Mediational effects of access barriers to cancer screenings in women with functional limitations

Women with disabilities are more likely than their nondisabled peers to report being out of adherence with the recommended frequency of cancer screenings. Although evidence indicates the presence of barriers to cancer screenings, it is difficult to determine whether or not the perceived barriers truly impede cancer screening rates. Hence, the purpose of this study is to examine the relative influence of access barriers upon the adherence with recommended cancer screenings among women with functional limitations (FL). Data were derived from national representative women aged 50 to 75 years from the National Health Interview Survey 2011. FL was defined as physical and/or social limitations. Of 5,713 women, participants were predominantly Caucasian (76%) with FL (58%). The weighted path models with the mediational analyses were performed on the Mplus. After controlling for age, race, and education, the results revealed that FL predicted the non-adherence with the frequency of mammograms (β= -.04) and Pap tests (β=-.14) in the past 12 months. Lack of transportation predicted the frequency of mammograms directly (β=-.06) and mediated between FL and the non-adherence with mammogram use (-0.1, p <0.5). Other barriers (e.g., difficulty making an appointment, wait time at provider's office), however, did not mediate between FL and cancer screening rates. Race was not associated with any variables. The findings indicate that the availability of transportation increases mammogram frequency in all women with FL. In order to improve cancer screening rates, the importance of targeting on social resources in community settings will be discussed.