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Almohammed HI. A Systematic Review to Evaluate the Barriers to Breast Cancer Screening in Women with Disability. J Clin Med 2024; 13:3283. [PMID: 38892994 PMCID: PMC11172480 DOI: 10.3390/jcm13113283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/27/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Breast cancer (BC) is one of the leading causes of mortality worldwide. There are observed disparities in patients with disability as compared to those without disability, which leads to poor BC screening attendance, thereby worsening disease management. Aim: The aim of this systematic review is to investigate if there are disparities in screening rates in women with disability as compared to those without disability, as well as the different factors that pose barriers to patients with disability for enrolment in BC screening programs. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed published articles between 2008 and 2023, which assessed different factors that contributed to poor attendance in BC screening programs held across different countries. Detailed study characteristics were obtained, and methodological quality assessment was performed on the individual studies included in this review. Result: A total of fifty-three articles were identified as eligible studies based on the pre-defined inclusion and exclusion criteria. These included 7,252,913 patients diagnosed with BC (913,902 patients with disability/6,339,011 patients without disability). The results revealed there are demographic, clinical, financial, and service-related barriers that contributed to lower screening rates in disabled patients as compared to non-disabled. Patient age is the most common factor, with the highest effect observed for 80 years (vs. 30-44 years) [odds ratio (OR) = 13.93 (95% confidence interval (CI) = 8.27-23.47), p < 0.0001], followed by race/ethnicity for Hispanic (vs. non-Hispanic white) [OR = 9.5 (95%CI = 1.0-91.9), p < 0.05]. Additionally, patients with multiple disabilities had the highest rate of dropouts [OR = 27.4 (95%CI = 21.5-33.3)]. Other factors like education, income, marital status, and insurance coverage were essential barriers in screening programs. Conclusions: This study presents a holistic view of all barriers to poor BC screening attendance in disabled patients, thereby exacerbating health inequalities. A standardized approach to overcome the identified barriers and the need for a tailored guideline, especially for disability groups, is inevitable.
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Affiliation(s)
- Huda I Almohammed
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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Development of a new pregnancy informational and decisional needs survey for women with physical disabilities. Disabil Health J 2020; 14:101056. [PMID: 33451968 DOI: 10.1016/j.dhjo.2020.101056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND While the literature on pregnancy and disability is growing, generating important knowledge of barriers to care and health risks, there is limited literature on pregnancy decision-making and informational needs. Such knowledge is critical for the development of interventions to mitigate the challenges women with disabilities and health care providers face in making this important decision. OBJECTIVE /Hypothesis: Develop a survey of pregnancy decisional and informational needs of women with physical disabilities. METHODS We developed a conceptual framework that guided item writing, defined the characteristics of the target population, engaged stakeholders with disabilities to collaborate with investigators, and tested the interpretability and relevance of items, and preferred mode of responding (online vs. telephone). A total of 123 women participated in cognitive interviews (N = 13), mode testing (N = 10), or survey data collection (N = 114). RESULTS Instructions, three screening questions, and 156 items were tested in one round of 17 cognitive interviews; 25 items were deleted, 94 were revised, and 37 items were retained without changes. The final version of the survey included six sub-sections: the experience of making a decision; information about pregnancy and disability; things affecting a decision; knowing what is important; support for making a decision; and working with health care providers. CONCLUSIONS The overall performance of the survey supported its content validity and utility as a useful way to gather information about the pregnancy decision-making experience and informational needs of women with physical disabilities.
