ASPO Abstracts
The effectiveness of interventions to increase mammography uptake among non-adherent Asian American women: A meta-analysis
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
a. Purpose: Breast cancer screening is underutilized among Asian American women despite the effectiveness of
mammography (MAM) to detect breast cancer early. Various interventions have been developed to improve their MAM
use. However, due to the inconsistency in the effectiveness of current interventions, synthesizing the existing results is
important to guide future studies attempting to decrease cancer disparities. Thus, this meta-analysis was conducted to
estimate the overall effects of existing interventions developed to increase MAM uptake for Asian American women.
b. Methods: A systematic review was conducted to identify studies found in four main databases using the following
keywords, including breast cancer screening, MAM, immigrants, and Asian Americans. Study eligibility included
randomized clinical trials to promote MAM uptake published in 2003-2019. Odds ratios (ORs) were calculated to estimate
effect sizes for each study and the pooled estimate. The heterogeneity was assessed to examine the variability in effect
estimates across studies followed by a random effects model to account for the presence of heterogeneity. A funnel plot
was generated along with other tests to detect the possibility of publication bias.
c. Results: A total of 9 studies were identified, involving interventions that used a individually tailored, culturally sensitive
media, or group settings. The pooled estimate of MAM uptake was statistically significant (OR = 2.56, 95% CI: 2.14-3.06).
Heterogeneity (Q = 61.57, p < 0.01) was identified in studies using the interventions involving a group setting compared to
individual-directed strategies (p < .01) but not in ethnicity groups. Interventions using a group setting (OR = 2.18, p = 0.04)
and individually tailored strategies provided a larger effect (OR = 2.05, p = 0.04). The pooled estimates during the
sensitivity analysis were similar despite inclusion of influential studies. No publication bias was identified.
d. Conclusions: Educational intervention programs are effective to increase MAM uptake in women who are not adherent
to the breast cancer screening guidelines. To yield a greater impact in improving MAM uptake in Asian American women,
future studies can use individually tailored interventions and/or a group setting.
Keywords: Mammography uptake, Asian American women, Meta-analysis