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PurposeBlack women are more likely to develop early-onset (≤50 years) breast cancer (BC) and have the lowest five-year, cause-specific survival rate of any United States (U.S.) racial or ethnic group. These disparities can be attributed partially to the higher rate of triple-negative BC (TNBC) in Blacks. Yet, little is known about health-related quality of life (HRQOL) among Black women with TNBC.MethodsBlack women with invasive BC ≤ 50 years were recruited via the Florida Cancer Data System as part of a population-based case-only study of etiology and outcomes of early-onset invasive BC. Of 460 consented participants, a subset of 355 self-reported sociodemographic, clinical, and psychosocial variables. Descriptive analyses included participants with known TNBC (n = 85) or non-TNBC (n = 245) disease. Univariable and multivariable analyses were conducted to examine differences in factors associated with HRQOL.ResultsIn unadjusted analyses, TNBC participants had significantly lower FACT-B total scores (90.1 ± 27.9) compared to non-TNBC (98.5 ± 27.6) participants (p

Shared decision-making (SDM) represents an opportunity to increase patient involvement in their healthcare. Limited research exists on the factors impacting women's reproductive decision-making and what practical needs may be. This study aimed to identify factors women perceived as influencing their reproductive health decisions (e.g., family planning, accessing routine gynecological care) and to understand how these factors impact SDM within the reproductive healthcare context. We completed six focus groups with women aged 18 to 45 years in the United States. Women's SDM processes were explored using techniques from grounded theory. This study offered insight into factors influencing women's reproductive healthcare decisions and how these factors can negatively impact SDM. Participants indicated a desire to be invited into the healthcare discussion in which providers listened, supported, and validated their choices and needs. Participants provided recommendations from positive experiences to identify their preferences during a woman's healthcare appointment. Additionally, participants described quality time as more important than the quantity of time spent during consultations. Prior negative healthcare experiences attributed to interaction with healthcare providers affected their SDM perspectives and healthcare engagement, as did family/friends and race. Participants suggested that previous interactions with healthcare providers influenced their decision to seek healthcare, explicitly citing community-based reproductive healthcare. Findings provide recommendations on how clinicians can engage in SDM, practical opportunities to fulfill women's patient–provider involvement needs, and new insights into continuing to develop the SDM model in reproductive healthcare. [ABSTRACT FROM AUTHOR]

Background: The current study examined self‐reported human papillomavirus (HPV) vaccination uptake and intentions, and associations with psychosocial constructs among United States adults aged 18 to 26 and 27 to 45 years. Methods: Data were collected via an online survey from participants recruited from a research panel. Outcomes were HPV vaccination uptake and intentions. Multivariable binary and ordered logistic regression models were used to examine associations between HPV vaccination outcomes and psychosocial constructs, sociodemographics, and previous health behaviors. Results: HPV vaccination uptake in both age cohorts (N = 2722) was associated with multiple variables, including but not limited to: provider recommendation (adjusted odds ratio [aOR], 11.63 [95% CI, 7.70–17.56] and aOR, 14.26 [95% CI, 9.52–21.38], for those aged 18 to 26 and 27 to 45 years, respectively) and positive HPV vaccine attitudes (aOR, 2.40 [95% CI, 1.70–3.40] and aOR, 1.46 [95% CI,1.06–2.02]). Among those who did not report or were unsure of prior HPV vaccination (N =1894), only 4.6% and 8.1% (aged 18–26 and 27–45 years, respectively) reported being very likely to receive the HPV vaccine in the next year. Increased intentions were associated with more positive vaccine attitudes (aOR, 2.45 [95% CI, 1.91–3.15] and aOR, 2.19 [95% CI, 1.72–2.78]) and provider recommendation (yes vs no; aOR, 1.97 [95% CI, 1.38–2.83] and aOR, 1.82 [95% CI, 1.31–2.52]; don't know/can't remember vs no; aOR, 1.38 [95% CI, 1.03–1.84] and aOR, 1.60 [95% CI, 1.17–2.18]). Sociodemographics and health behaviors associated with increased intentions differed for each age cohort. Conclusions: Individual and interpersonal factors were associated with HPV vaccination uptake and intentions. Findings reveal the need for targeted interventions to improve HPV vaccination rates among these age groups. Findings on low human papillomavirus vaccination proportions highlight the need for vaccine promotion among age‐eligible individuals. Factors to target in future age‐relevant interventions include provider recommendations, modifiable health behavior constructs, and sociodemographics. [ABSTRACT FROM AUTHOR]

Objectives: In 2012, onetime hepatitis C virus (HCV) screening was recommended for all baby boomers (people born during 1945-1965) in the United States, but only 4.0%-12.9% of baby boomers have ever had a screening ordered by a health care provider. This study examined the HCV screening prevalence among adult patients in a large academic health care system and assessed factors associated with the completion of screening when ordered for baby boomers. Methods: We defined HCV screening completion as the completion of an HCV antibody test when it was ordered. We used electronic health records to examine HCV screening completion rates among adults (N = 106 630) from August 1, 2015, through July 31, 2020, by birth cohort. Among baby boomers whose health care provider ordered HCV screening, we examined frequency and percentages of HCV screening completion by sociodemographic and clinical characteristics. We conducted univariate and multivariable logistic regression analyses to assess factors associated with HCV screening completion among baby boomers. Results: During the study period, 73.0% of baby boomers completed HCV screening when it was ordered. HCV completion did not differ by sex or race and ethnicity among baby boomers. Baby boomers with Medicare supplemental health insurance compared with commercial health insurance (adjusted odds ratio [aOR] = 1.87) and those seeing only advanced practice professionals compared with specialty care physicians (aOR = 2.24) were more likely to complete HCV screening when it was ordered. Conclusions: Noncompletion of HCV screening is one of many barriers along the HCV treatment continuum. Our findings suggest a need for interventions targeting systems, health care providers, and patients to increase HCV screening rates in the United States. [ABSTRACT FROM AUTHOR]

This study examined associations between general attitudes toward seeking medical care, attitudes about vaccines/fear of shots, and human papillomavirus (HPV) vaccine uptake and intentions in college women. Hypothesized associations were framed by the Theory of Planned Behavior (TPB). Participants (N = 330, mean age = 18.9 years, 75% White) completed a one-time survey. The majority (61%; n = 201) had received ≥1 HPV vaccine dose. Hierarchical logistic regression examined relationships between attitudes and vaccine uptake. Pearson correlation coefficients and Kruskal-Wallis tests examined associations between attitudes and vaccine intentions. Results were partially consistent with the TPB. In the final model, perceived benefits, but not fear of shots, were associated with vaccine uptake. Among the unvaccinated, perceived benefits, but not fear of shots, were associated with vaccine intentions. Provider recommendation was the strongest predictor of vaccine uptake. Findings suggest interventions incorporating discussion of perceived benefits and provider recommendation may improve HPV vaccine receipt among college women. [ABSTRACT FROM AUTHOR]