Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.

Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and...

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Autores principales:	Rhoda K Moise, Raymond Balise, Camille Ragin, Erin Kobetz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1b20f5772dea4a498069a806d48c595f
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spelling	oai:doaj.org-article:1b20f5772dea4a498069a806d48c595f2021-12-02T20:09:39ZCervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.1932-620310.1371/journal.pone.0254089https://doaj.org/article/1b20f5772dea4a498069a806d48c595f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254089https://doaj.org/toc/1932-6203Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30-65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52-6.84), access to routine care (OR = 2.11, 95%CI = 1.04-4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00-1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74-0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.Rhoda K MoiseRaymond BaliseCamille RaginErin KobetzPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254089 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rhoda K Moise Raymond Balise Camille Ragin Erin Kobetz Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
description	Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30-65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52-6.84), access to routine care (OR = 2.11, 95%CI = 1.04-4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00-1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74-0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.
format	article
author	Rhoda K Moise Raymond Balise Camille Ragin Erin Kobetz
author_facet	Rhoda K Moise Raymond Balise Camille Ragin Erin Kobetz
author_sort	Rhoda K Moise
title	Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
title_short	Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
title_full	Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
title_fullStr	Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
title_full_unstemmed	Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.
title_sort	cervical cancer risk and access: utilizing three statistical tools to assess haitian women in south florida.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1b20f5772dea4a498069a806d48c595f
work_keys_str_mv	AT rhodakmoise cervicalcancerriskandaccessutilizingthreestatisticaltoolstoassesshaitianwomeninsouthflorida AT raymondbalise cervicalcancerriskandaccessutilizingthreestatisticaltoolstoassesshaitianwomeninsouthflorida AT camilleragin cervicalcancerriskandaccessutilizingthreestatisticaltoolstoassesshaitianwomeninsouthflorida AT erinkobetz cervicalcancerriskandaccessutilizingthreestatisticaltoolstoassesshaitianwomeninsouthflorida
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Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida.

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