer-rated proficiency scores, and nodule detection scores. FINDINGS: The group receiving both the belief and information interventions had significantly higher frequency (t = 2.22, p < or = 0.05) and higher proficiency scores (t = 3.22, p < or = 0.01) for BSE than the control group. The control group had significantly lower rates than the belief/information group for observed proficiency of BSE (t = 7.72, p < or = 0.01) and for nodule detection (t = 8.91, p < or = 0.01). CONCLUSIONS: The intervention consisting of information, BSE demonstration, and follow-up demonstration significantly increased logged frequency, logged proficiency, observed proficiency, and nodule detection one year postintervention. The group receiving both the belief intervention and information intervention demonstrated the highest nodule detection. IMPLICATIONS FOR NURSING PRACTICE: BSE teaching should include assessment and discussion about belief toward breast cancer and BSE while providing instruction with return demonstration.

Adult↗
PubMed1994

Strategies to increase mammography utilization.

This study compared the effects of theoretically driven interventions on compliance with mammography utilization. A 2 x 2 factorial design yielded four groups: a control group, a belief intervention group, an informational intervention group, and a belief/informational intervention group. A probability sample of 301 women, age 35 and older, without a history of breast cancer were randomly assigned to groups. Subjects in the intervention groups received individually tailored messages to alter beliefs or provider information related to mammography screening. Belief messages were developed from Health Belief Model constructs. Belief interventions significantly influenced all belief variables except perceived susceptibility in the desired direction. Women in the belief/informational intervention group were almost four times more likely than those in the control group to comply with mammography recommendations in the year following intervention (odds ratio = 3.75). In addition, belief variables and intervention significantly predicted mammography compliance 1 year postintervention.

Adult↗
PubMed1994

Beliefs about breast cancer and mammography by behavioral stage.

PURPOSE/OBJECTIVES: To explore the relationships of Health Belief Model (HBM) variables and the Trans-theoretical Model with regard to behavioral stage of mammography adoption. DESIGN: Descriptive, correlational. SETTING: Large midwestern city. SAMPLE: 405 women over age 40 obtained through random digit dialing. Subjects had agreed to participate in a larger intervention study. METHODS: Data were collected during in-home interviews. Subjects completed six scales developed from the HBM and answered questions related to mammography compliance. MAIN RESEARCH VARIABLES: Perceptions of breast cancer susceptibility and seriousness, perceived benefits of and barriers to mammography, motivation to stay healthy, and perceived control over health; degree of mammography compliance. FINDINGS: Women complaint with mammography guidelines had significantly higher scores on seriousness, benefits, health motivation, and control as well as significantly lower scores on barriers. In addition, scores on susceptibility, seriousness, benefits, barriers, and health motivation were significantly different across stages of mammography (precontemplation, contemplation, and action/maintenance). CONCLUSIONS: Interventions should target attitudes about susceptibility and seriousness of breast cancer in women who do not comply with established guidelines for mammography. Women who are not in compliance and have no plans to seek mammography would benefit from additional emphasis on mammography benefits and from removal of barriers. Health motivation also must be addressed in noncompliant women. IMPLICATIONS FOR NURSING PRACTICE: These results promise to expand the understanding of a person's motivation to change health-seeking behaviors, specifically obtaining routine screening mammograms. Further research using this new framework is needed to substantiate these results with a cross section of women.

Adaptation, Psychological↗
PubMed1993

Mammography in women > or = 50 years of age. Predisposing and enabling characteristics.

The purpose of this study was to identify the relationship of selected predisposing and enabling characteristics of women > or = 50 years of age to mammography utilization. Andersen and Aday's theoretical model for health services utilization guided data collection. Data were collected from a convenience sample of 161 women members of four urban churches, using a mailed survey. Results showed that 81% reported at least one mammogram and 24% had followed mammography guidelines for the preceding 3 years. Results of logistic regression analyses with variables having a bivariate significance of p < or = 0.01 showed that higher income was associated with both ever having a mammogram and adherence. Willingness to pay > $50 out of pocket for a mammogram was significant for 3 year adherence. Additionally, the sociodemographic variables of age and religion were associated with adherence, whereas a college education was highly significant (odds ratio = 13.78) for ever having a mammogram. Having a regular place for health care and having yearly Papanicolaou tests were associated with ever having a mammogram, but not adherence. Finally, intending to get a mammogram was associated with ever having a mammogram. In this study, belief and knowledge variables showed no association with utilization, and social influence had bivariate significance only for ever having a mammogram. This study suggests the importance of addressing economic and health-care delivery system factors to promote increased mammography utilization, particularly for older women.

Aged↗
PubMed1992

Compliance with guidelines for mammography screening.

The health belief model was used to identify potential variables related to intention or compliance with mammography guidelines. Scales to measure independent and dependent variables were developed from previous research and assessed for validity and reliability. A probability sample of women 35 and older (x = 50) who resided in a large metropolitan area and surrounding counties (n = 322) participated in in-home interviews. Intent to complete mammography was related to having a family history of breast cancer, perceived barriers to mammography, and perceived control over breast cancer. Compliance with mammography was influenced by general health motivation and perceived susceptibility to and seriousness of breast cancer, benefits, and control over breast cancer. In addition, knowledge about breast cancer and breast cancer detection, age, having a health care provider suggest mammography, having symptoms of breast cancer, and socioeconomic status were significantly related to actual compliance with mammography.

Adult↗
PubMed1990

Breast self-examination in women 35 and older: a prospective study.

A correlational study was conducted to identify attitudinal variables specified by the Health Belief Model that were related to frequency and total performance (frequency and proficiency) of breast self-examination (BSE). The probability sample consisted of 362 women, ages 35 and over, who were initially contacted via random digit dialing. Data were collected during in-home interviews by trained graduate assistants and by telephone interview 1 year later. Results supported the ability of past performance, perceived barriers, and knowledge to predict current total performance (combined frequency and proficiency). In addition, frequency for breast self-examination was predicted by past frequency, barriers, health motivation, control, being taught by a doctor, confidence, having BSE procedure checked, benefits, and susceptibility. Results lend support to use of attitudinal and experimental variables in predicting women's actual behaviors in relation to breast self-examination.

Adult↗
PubMed1990

Relationship between cross-cultural health attitudes and community health indicators.

Improving health standards both nationally and cross-culturally is a goal for all community health nurses. Previous research has supported links between health attitudes and behavior. The purpose of the present study was to investigate the relationship between attitudes toward health and indexes of community health using a cross-cultural data set. Concepts selected from the data set were I (myself), body, sickness, disease, life, doctor, health, medicine, hospital, nurse, death, and insane. Community health indicators were male and female life expectancy, infant mortality, economic and public health expenditures, and net social progress. The original sample included 1200 high school males within each of 30 language and cultural communities. Data were derived from students' ratings of the dimensions of evaluation, potency, and activity for each concept. The results supported the association between attitudes and objective community health indicators. Unexpected negative correlations were found between attitudes toward medicine and nurse attitudes toward body and life, perhaps indicating that extended contact with health care providers may result in negative attitudes toward them. Positive relationships were found between public health expenditures and nurses, indicating that in countries with more expenditures for community and public health, attitudes toward nurses were more positive.

Adolescent↗