The Impact of IT-Based Healthcare Communication on Mammography Screening Utilization among Women in the United States: National Health Interview Survey (2011–2018)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Resource
2.2. Study Population and Sample Data
2.3. Variables
2.3.1. Outcomes
2.3.2. Exposures
2.3.3. Confounding Variables
2.4. Statistical Analysis
3. Results
3.1. Characteristics of Study Participants
3.2. Associations between IT-Based Healthcare Communication Strategies and Mammography Screening Utilization
3.3. Associations between IT-Based Healthcare Communication Strategies and Mammography Screening Utilization after Adjusting for Mammography Recommendation
3.4. The Predicted Probability of Mammography Screening Utilization by the Number of IT-Based Healthcare Communication Strategies
3.5. Effect Modification by Race/Ethnicity on the Association between IT-Based Healthcare Communication and Mammography Utilization
3.6. Effect Modification by Age on the Association between IT-Based Healthcare Communication and Mammography Utilization
4. Discussion
Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Frequency (N) | Percentage (%) | |
---|---|---|---|
Age group | 40–49 | 21,645 | 22.96 |
50+ | 72,645 | 77.04 | |
Race/ethnicity | Hispanic | 11,548 | 12.25 |
NH White a | 63,843 | 67.71 | |
NH Black b | 13,287 | 14.09 | |
NH Other c | 5612 | 5.95 | |
Marital Status | Currently married | 40,382 | 42.83 |
Otherwise | 53,908 | 57.17 | |
Region | Northeast | 16,527 | 17.53 |
Midwest | 20,246 | 21.47 | |
South | 34,456 | 36.54 | |
West | 23,061 | 24.46 | |
Insurance Coverage | Private | 56,171 | 59.73 |
Public | 25,374 | 26.98 | |
Military | 3350 | 3.56 | |
Other | 1325 | 1.41 | |
Uninsured | 7814 | 8.31 | |
Education | Less than high school | 16,769 | 17.88 |
High school | 22,561 | 24.05 | |
Some college | 28,120 | 29.98 | |
Bachelor’s degree | 15,940 | 16.99 | |
Graduate degree | 10,408 | 11.10 | |
Ratio of Family Income to the Poverty Threshold | <100% | 12,863 | 15.23 |
100–199% | 17,511 | 20.73 | |
200–399% | 23,969 | 28.38 | |
≥400% | 30,113 | 35.66 | |
Work Status | Yes | 46,519 | 49.36 |
No | 47,718 | 50.64 | |
Survey Year | Year 2011 | 11,574 | 12.27 |
Year 2012 | 12,306 | 13.05 | |
Year 2013 | 12,364 | 13.11 | |
Year 2014 | 13,436 | 14.25 | |
Year 2015 | 12,483 | 13.24 | |
Year 2016 | 12,253 | 13.00 | |
Year 2017 | 10,099 | 10.71 | |
Year 2018 | 9775 | 10.37 |
Mammography Utilization by Time Period | Odds Ratio | S.E. | p | 95% Conf. Interval | |
---|---|---|---|---|---|
All years 2011–2018 (n = 94,290) b | |||||
Q1 c | 1.22 | 0.02 | <0.001 | 1.18 | 1.27 |
Q2 d | 1.23 | 0.04 | <0.001 | 1.16 | 1.30 |
Q3 e | 1.33 | 0.03 | <0.001 | 1.26 | 1.40 |
Q4 f | 1.27 | 0.02 | <0.001 | 1.23 | 1.32 |
Year 2011 (n = 11,574) | |||||
Q1 c | 1.20 | 0.06 | 0.001 | 1.08 | 1.34 |
Q2 d | 1.43 | 0.18 | 0.004 | 1.12 | 1.83 |
Q3 e | 1.26 | 0.13 | 0.029 | 1.02 | 1.56 |
Q4 f | 1.24 | 0.07 | <0.001 | 1.12 | 1.38 |
Year 2012 (n = 12,306) | |||||
Q1 c | 1.14 | 0.06 | 0.010 | 1.03 | 1.26 |
