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APHA Scientific Session and Event Listing

Recorded presentation

Amal Khoury, PhD, College of Public Health & Health Professions, University of Florida, PO Box 100195, Gainesville, FL 32610, Nedra Lisovicz, PhD, MPH, CHES, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35294, 205-996-2850, nlisovicz@dopm.uab.edu, and Amanda Avis, MPH, CHES, University of Southern Mississippi, 118 College Drive, Hattiesburg, MS 39406.

Background: Breast cancer is a leading cause of death. Many women in the rural south do not participate in breast cancer screening and clinical trials. Providers have a key role in educating and referring women. Objective: This study identified knowledge, attitudes, and practices of primary care providers toward breast cancer screening and clinical trials. Method: Semi-structured in-depth interviews were conducted in 2002 with 34 primary care physicians and nurse practitioners in rural and urban Mississippi. The study's advisory committee had identified the providers as key informants. Interviews lasted 45-60 minutes each and were audio-taped. Tapes were transcribed, and data were analyzed for cross-cutting issues and themes. Results: Providers were overall knowledgeable about breast health and concerned about their patient welfare. There was wide variation in their practices regarding patient education and counseling, referral to screening mammography, and follow-up. Knowledge of costs of screening and of programs that cover screening and treatment was limited. Providers faced barriers to referring women to screening tests, including time constraints, fragmentation in women's health care, lack of health insurance, and patient characteristics. Provider knowledge of current clinical trials was also limited. Facilitators and barriers to provider participation in clinical trials were identified. Conclusion: Providers participation in screening and clinical trials could be improved by: 1) educating providers about risk factors, screening guidelines, and programs such as the Breast and Cervical Cancer Early Detection Program, 2) instituting systems to monitor missed screening appointments, 3) addressing time barriers, and 4) addressing the fragmentation in women's health care.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe qualitative research methods to collect in-depth information from providers.
• Identify knowledge, attitudes, and practices of primary care providers in the rural south toward breast cancer screening and clinical trials.
• Articulate programs and policies to promote provider participation in breast cancer control efforts.

Keywords: Breast Cancer Screening, Providers

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation