Abstract

Using a national database for secondary analysis, the purpose of this investigation was to determine if women with diabetes have different patterns of screening for breast and cervical cancer than women of the general population; and, if so, identify the determinants of the screening pattern. The PRECEDE Model was the organizing framework for this investigation of the complex issues related to cancer screening. The 12 states utilizing the optional women's health module for the 2003 Behavioral Risk Factor Surveillance System (BRFSS) was downloaded into STATA Software. Inclusion criteria were women who self-report that they have diabetes in comparison to women who report not having diabetes. For mammography, selected women were 40 years of age or older which provided a weighted population size of 9,017,661. Pap screening age of 21 and older yielded a weighted population size of 13,025,863. Contingency tables were used to identify the prevalence of cancer screening in women with and without diabetes. No significant association was found between having a diagnosis of diabetes and mammography screening rates (F = 1.5, p-value = .22). Cervical cancer screening rates were statistically significantly different among women with diabetes and those without diabetes (F = 39.01, p-value = .00). Regional exceptions were noted when the 12 states were viewed individually. The states demonstrating inadequate screening rates were the states with the most negative predisposing and enabling factors. Using logistic regression, 10 of the 11 PRECEDE variables demonstrated a significant association with Pap screening rates. Women with poorer perceptions of general and mental health, unemployment, low income, decreased education, lack of health plan coverage, not having a personal physician, having a disability that limits activity or requires the use of special equipment had lower Pap screening rates. Whites were less likely to be screened than non-whites. This study represented an improvement over other studies limited to a single practice or region. Further studies utilizing secondary analysis of state and national data will assist in confirming these findings and promote the development of trend data to evaluate the success of current local, state and national cancer screening programs that will guide the direction of future programs.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3189186; ProQuest document ID: 305365735. The author still retains copyright.

Author Details

Janet G. Marshall, PhD, RN

Sigma Membership

Non-member

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Quantitative Research

Keywords:

Diabetic Women, Chronic Conditions, Health Care and Self-care

Advisors

Cowell, Julia

Degree

Doctoral-Other

Degree Grantor

Rush University

Degree Year

2005

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2019-09-13

Full Text of Presentation

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