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Kalpakjian CZ, Kreschmer JM, Slavin MD, Kisala PA, Quint EH, Chiaravalloti ND, Jenkins N, Bushnik T, Amtmann D, Tulsky DS, Madrid R, Parten R, Evitts M, Grawi CL. Reproductive Health in Women with Physical Disability: A Conceptual Framework for the Development of New Patient-Reported Outcome Measures. J Womens Health (Larchmt) 2020; 29:1427-1436. [PMID: 32429740 PMCID: PMC7703246 DOI: 10.1089/jwh.2019.8174] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Barriers in the built environment, enduring stereotypes and biases, and limited disability competency of health care providers compromise access to and quality of reproductive health care for women with physical disabilities. One way to improve our understanding of critical factors that drive reproductive health inequity and its impact on access to care is to use patient-reported outcome measures (PROMs) that capture relevant and meaningful information about experience. In this study, we developed a conceptual framework as the foundation for relevant and clinically meaningful patient-reported outcome measures targeting the interface of disability and reproductive health. Materials and Methods: We conducted semistructured focus groups and interviews to assess women's experiences around their reproductive health and contextual factors related to disability. We used deductive and inductive qualitative coding approaches to develop the conceptual framework. Results: Eighty-one women between the ages of 16 and 50 with a self-reported physical disability, defined by an impairment of mobility, participated in 13 focus groups (N = 64) and 17 individual interviews. Five major themes characterized the conceptual framework that emerged-knowledge about reproductive health, communication about reproductive health, relationships, the reproductive health care environment, and self-advocacy/identity-all of which had some relationship with five major reproductive health issues-pregnancy and labor/delivery, periods and menstrual management, contraception, sexuality and sexual functioning, and pelvic examinations. Conclusions: This conceptual framework will serve as a foundation for PROM and guide intervention development to reduce reproductive health inequity and improve reproductive health outcomes of women with physical disabilities.
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Affiliation(s)
- Claire Z. Kalpakjian
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jodi M. Kreschmer
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Mary D. Slavin
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - Pamela A. Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Elisabeth H. Quint
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Natalie Jenkins
- Langone Health Department of Research/Rusk Rehabilitation, New York University, New York, New York, USA
| | - Tamara Bushnik
- Langone Health Department of Research/Rusk Rehabilitation, New York University, New York, New York, USA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - David S. Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Roxanne Madrid
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Rebecca Parten
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael Evitts
- Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Carolyn L. Grawi
- Ann Arbor Center for Independent Living, Ann Arbor, Michigan, USA
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Deroche CB, McDermott SW, Mann JR, Hardin JW. Colorectal Cancer Screening Adherence in Selected Disabilities Over 10 Years. Am J Prev Med 2017; 52:735-741. [PMID: 28214250 DOI: 10.1016/j.amepre.2017.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 11/17/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.; however, if the population aged 50 years or older received routine screening, approximately 60% of these deaths could be eliminated. This study investigates whether adults, aged 50-75 years, with one of three disabilities (blind/low vision [BLV], intellectual disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent to adults without the three disabilities, by accounting for combinations of recommended CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood test). METHODS South Carolina Medicaid and Medicare, State Health Plan, and hospital discharge data (2000-2009) were analyzed (2013-2015) to estimate the proportion of adherence to and adjusted odds of CRC screening over time among adults with one of the three disabilities, BLV, ID, or SCI, versus adults without these conditions. RESULTS The estimated proportion of adults who adhere to changing recommendations over time was lower for adults with ID (34.32%) or SCI (44.14%) compared with those without these disabilities (48.48%). All three case groups had significantly lower AORs of adherence versus those without (BLV: AOR=0.88, 95% CI=0.80, 0.96; ID: AOR=0.55, 95% CI=0.52, 0.59; SCI: AOR=0.88, 95% CI=0.82, 0.95). CONCLUSIONS In this study, adults with BLV, ID, or SCI were less likely to receive and adhere to CRC screening recommendations than those without these disabilities. This method provides a thorough evaluation of adherence to CRC screening by considering levels of adherence during each month of Medicaid or Medicare coverage.