Q2 d | 1.40 | 0.17 | 0.005 | 1.10 | 1.77 |
Q3 e | 1.25 | 0.13 | 0.031 | 1.02 | 1.53 |
Q4 f | 1.16 | 0.06 | <0.001 | 1.05 | 1.29 |
Year 2013 (n = 12,364) | |||||
Q1 c | 1.15 | 0.06 | 0.004 | 1.05 | 1.27 |
Q2 d | 1.24 | 0.12 | 0.020 | 1.03 | 1.50 |
Q3 e | 1.32 | 0.11 | 0.001 | 1.12 | 1.56 |
Q4 f | 1.16 | 0.06 | 0.001 | 1.05 | 1.28 |
Year 2014 (n = 13,436) | |||||
Q1 c | 1.29 | 0.06 | <0.001 | 1.18 | 1.41 |
Q2 d | 1.35 | 0.13 | 0.002 | 1.12 | 1.63 |
Q3 e | 1.41 | 0.12 | <0.001 | 1.20 | 1.65 |
Q4 f | 1.33 | 0.06 | <0.001 | 1.22 | 1.46 |
Year 2015 (n = 12,483) | |||||
Q1 c | 1.23 | 0.06 | <0.001 | 1.21 | 1.35 |
Q2 d | 1.32 | 0.10 | <0.001 | 1.13 | 1.53 |
Q3 e | 1.25 | 0.09 | 0.002 | 1.09 | 1.43 |
Q4 f | 1.27 | 0.06 | <0.001 | 1.16 | 1.40 |
Year 2016 (n = 12,253) | |||||
Q1 c | 1.28 | 0.06 | <0.001 | 1.17 | 1.41 |
Q2 d | 1.29 | 0.09 | 0.001 | 1.12 | 1.49 |
Q3 e | 1.48 | 0.10 | <0.001 | 1.30 | 1.69 |
Q4 | 1.30 | 0.06 | <0.001 | 1.18 | 1.42 |
Year 2017 (n = 10,099) | |||||
Q1 c | 1.30 | 0.07 | <0.001 | 1.18 | 1.44 |
Q2 d | 1.19 | 0.09 | 0.019 | 1.03 | 1.38 |
Q3 e | 1.61 | 0.11 | <0.001 | 1.40 | 1.84 |
Q4 f | 1.38 | 0.07 | <0.001 | 1.25 | 1.53 |
Year 2018 (n = 9775) | |||||
Q1 c | 1.36 | 0.07 | <0.001 | 1.23 | 1.50 |
Q2 d | 1.21 | 0.08 | 0.005 | 1.06 | 1.39 |
Q3 e | 1.34 | 0.09 | <0.001 | 1.18 | 1.52 |
Q4 f | 1.43 | 0.08 | <0.001 | 1.28 | 1.59 |
Mammography Utilization | Odds Ratio | S.E. | p | 95% Conf. Interval | |
---|---|---|---|---|---|
Q1 a | |||||
Adjusted model 1 b | 1.23 | 0.06 | <0.001 | 1.12 | 1.35 |
Adjusted model 2 c | 1.15 | 0.06 | 0.006 | 1.04 | 1.27 |
Q2 d | |||||
Adjusted model 1 b | 1.32 | 0.10 | <0.001 | 1.12 | 1.54 |
Adjusted model 2 c | 1.34 | 0.12 | 0.001 | 1.13 | 1.59 |
Q3 e | |||||
Adjusted model 1 b | 1.25 | 0.09 | 0.002 | 1.08 | 1.43 |
Adjusted model 2 c | 1.16 | 0.09 | 0.049 | 1.00 | 1.35 |
Q4 f | |||||
Adjusted model 1 b | 1.27 | 0.06 | <0.001 | 1.16 | 1.40 |
Adjusted model 2 c | 1.18 | 0.06 | 0.001 | 1.07 | 1.31 |
Mammography Utilization | Odds Ratio | S.E. | p | 95% Conf. Interval | |
---|---|---|---|---|---|
Q1 c | |||||
Exposure effect | 1.23 | 0.02 | <0.001 | 1.18 | 1.27 |
Baseline difference | |||||
Hispanic | 1.55 | 0.04 | <0.001 | 1.46 | 1.64 |
NH Black d | 1.54 | 0.04 | <0.001 | 1.46 | 1.63 |
NH other e | 1.05 | 0.04 | 0.186 | 0.97 | 1.14 |
Effect modification by race | |||||
Hispanic vs. NH White a | 0.76 | 0.03 | <0.001 | 0.70 | 0.84 |
NH Black d vs. NH White a | 0.84 | 0.04 | <0.001 | 0.77 | 0.92 |
NH other e vs. NH White a | 0.93 | 0.06 | 0.275 | 0.83 | 1.05 |
Q2 f | |||||
Exposure effect | 1.14 | 0.03 | <0.001 | 1.08 | 1.21 |
Baseline difference | |||||
Hispanic | 1.38 | 0.03 | <0.001 | 1.32 | 1.45 |
NH Black d | 1.41 | 0.03 | <0.001 | 1.35 | 1.48 |
NH other e | 0.98 | 0.03 | 0.497 | 0.92 | 1.04 |
Effect modification by race | |||||
Hispanic vs. NH White a | 0.86 | 0.08 | 0.106 | 0.73 | 1.03 |
NH Black d vs. NH White a | 1.02 | 0.08 | 0.768 | 0.87 | 1.20 |
NH other e vs. NH White a | 1.18 | 0.12 | 0.102 | 0.97 | 1.43 |
Q3 g | |||||
Exposure effect | 1.28 | 0.03 | <0.001 | 1.22 | 1.35 |
