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Table 4 Factors influencing the utilisation of BCS services by geographical regions

From: Distribution and predictors associated with the use of breast cancer screening services among women in 14 low-resource countries

Participants characteristics Americas Asian African
Un-adjusted OR (95% CI) Adjusted OR
(95% CI)
Un-adjusted OR
(95% CI)
Adjusted OR
(95% CI)
Un-adjusted OR (95% CI) Adjusted OR
(95% CI)
Age group
 40–44 years (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
 ≥ 45 years 1.57 (1.47, 1.68) 1.48 (1.37, 1.60) 0.69 (0.66, 0.72) 0.76 (0.70, 0.82) 0.92 (0.87, 0.97) 0.91 (0.85, 0.98)
Educational level
No education (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Primary 1.71 (1.43, 2.04) 1.48 (1.22, 1.80) 1.19 (1.10, 1.29) 0.67 (0.58, 0.76) 4.68 (4.24, 5.16) 3.82 (3.39, 4.31)
Secondary 2.92 (2.43, 3.50) 1.67 (1.35, 2.07) 3.54 (3.34, 3.74) 0.83 (0.74, 0.94) 5.38 (4.87, 5.93) 3.47 (3.05, 3.94)
Higher 3.41 (2.81, 4.14) 1.12 (0.88, 1.43) 6.23 (5.84, 6.65) 1.10 (0.84, 1.44) 8.29 (7.33, 9.37) 3.65 (3.08, 4.32)
Gender of the household head
Male (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Female 0.92 (0.86, 0.99) 0.99 (0.91, 1.07) 0.83 (0.78, 0.89) 1.43 (1.29, 1.59) 2.05 (1.94, 2.16) 1.81 (1.69, 1.95)
Respondent’s age at 1st birth
  < 18 years (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
18–20 years 1.25 (1.14, 1.37) 1.15 (1.04, 1.27) 1.96 (1.83, 2.09) 1.12 (1.01, 1.25) 1.19 (1.11, 1.28) 0.99 (0.90, 1.08)
21–25 years 1.62 (1.47, 1.78) 1.28 (1.15, 1.44) 2.78 (2.61, 2.97) 1.20 (1.08, 1.34) 1.17 (1.09, 1.26) 0.79 (0.71, 0.87)
  > 25 years 2.03 (1.81, 2.28) 1.40 (1.20, 1.64) 3.60 (3.32, 3.9) 1.80 (1.51, 2.14) 1.38 (1.25, 1.52) 0.74 (0.64, 0.84)
Number of childbirths
  < 4 (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
4–5 0.67 (0.62, 0.73) 0.91 (0.82, 1.00) 2.24 (2.12, 2.38) 1.32 (1.20, 1.46) 0.67 (0.63, 0.72) 0.95 (0.87, 1.04)
  > 5 0.46 (0.42, 0.50) 0.87 (0.77, 0.98) 3.49 (3.30, 3.69) 1.53 (1.35, 1.73) 0.59 (0.55, 0.63) 0.99 (0.89, 1.09)
Mass media exposure
No (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Yes 1.72 (1.45, 2.03) 0.99 (0.83, 1.19) 2.45 (2.29, 2.62) 0.81 (0.72, 0.91) 1.25 (1.17, 1.35) 0.92 (0.84, 1.01)
Health insurance coverage
No (= ref) 1.00 1.00 1.00 1.00 1.00
Yes 0.99 (0.91, 1.08)   0.48 (0.44, 0.54) 0.53 (0.47, 0.59) 3.70 (3.47, 3.94) 2.25 (2.07, 2.45)
Body mass index
Under weight 1.15 (0.79, 1.68) 1.48 (1.00, 2.19) 0.69 (0.61, 0.77) 0.84 (0.73, 0.96) 0.86 (0.74, 1.01) 1.17 (0.99, 1.38)
Normal weight (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Overweight 1.55 (1.39, 1.72) 1.42 (1.28, 1.59) 1.74 (1.63, 1.85) 1.03 (0.93, 1.15) 0.91 (0.84, 0.98) 0.80 (0.73, 0.87)
Obese 1.59 (1.43, 1.76) 1.41 (1.26, 1.57) 2.96 (2.78, 3.14) 1.11 (0.96, 1.28) 0.51 (0.47, 0.55) 0.46 (0.42, 0.51)
Community
Urban 1.86 (1.72, 2.00) 1.22 (1.11, 1.35) 2.66 (2.55, 2.77) 1.21 (1.08, 1.34) 1.71 (1.62, 1.81) 0.94 (0.86, 1.03)
Rural (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Wealth quintile
Q1 (Poorest 20%) (= ref) 1.00 1.00 1.00 1.00 1.00 1.00
