Jill M. Abbott, MPH, DrPH, Comprehensive Cancer Center, Ohio State University, A350B Starling-Loving Hall, 320 W. 10th Avenue, Columbus, OH 43210, 614-293-8174, email@example.com, Kathryn J. Luchok, PhD, Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, 800 Sumter Street HESC 216, Columbia, SC 29208, Sara J. Corwin, MPH, PhD, Office of Public Health Practice, University of South Carolina, Arnold School of Public Health, 800 Sumter Street, Columbia, SC 29208, Ann L. Coker, PhD, School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler, PO Box 20186, Houston, TX 77225, and Irene Prabhu Das, MPH, Division of Cancer Prevention & Control, SC Department of Health and Environmental Control, PO Box 101106, Columbia, SC 29211.
BACKGROUND: Competing life priorities place unique demands on low-income women. Such demands may contribute to delay in preventive or follow-up care, ultimately resulting in poorer health outcomes by taxing a woman’s already-stretched resources. It is incumbent upon health care providers to understand these priorities so that they can provide quality health care to women. METHODS: Seventeen income-eligible clients in the South Carolina Breast and Cervical Cancer Early Detection Program (SC-BCCEDP) who had an abnormal Pap test result in the four years prior to the study completed open-ended, in-person interviews to explore competing life priorities as a factor theorized to affect their adherence to follow-up. The interviews were tape-recorded, transcribed and analyzed with NVivo®, a software application that permits flexible and hierarchical coding of qualitative data. The coding scheme and analysis were driven by the data collected, and recurrent themes were examined across all interviews. RESULTS: Approximately equal numbers of African American and Caucasian women participated, and their mean age was 59.9 years. The participants identified the following as competing life priorities which interfered with their ability or desire to seek follow-up treatment: meeting the needs of significant others, living on restricted income, and living with co-morbid conditions. Several participants reported providing daily or intermittent care for needy or disabled family members. Despite the free services provided through the SC-BCCEDP, a majority of women reported paying for health care expenses out-of-pocket. Finally, living with co-morbid conditions seemed to reduce the urgency of abnormal Pap follow-up. Based on the women’s accounts, these competing needs precluded taking care of their cervical health needs. CONCLUSION: Competing life priorities have the potential to negatively influence women’s health seeking behavior, including adherence to follow-up recommendations following an abnormal Pap test result. Insight into such factors suggests opportunities for health care providers to address barriers that are especially pressing for low-income women during patient-provider interactions, particularly when critical follow-up care is anticipated. As a result, women may perceive greater provider concern for their health and may participate more actively in their own health care. Ultimately, this may lead to improved health outcomes, including lower incidence and mortality for all medical conditions.
Learning Objectives: At the conclusion of this session, the participant will be able to
Keywords: Barriers to Care, Cancer Screening
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 132nd Annual Meeting (November 6-10, 2004) of APHA