Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations

Sorensen, Glorian; Emmons, Karen M.; Hunt, Mary Kay; Barbeau, Elizabeth M.; Goldman, Roberta E.; Peterson, Karen E.; Kuntz, Karen M.; Stoddard, Anne M.; Berkman, Lisa F.

doi:10.1016/s0091-7435(03)00111-7

Cited by 218 publications

(235 citation statements)

References 52 publications

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“…The causes of these disparities are still poorly understood, but likely involve the multiple social barriers experienced by low-income, multicultural populations (Sorensen et al, 2003). Research on the "intersecting roles of multiple sources of disparities" and the origin of observed health inequalities is urgently needed to improve cervical cancer screening among Aboriginal women (Sorensen et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women

Maar¹,

Burchell²,

Little³

et al. 2013

Women's Health Issues

128

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Objective-In Canada, opportunistic screening programs have successfully reduced mortality from cervical cancer; however, minority or disadvantaged groups, as well as women in northern and rural areas, are inadequately recruited by this approach. Hence, we set out to examine the structural barriers that prevent First Nations women's participation in cervical cancer screening.Methods-Using a participatory action research approach and semistructured interview guides, we conducted in-depth interviews with 18 experienced health care professionals, 12 of whom were also community members. These individuals included nurses, nurse practitioners, community health representatives, social workers and physicians who provide care to women in our First CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptNations partner communities. In the current report, we explored perceived barriers to cervical cancer screening through the lens of service providers.Results-Structural barriers to cervical cancer screening for First Nations women included shortage of appropriate health care providers, lack of a recall-based screening system, geographic and transportation barriers; health literacy and socioeconomic inequalities, generational effects, and the colonial legacy.Conclusion-Existing, opportunistic cervical cancer screening programs do not perform well for First Nations women who experience significant screening-related health inequalities that are largely influenced by structural barriers. Sustainable screening interventions in First Nations communities require approaches that resolve these structural barriers, explore new ways of screening, and provide education for both women and health care providers. Many of the structural barriers are rooted in colonial history. Given the negative impact of the consequences of colonization on indigenous women worldwide, many of our findings strongly resonate with marginalized populations in other countries.

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Section: Introductionmentioning

confidence: 99%

“…Research on the "intersecting roles of multiple sources of disparities" and the origin of observed health inequalities is urgently needed to improve cervical cancer screening among Aboriginal women (Sorensen et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women

Maar¹,

Burchell²,

Little³

et al. 2013

Women's Health Issues

128

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“…Just as the physical environment either inhibits or facilitates health behavior, so does the social or collective characteristics of the community. 16,17 One way in which the environment "gets under one's skin" and influences physiology is through its effect on risk behaviors, such as PA and diet. 18,19 Studies have examined both physical and social aspects or multiple dimensions of the environment.…”

mentioning

confidence: 99%

A Multilevel Study of the Associations Between Economic and Social Context, Stage of Adolescence, and Physical Activity and Body Mass Index

et al. 2007

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OBJECTIVE. Prevention efforts targeting adolescent risk behavior have had limited effectiveness, partly because of the reliance on individual-level interventions that do not consider the context within which behavior occurs. In addition, the role of development has not been well studied regarding its possible moderating effects on contextual influences on behavior. The purpose of this study was to examine the influence of economic and social context on the odds of being inactive or having above-normal weight and whether the influence differed on the basis of stage of adolescence.METHODS. Analysis used a subset of adolescents aged 10 to 17 years from the National Survey of Children's Health (n ϭ 37 930) from all states and the District of Columbia (n ϭ 51). Dependent variables included physical activity and BMI. State-level economic context was measured by the proportion of families living below 200% of the federal poverty level. Social context was measured by aggregated means of responses to 2 indicators of social capital: mutual aid and social trust. Multilevel modeling was conducted to investigate associations between state-level economic and social context and physical activity and BMI, while controlling for individual sociodemographic characteristics, and whether these associations were dependent on an individual's stage of adolescence. RESULTS. Both state-level mutual aid and social trust were significantly related to the odds of an adolescent not meeting current physical activity recommendations, yet state-level poverty was not. For BMI, all 3 state-level variables were significant predictors of having an above-normal BMI. Evidence was found of the moderating influence of stage of adolescence for both outcomes.CONCLUSIONS. These findings point to the need for the inclusion of contextual-level data in surveillance systems assessing risk behavior in adolescents and consideration of the multilevel nature of the growing problem of inactivity and abovenormal weight when focusing public health prevention efforts.www.pediatrics.org/cgi

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“…This means that health consists of complex and multidimensional factors [3][4][5]. Where the socioeconomic and cultural components and their outputs like religion, behaviour, beliefs, attitudes, and the political framework affect the health of the individual [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. And so, it is necessary to work on improving the environment which incubates these factors to improve health [25].…”

Section: Introductionmentioning

confidence: 99%

Beliefs and Attitudes Regarding Determinants of Health in Turkey and Palestine

Wa¹

2017

J Community Med Health Educ

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Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations

Cited by 218 publications

References 52 publications

A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women

A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women

A Multilevel Study of the Associations Between Economic and Social Context, Stage of Adolescence, and Physical Activity and Body Mass Index

Beliefs and Attitudes Regarding Determinants of Health in Turkey and Palestine

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