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Affiliation(s)
- Chelsea B Deroche
- Department of Health Management and Informatics, Biostatistics and Research Design Unit, University of Missouri School of Medicine, Columbia, Missouri.
| | - Suzanne W McDermott
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
| | - Joshua R Mann
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
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Trends in colorectal cancer screening over time for persons with and without chronic disability. Disabil Health J 2016; 9:498-509. [PMID: 27130194 DOI: 10.1016/j.dhjo.2016.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/10/2016] [Accepted: 02/19/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Persons with disabilities have often experienced disparities in routine cancer screening. However, with civil rights protections from the 1990 Americans with Disabilities Act, such disparities may diminish over time. OBJECTIVE To examine whether disability disparities exist for colorectal cancer screening and whether these screening patterns have changed over time. METHODS We analyzed National Health Interview Survey responses from civilian, non-institutionalized U.S. residents 50-75 years old from selected years between 1998 and 2010. We specified 7 chronic disability indicators using self-reported functional impairments, activity/participation limitations, and expected duration. Separately for women and men, we conducted bivariable and multivariable logistic regression analyses examining associations of self-reported colorectal cancer screening services with sociodemographic factors and disability type. RESULTS Patterns of chronic disability differed somewhat between women and men; disability rates generally rose over time. For both women and men, colorectal cancer screening rates increased substantially from 1998 through 2010. Over time, relatively few statistically significant differences were reported in colorectal cancer screening rates between nondisabled persons and individuals with various disabilities. In 2010, reported screening rates were generally comparable between nondisabled and disabled persons. In the few statistically significant differences, persons with disabilities almost always reported higher colorectal cancer screening rates than nondisabled individuals. CONCLUSIONS According to national survey data, reported use of colorectal cancer screening is similar between nondisabled persons and individuals with a variety of different disability types. Despite physical demands of some colorectal cancer screening tests, disparities do not appear between populations with and without disability.
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Peters K, Cotton A. Barriers to breast cancer screening in Australia: experiences of women with physical disabilities. J Clin Nurs 2014; 24:563-72. [PMID: 25236777 DOI: 10.1111/jocn.12696] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of breast cancer screening for women with physical disabilities. BACKGROUND Despite women with disabilities having the same or greater risk of having breast cancer than women without disabilities, they are less likely to uptake breast cancer screening services. DESIGN Qualitative descriptive study. METHODS Twelve women with physical disabilities were recruited for the purpose of this study. Data were collected via semi-structured face to face or telephone interviews. Interviews were transcribed and data were analysed thematically. RESULTS Overwhelmingly, participants conveyed that their breast screening experiences were negative. The following four themes describe the experiences of breast cancer screening for women with physical disabilities: feeling I'm not in control; being ignored and not listened to; being helpless, alone and afraid and; experiencing pain, torture and humiliation. CONCLUSIONS Women with physical disabilities experience substantial barriers to breast cancer screening. This research highlights that the attitudes and poor communication skills of health professionals served as a deterrent to future screening for participants. RELEVANCE TO CLINICAL PRACTICE By exploring experiences of women with physical disabilities of breast cancer screening, nurses and other health-care professionals can use this to develop and implement optimal approaches, such as collaborative models of care which empower women with disabilities.
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Affiliation(s)
- Kath Peters
- School of Nursing & Midwifery, University of Western Sydney, Penrith, NSW, Australia
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Choi KH, Heo J, Kim S, Jeon YJ, Oh M. Factors Associated With Breast and Cervical Cancer Screening in Korea. Asia Pac J Public Health 2013; 25:476-86. [DOI: 10.1177/1010539513506601] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated factors associated with breast and cervical cancer screening using data from a nationwide community survey. A nationwide cross-sectional study was performed in all 253 administrative districts of Korea. The breast and cervical cancer screening rate was negatively associated with the obesity (β = −2.91, 95% confidence interval [CI] = −4.73 to −1.03; β = −1.93, 95% CI = −3.43 to −0.43), positively associated with the European Quality of Life-5 Dimensions scale (β =2.53, 95% CI = 0.24 to 4.81; β = 2.51, 95% CI = 0.68 to 4.34). Moreover, higher alcohol consumption rate was negatively related to screening rates for breast cancer, while areas with higher proportion of diabetes were found to have higher screening rates. Area with higher rate of osteoarthritis had a lower screening rate for cervical cancer. This study showed breast and cervical cancer screening was associated with particular area characteristics. This ecological approach is thought to be a major complement to measures of health attributes.
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Affiliation(s)
- Kyung-Hyun Choi
- Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | | | - Soyeun Kim
- Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | | | - Myungju Oh
- CHA Bundang Medical Center, CHA University, Bundang, Korea
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