Maryam Ahmadian

Application of Health Behavior Theories to Breast Cancer Screening among Asian Women

BACKGROUND Although breast cancer is a major public health worry among Asian women, adherence to screening for the disease remains an obstacle to its prevention. A variety of psycho-social and cultural factors predispose women to delay or avoidance of screening for breast cancer symptoms at the early stages when cure is most likely to be successful. Yet few interventions implemented to date to address this condition in this region have drawn on health behavior theory. MATERIALS AND METHODS This paper reviews the existing literature on several cognitive theories and models associated with breast cancer screening, with an emphasis on the work that has been done in relation to Asian women. To conduct this review, a number of electronic databases were searched with context-appropriate inclusion criteria. RESULTS Little empirical work was found that specifically addressed the applicability of health theories in promoting adherence to the current breast cancer prevention programs Among Asian women. However, a few studies were found that addressed individual cognitive factors that are likely to encourage womens motivation to protect themselves against breast cancer in this region of the world. The findings suggest that multi-level, socio-cultural interventions that focus on cognitive factors have much promise with this issue. CONCLUSIONS Interventions are needed that effectively and efficiently target the personal motivation of at-risk Asian women to seek out and engage in breast cancer prevention. Concerning implications, personal motivation to seek out and engage in individual preventive actions for breast cancer prevention among Asian women is a timely, high priority target with practical implications for community development and health promotion. Further studies using qualitative, anthropologic approaches shaped for implementation in multi-ethnic Asian settings are needed to inform and guide these interventions.

Socio-demographic correlates of participation in mammography: a survey among women aged between 35- 69 in Tehran, Iran.

BACKGROUND The rates of breast cancer have increased over the past two decades, and this raises concern about physical, psychological and social well-being of women with breast cancer. Further, few women really want to do breast cancer screening. We here investigated the socio-demographic correlates of mammography participation among 400 asymptomatic Iranian women aged between 35 and 69. METHODS A cross-sectional survey was conducted at the four outpatient clinics of general hospitals in Tehran during the period from July through October, 2009. Bi-variate analyses and multi-variate binary logistic regression were employed to find the socio- demographic predictors of mammography utilization among participants. RESULTS The rate of mammography participation was 21.5% and relatively high because of access to general hospital services. More women who had undergone mammography were graduates from university or college, had full-time or part-time employment, were insured whether public or private, reported a positive family history of breast cancer, and were in the middle income level (P <0.01).The largest number of participating women was in the age range of 41 to 50 years. The results of multivariate logistic regression further showed that education (95%CI: 0.131-0.622), monthly income (95%CI: 0.038-0.945), and family history of breast cancer (95%CI: 1.97-9.28) were significantly associated (all P <0.05)with mammography participation. CONCLUSIONS The most important issue for a successful screening program is participation. Using a random sample, this study found that the potential predictor variables of mammography participation included a higher education level, a middle income level, and a positive family history of breast cancer for Iranian women after adjusting for all other demographic variables in the model.

Predictors of Mammography Screening among Iranian Women Attending Outpatient Clinics in Tehran, Iran

Mammography utilization is low in Iran compared with other countries. Here a cross-sectional survey design was used to investigate psycho-social and individual factors associated with mammography among 400 women asymptomatic of breast cancer. The study was carried out at the four outpatient clinics of Tehran during the period from July through October, 2009. We found that mammography screening was related to higher self-efficacy and womens occupation. Future tailored interventions on potential psycho-social determinants and specific demographic factors are critical in increasing mammography screening rates among Iranian women.

Barriers to mammography among women attending gynecologic outpatient clinics in Tehran, Iran

The aim of this study was to understand barriers to mammography among women attending obstetric and gynecologic outpatient clinics. Women at 4 obstetric and gynecologic clinics affiliated to Tehran University of Medical Sciences in Tehran were invited to participate in a cross-sectional survey with self-administered questionnaire and divided into two groups. The participant group consisted of women who had mammogram in the last two years and the non-participant group of women who had never had mammogram or for whom it had been over 2 years since their last mammogram. A total of 400 women aged 35 to 69 years, were randomly selected using random cluster sampling: 86(21.5%) were evaluated as the participant group and 314(78.5%) as the non-participant group. The result showed that lack of doctors’ advice, for the participant group, and embarrassment, for the non-participant group, are the most salient barriers. Mammography screening remains a health challenge for women and results suggest a comprehensive approach to focus on the attitudinal and logistic barriers.