Baseline difference | |||||
Hispanic | 1.41 | 0.03 | <0.001 | 1.34 | 1.48 |
NH Black d | 1.43 | 0.03 | <0.001 | 1.36 | 1.49 |
NH Other e | 1.01 | 0.03 | 0.835 | 0.94 | 1.07 |
Effect modification by race | |||||
Hispanic vs. NH White a | 0.72 | 0.06 | <0.001 | 0.60 | 0.86 |
NH Black d vs. NH White a | 0.95 | 0.08 | 0.574 | 0.81 | 1.12 |
NH other e vs. NH White a | 0.95 | 0.09 | 0.620 | 0.79 | 1.15 |
Q4 h | |||||
Exposure effect | 1.28 | 0.02 | <0.001 | 1.23 | 1.33 |
Baseline difference | |||||
Hispanic | 1.57 | 0.05 | <0.001 | 1.48 | 1.67 |
NH Black d | 1.55 | 0.04 | <0.001 | 1.47 | 1.64 |
NH other e | 1.07 | 0.04 | 0.105 | 0.98 | 1.16 |
Effect modification by race | |||||
Hispanic vs. NH White a | 0.75 | 0.03 | <0.001 | 0.69 | 0.83 |
NH Black d vs. NH White a | 0.85 | 0.04 | <0.001 | 0.78 | 0.93 |
NH other e vs. NH White a | 0.93 | 0.06 | 0.212 | 0.82 | 1.04 |
Mammography Utilization | Odds Ratio | S.E. | p | 95% Conf. Interval | |
---|---|---|---|---|---|
Q1 b | |||||
Exposure effect | 0.72 | 0.02 | <0.001 | 0.69 | 1.76 |
Baseline difference | |||||
50+ | 2.71 | 0.06 | <0.001 | 2.58 | 0.76 |
Effect modification by age | |||||
50+ vs. 40–49 | 1.85 | 0.05 | <0.001 | 1.74 | 1.96 |
Q2 c | |||||
Exposure effect | 1.06 | 0.03 | 0.016 | 1.01 | 1.12 |
Baseline difference | |||||
50+ | 3.29 | 0.07 | <0.001 | 3.16 | 3.42 |
Effect modification by age | |||||
50+ vs. 40–49 | 1.35 | 0.02 | <0.001 | 1.30 | 1.40 |
Q3 d | |||||
Exposure effect | 1.14 | 0.03 | <0.001 | 1.09 | 1.19 |
Baseline difference | |||||
50+ | 3.31 | 0.07 | <0.001 | 3.18 | 3.44 |
Effect modification by age | |||||
50+ vs. 40–49 | 1.34 | 0.02 | <0.001 | 1.29 | 1.39 |
Q4 e | |||||
Exposure effect | 0.80 | 0.02 | <0.001 | 0.76 | 0.84 |
Baseline difference | |||||
50+ | 3.88 | 0.07 | <0.001 | 2.75 | 3.02 |
Effect modification by age | |||||
50+ vs. 40–49 | 1.67 | 0.05 | <0.001 | 1.57 | 1.76 |
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Alabdullatif, N.; Arrieta, A.; Dlugasch, L.; Hu, N. The Impact of IT-Based Healthcare Communication on Mammography Screening Utilization among Women in the United States: National Health Interview Survey (2011–2018). Int. J. Environ. Res. Public Health 2022, 19, 12737. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912737
Alabdullatif N, Arrieta A, Dlugasch L, Hu N. The Impact of IT-Based Healthcare Communication on Mammography Screening Utilization among Women in the United States: National Health Interview Survey (2011–2018). International Journal of Environmental Research and Public Health. 2022; 19(19):12737. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912737
Chicago/Turabian StyleAlabdullatif, Noof, Alejandro Arrieta, Lucie Dlugasch, and Nan Hu. 2022. "The Impact of IT-Based Healthcare Communication on Mammography Screening Utilization among Women in the United States: National Health Interview Survey (2011–2018)" International Journal of Environmental Research and Public Health 19, no. 19: 12737. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912737