Association between employer-based health promotion programs and adherence to breast cancer screening in Texas

Monalisa Chandra; Robert Yu; Sanjay Shete

doi:10.1016/j.pmedr.2023.102128

Association between employer-based health promotion programs and adherence to breast cancer screening in Texas

Prev Med Rep. 2023 Feb 4:32:102128. doi: 10.1016/j.pmedr.2023.102128. eCollection 2023 Apr.

Authors

Monalisa Chandra¹, Robert Yu², Sanjay Shete^{1

2

3}

Affiliations

¹ Department of Epidemiology, UT MD Anderson Cancer Center, Houston TX, USA.
² Department of Biostatistics, UT MD Anderson Cancer Center, Houston TX, USA.
³ Division of Cancer Prevention and Population Sciences, UT MD Anderson Cancer Center, Houston TX, USA.

Abstract

Breast cancer is the most common cancer diagnosed among women in Texas. Although adherence to recommended screening mammogram guidelines enables early detection and reduces breast cancer risks, screening mammogram adherence is low in Texas. With the rising percentage of women in the workforce, employer-based health promotion programs could be an effective measure in increasing mammogram adherence, thereby reducing breast cancer risk in Texas. Although employer-based health programs are common in the state, little is known about their effectiveness in increasing screening mammogram adherence among age-eligible employed females. The study survey was administered using Qualtrics and the study participants were representative of the Texas population. The study population included 318 females from Texas who were 50-74 years old. Among those who had access to employer-based health promotion programs, 65.4 % were adherent and 34.6 % were non-adherent to the guidelines. Population-weighted survey logistic regression analysis showed no significant association between access to employer-based health promotion programs and mammogram adherence for employed women (AOR: 0.85 [0.15-4.79], p-value = 0.86). However, access to healthcare coverage (AOR: 7.58 [2.89-19.88], p-value < 0.001), those who disagree with the fatalistic belief that everything causes cancer (AOR: 2.99 [1.45-6.19], p-value < 0.001), and those who perceive cancer screening important (AOR: 12.36 [2.26-67.47], p < 0.05) were found as significant determinants of mammogram adherence among females in Texas. The study concluded that access to employer-based health promotion programs alone was insufficient to improve breast cancer screening. The employers and the insurance companies, with support from the government, should develop a comprehensive program that addresses all structural and psychosocial barriers to employee breast cancer screening adherence.

Keywords: Breast cancer; Cancer beliefs and perceptions; Health-promotion; Mammogram; Prevention; Screening-adherence.