Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

Wang, K H; Thompson, Terri-Ann; Galusha, Deron; Friedman, Hannah E.; Nazario, Cruz M.; Nunez, Maxine; Maharaj, Ravi; Adams, O Peter; Nuñez-Smith, Marcella

doi:10.1007/s10552-018-1005-4

Cited by 12 publications

(15 citation statements)

References 44 publications

(47 reference statements)

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“…Women having employer or union purchased health insurance coverage were more likely to have a mammogram in the past two years when compared to women who were underinsured through state or state subsidized insurance programs. This nding supports currently available literature linking social determinants of health with preventative screening 9 . The ndings of this analysis are consistent with the ndings of a retrospective chart review of 157 women ages 40-75 years 10 .…”

Section: Insurance Status and Mammogramsupporting

confidence: 89%

“…Black women were less like to have a mammogram in the past two years when compared to other races. Existing evidence indicates that racial and ethnic minority women are prone to experience delays in treatment, as well as lower than recommended rates of mammogram screening 9 . This delay in diagnosis and treatment for black women leads to an increased rate of diagnosis at a later-stage breast cancer and subsequently leads to an increased morbidity and mortality rates 8 .…”

Section: Race and Mammogrammentioning

confidence: 99%

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The Impact of Race, and Insurance Status on Breast Cancer Screening: Results from the Behavioral Risk Factor Surveillance System Data

Yoda

Mallow

Theeke

2021

Preprint

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Purpose Breast cancer is the second major cause of cancer-related death of women in the United States 1, yet current gaps exist in breast cancer screening for minority women 2. The purpose of this study is to address these gaps by assessing the relationships among race, health insurance coverage, and breast cancer screening in a nationally representative sample of women. Design: A cross-sectional descriptive analysis of the 2018 BRFSS survey data was used to meet the study purpose. BRFSS participants who declared themselves to be of female sex and who were adults with the age ≥ of 40 years were selected for inclusion. Methods Data were analyzed using SPSS version 26. Exploratory and descriptive analyses were performed, followed by comparative analyses based on the variable type. Relationships between race, insurance status, and mammogram screening were examined. Chi-square, logistic, and multinomial logistic regression were used. Findings: The original 2018 BRFSS dataset included 437,436 participants and 145,837 women were selected based on inclusion criteria. Participant age ranged from 40 to 74 years. The majority were White only non-Hispanic (78.1%), reported having a mammogram in the past two years (76.1%), had earned < a 4-year college degree (61.1%), had an annual income of < $75,000 (58.4%) and married (58.2%). Less than half had a healthcare plan through an employer (44.9%) and were employed (40.5%). Participants who had a plan purchased through an employer or union were more likely to have a mammogram in the past two years when compared with other health coverage. Furthermore, White only, non-Hispanics were 1.25 times more likely and Black only, non-Hispanics were 1.98 times more likely to have a mammogram in the past two years compared to participants from other racial and ethnic groups. Conclusion The findings of this study provide an additional indication that race, and health insurance status do impact breast cancer screening. Clinical Relevance: Knowledge gained from this study can be used by practicing nurses to educate racial and ethnic minority women on the significance of breast cancer screening and prevention.

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Section: Insurance Status and Mammogramsupporting

confidence: 89%

Section: Race and Mammogrammentioning

confidence: 99%

The Impact of Race, and Insurance Status on Breast Cancer Screening: Results from the Behavioral Risk Factor Surveillance System Data

Yoda

Mallow

Theeke

2021

Preprint

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“…The Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study follows community-dwelling adults older than 40 years residing in Barbados, Trinidad, Tobago, and the United States’ territories of the US Virgin Islands and Puerto Rico [ 15 ]. Baseline participants were enrolled between 2013 and 2016 and completed a questionnaire to capture self-reported sociodemographics and health-related information.…”

Section: Methodsmentioning

confidence: 99%

Information Loss in Harmonizing Granular Race and Ethnicity Data: Descriptive Study of Standards