Q2 1.57 (1.37, 1.80) 1.52 (1.29, 1.79) 0.76 (0.71, 0.82) 0.82 (0.72, 0.94) 1.69 (1.52, 1.87) 1.63 (1.44, 1.85)
Q3 1.29 (1.12, 1.48) 1.11 (0.94, 1.32) 0.87 (0.81, 0.93) 0.82 (0.70, 0.96) 2.07 (1.87, 2.28) 1.63 (1.44, 1.85)
Q4 2.05 (1.80, 2.34) 1.64 (1.38, 1.95) 0.96 (0.90, 1.02) 0.85 (0.71, 1.02) 2.54 (2.30, 2.80) 2.49 (2.18, 2.85)
Q5 (Richest 20%) 4.26 (3.76, 4.82) 3.39 (2.84, 4.06) 1.15 (1.07, 1.22) 0.83 (0.68, 1.01) 3.94 (3.59, 4.32) 3.58 (3.08, 4.17)
LR Chi-square (P-value)   131.51 (P < 0.001)   550.95 (P < 0.001)   303.15 (P = 0.005)
Linktest hat-OR (P-value)   2.63 (P < 0.001)   3.98 (P < 0.001)   2.62 (P < 0.001)
Hosmer-Lemeshow statistic
(P-value)
  15.98 (P < 0.001)   11.78 (P = 0.001)   14.54 (P = 0.002)
Area under ROC curve   0.79   0.72   0.75
VIF Mean (Max)   3.21 (4.56)   2.45 (3.96)   2.90 (4.13)
Participants characteristics European Overall
Un-adjusted OR (95% CI) Adjusted OR (95% CI) Un-adjusted OR (95% CI) Adjusted OR (95% CI)
Age group
 40–44 years (= ref) 1.00 1.00 1.00
 ≥ 45 years 1.23 (0.75, 2.03)   0.86 (0.84, 0.89) 0.91 (0.87, 0.94)
Educational level
No education (= ref) 1.00 1.00 1.00 1.00
Primary 0.95 (0.56, 1.97) 4.01 (3.63, 4.43) 2.44 (2.32, 2.56) 2.39 (2.25, 2.53)
Secondary 1.97 (1.56, 2.49) 3.55 (3.20, 3.94) 4.01 (3.82, 4.20) 2.08 (1.95, 2.21)
Higher 1.57 (1.39, 1.76) 3.24 (2.83, 3.73) 6.50 (6.16, 6.86) 2.48 (2.25, 2.73)
Gender of the household head
Male (= ref) 1.00 1.00 1.00
Female 1.40 (0.29, 6.69)   1.19 (1.15, 1.23) 1.65 (1.58, 1.73)
Respondent’s age at 1st birth
  < 18 years (= ref) 1.00 1.00 1.00
18–20 years 2.57 (0.24, 7.29)   1.51 (1.45, 1.58) 1.19 (1.13, 1.26)
21–25 years 2.86 (0.28, 8.92)   1.93 (1.85, 2.02) 1.30 (1.23, 1.38)
  > 25 years 1.35 (0.32, 4.81)   2.40 (2.27, 2.53) 1.65 (1.52, 1.78)
Number of childbirths
  < 4 (= ref) 1.00 1.00 1.00
4–5 0.59 (0.35, 1.00)   1.11 (1.07, 1.15) 1.25 (1.18, 1.31)
  > 5 0.33 (0.10, 1.02)   1.21 (1.17, 1.26) 1.48 (1.40, 1.57)
Mass media exposure
No (= ref) 1.00 1.00 1.00 1.00
Yes 6.02 (1.54, 23.59) 1.86 (1.79, 1.93) 1.93 (1.85, 2.02) 1.84 (1.79, 1.89)
Health insurance coverage
No (= ref) 1.00 1.00 1.00 1.00
Yes 3.19 (1.65, 6.19) 2.60 (2.42, 2.80) 1.32 (1.27, 1.38) 1.09 (1.04, 1.14)
Body mass index
Under weight ns   0.68 (0.62, 0.75) 0.96 (0.87, 1.06)
Normal weight (= ref) 1.00 1.00 1.00
Overweight 1.49 (0.92, 2.43)   1.43 (1.37, 1.49) 1.04 (0.98, 1.09)
Obese 1.27 (0.70, 2.32)   1.44 (1.38, 1.51) 0.89 (0.84, 0.94)
Community
Urban 2.88 (1.75, 4.75) 1.13 (1.05, 1.22) 2.19 (2.12, 2.25) 1.20 (1.14, 1.26)
Rural (= ref) 1.00 1.00 1.00 1.00
Wealth quintile
Q1 (Poorest 20%) (= ref) 1.00 1.00 1.00 1.00
Q2 1.07 (0.59, 1.94) 1.44 (1.30, 1.60) 1.08 (1.03, 1.14) 1.26 (1.17, 1.36)
Q3 1.96 (1.06, 3.62) 1.46 (1.32, 1.63) 1.21 (1.15, 1.27) 1.17 (1.08, 1.26)
Q4 3.40 (1.63, 7.07) 1.65 (1.47, 1.84) 1.46 (1.39, 1.53) 1.43 (1.31, 1.55)
Q5 (Richest 20%) 1.27 (1.08, 3.17) 2.05 (1.81, 2.32) 2.10 (2.00, 2.20) 2.01 (1.84, 2.20)
LR Chi-square (P-value)   130.46 (P < 0.005)   375.12 (P < 0.001)
Linktest hat-OR (P-value)   2.98 (P < 0.001)   3.26 (P < 0.005)
Hosmer-Lemeshow statistic (P-value)   75.19 (P < 0.002)   20.62
Area under ROC curve   0.80   0.80
VIF Mean (Max)   3.16 (3.15)   3.20 (3.51)