241121 Barriers to Obtaining Cancer Screenings for Underserved Women with Mobility Impairments: Process Evaluation

Sunday, October 30, 2011

Rie Suzuki, PhD , Department of Public Health & Health Sciences, University of Michigan-Flint, Flint, MI
Jana J. Peterson, MPH, PhD , UMKC Institute for Human Development (UCEDD), University of Missouri - Kansas City, Kansas City, MO
Emily S. Walsh, MPH, CPH , Child Development & Rehabilitation Center, RRTC: Health & Wellness, Portland, OR
David I. Buckley, MD, MPH , Departments of Family Medicine, Medical Informatics & Clinical Epidemiology, and Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR
Gloria L. Krahn, PhD, MPH , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Background. Promoting Access to Health Services (PATHS) is a theory-based intervention program designed to increase receipt of clinical preventive services by women with mobility impairments. The results of a previous randomized control trial to examine the efficacy of PATHS indicated that the intervention group was more likely to have received a Pap test, with no significant group effect observed for mammography. Objectives. To improve the 90 minute PATHS workshop, the present study identified the barriers and concerns expressed narratively by women in regards to obtaining mammogram screening and cervical cancer screening. Targeted population. Eligibility criteria included: being a woman between 35 and 64 years old; having a mobility limitation; having health insurance; no recent experience of either cervical cancer screening or mammography. Workshop participants were recruited via a Medicaid managed care organization and a durable medical equipment vendor in Oregon. Of the 197 workshop participants, 75 completed phone interviews to discuss barriers. Analysis. Phone transcripts were reviewed and the most frequent barriers and concerns to obtain cancer screenings were organized by the Transtheoretical Model (TTM). Results. Qualitative results indicated that physical secondary conditions and affordability were the most frequent barriers and concerns related to obtaining cancer screenings across TTM stages. Of note, women who were in the action stage indicated a lack of knowledge about the cancer screenings as their barrier to maintain their performance. Implication. Efforts to improve clinical preventive screening rates among women with disabilities need to address the barriers and concerns that they encounter.

Learning Areas:
Clinical medicine applied in public health
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
•List concerns to develop intervention programs for persons with disabilities •Discuss the implication of these findings for strategies to improve health care access

Keywords: Disability, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was in charge of the intervention study as the Co-PI.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.