Risky Sexual Behavior among Rural Female Adolescents in Malaysia: A Limited Role of Protective Factors

Purpose: This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. Methods: We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Results: Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. Conclusion: The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents’ risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia.

Relationship between Body Image and Breast Self-examination Intentions and Behaviors among Female University Students in Malaysia

This study aimed to examine the relationship between body image satisfaction and breast self-screening behavior and intentions. The sample for this cross-sectional study consisted of 842 female university students who were recruited from a number of public and private universities. Data were obtained between the months of November and December, 2013, using multistage random cluster sampling. Main research variables were breast cancer screening behavior and intentions, demographic factors, and the total scores on each of the Multidimensional Body-Self Relations Questionnaire (MBSRQ-Appearance Scales) subscales. Results of multivariate analysis showed that having higher satisfaction and more positive evaluation of appearance were related to having performed breast self-examination more frequently in the last year and intending to perform breast self-examination more frequently in the next year. Longitudinal research can potentially provide detailed information about overall body image satisfaction and breast cancer screening behavior among various communities.

An Outline of the Need for Psychology Knowledge in Health Professionals: Implications for Community Development and Breast Cancer Prevention

Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

The Influence of Psycho-social Factors on Participation Levels in Community-based Breast Cancer Prevention Programs in Tehran, Iran

Background: Although significant consideration has been devoted to women participation in breast cancer prevention programs, our understanding about the psychosocial factors which influence participation remains incomplete. Method: The study applied a quantitative approach based on the cross-sectional survey design and multistage cluster random sampling. A total of 400 women aged 35-69 years, were surveyed at 4 obstetric and gynecologic clinics affiliated to Tehran University of Medical Sciences in Tehran: the participation levels of 86 women who have had a mammogram were analyzed based on their self-efficacy, belief, social influence, and barriers concerning mammography utilization. Results: Consistent with the study framework, in bivariate analysis, the higher level of women’s participation in breast cancer prevention programs was significantly related to more positive belief about mammography (p< .05), greater social influence on mammography (p< .01) and fewer barriers to mammography (p< .01). Self efficacy (p= .114) was not significantly related to the higher level of participation. Conclusion: Results suggest that women’s participation levels in breast cancer prevention programs might be associated with the specific psychosocial factors on breast cancer preventive behavior such as mammography screening.

Insufficient Knowledge of Breast Cancer Risk Factors Among Malaysian Female University Students

Background: Despite continuous argument about the efficacy of breast self-examination; it still could be a life-saving technique through inspiring and empowering women to take better control over their body/breast and health. This study investigated Malaysian female university students’ knowledge about breast cancer risk factors, signs, and symptoms and assessed breast self-examination frequency among students. Method: A cross-sectional survey was conducted in 2013 in nine public and private universities in the Klang Valley and Selangor. 842 female students were respondents for the self-administered survey technique. Simple descriptive and inferential statistics were employed for data analysis. Results: The uptake of breast self-examination (BSE) was less than 50% among the students. Most of students had insufficient knowledge on several breast cancer risk factors. Conclusion: Actions and efforts should be done to increase knowledge of breast cancer through the development of ethnically and traditionally sensitive educational training on BSE and breast cancer literacy.

A Survey on Men’s Awareness of Premenstrual Syndrome and Marital Satisfaction in Married Women in Tehran, Iran

RESEARCH ARTICLE A Survey on Men’s Awareness of Premenstrual Syndrome and Marital Satisfaction in Married Women in Tehran, Iran Afsaneh Tavassoli, Maryam Ahmadian, Asnarulkhadi Abu Samah, Latiffah A. Latiff and Narges Taheri Department of Women and Family Studies, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran Department of Women and Gender Studies, George Mason University, Fairfax, VA, USA Institute for Social Science Studies, Universiti Putra Malaysia (UPM), Selangor, Malaysia Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Selangor, Malaysia