Wang

Nardini

Post³

et al. 2020

J Med Internet Res

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Background Data standards for race and ethnicity have significant implications for health equity research. Objective We aim to describe a challenge encountered when working with a multiple–race and ethnicity assessment in the Eastern Caribbean Health Outcomes Research Network (ECHORN), a research collaborative of Barbados, Puerto Rico, Trinidad and Tobago, and the US Virgin Islands. Methods We examined the data standards guiding harmonization of race and ethnicity data for multiracial and multiethnic populations, using the Office of Management and Budget (OMB) Statistical Policy Directive No. 15. Results Of 1211 participants in the ECHORN cohort study, 901 (74.40%) selected 1 racial category. Of those that selected 1 category, 13.0% (117/901) selected Caribbean; 6.4% (58/901), Puerto Rican or Boricua; and 13.5% (122/901), the mixed or multiracial category. A total of 17.84% (216/1211) of participants selected 2 or more categories, with 15.19% (184/1211) selecting 2 categories and 2.64% (32/1211) selecting 3 or more categories. With aggregation of ECHORN data into OMB categories, 27.91% (338/1211) of the participants can be placed in the “more than one race” category. Conclusions This analysis exposes the fundamental informatics challenges that current race and ethnicity data standards present to meaningful collection, organization, and dissemination of granular data about subgroup populations in diverse and marginalized communities. Current standards should reflect the science of measuring race and ethnicity and the need for multidisciplinary teams to improve evolving standards throughout the data life cycle.

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“…This unique partnership created the ECHORN Cohort Study (ECS), the first regional cohort study. 18,19 The ECS is an ongoing prospective cohort study that seeks to improve our understanding of early predictors and risk factors for NCDs in Caribbean and Caribbean-descent populations. With 3,000 cohort participants, the ECS collects data using survey tools, clinical assessment, and blood testing.…”

Section: Methodsmentioning

confidence: 99%

“…Collected data include a wide range of participant and household characteristics, past medical diagnoses, health biomarkers and health outcomes, and health care utilization. 18,19 One of the main aims of the Yale-TCC is to create a mechanism to share de-identified and aggregated population-level data from the ECS with community stakeholders and ECS participants. Aligned with a precision medicine approach, the Yale-TCC seeks also to merge publicly available population-level, health-related contextual data (such as social determinants of health, environmental data, or others) with biological, clinical and health-related data from the ECS participants.…”

Section: Methodsmentioning

confidence: 99%

Toward Reducing Health Information Inequities in the Caribbean: Our Experience Building a Participatory Health Informatics Project

Wang

Hambleton

Linnander³

et al. 2020

Ethn Dis

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Precision medicine seeks to leverage technology to improve the health for all individuals. Successful health information systems rely fundamentally on the integration and sharing of data from a range of disparate sources. In many settings, basic infrastructure inequities exist that limit the usefulness of health information systems. We discuss the work of the Yale Transdisciplinary Collaborative Center for Health Disparities focused on Precision Medicine, which aims to improve the health of people in the Caribbean and Caribbean diaspora by leveraging precision medicine approaches. We describe a participatory informatics approach to sharing data as a potential mechanism to reducing inequities in the existing data infrastructure.Ethn Dis. 2020;30(Suppl 1):193-202; doi:10.18865/ed.30.S1.193

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Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study

Abstract: We found that half of eligible women received timely screening mammography. Diabetes and hypertension, though common, are not associated with timely screening mammography. Usual source of care remains an important factor to timely breast cancer screening.

Cited by 12 publications

References 44 publications

The Impact of Race, and Insurance Status on Breast Cancer Screening: Results from the Behavioral Risk Factor Surveillance System Data

The Impact of Race, and Insurance Status on Breast Cancer Screening: Results from the Behavioral Risk Factor Surveillance System Data

Information Loss in Harmonizing Granular Race and Ethnicity Data: Descriptive Study of Standards

Toward Reducing Health Information Inequities in the Caribbean: Our Experience Building a Participatory Health Informatics Project

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