Clinician-perceived barriers to cervical cancer screening before and during the COVID-19 pandemic at three US healthcare systems.

Autor:	Boratyn VM; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States., Pocobelli G; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States., Atlas SJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States., Clark CR; Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Feldman S; Department of Obstetrics Gynecology & Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Kruse G; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.; Division of General Internal Medicine, University of Colorado School of Medicine, Denver, CO, United States., Marie McCarthy A; Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States., Rieu-Werden M; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States., Silver MI; Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States., Santini NO; Parkland Health, Dallas, TX, United States.; Division of General Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States., Tiro JA; Division of General Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.; Department of Public Health Sciences, Biological Sciences Division, University of Chicago, Chicago, IL, United States., Haas JS; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Jazyk:	angličtina
Zdroj:	Preventive medicine reports [Prev Med Rep] 2024 Jun 01; Vol. 43, pp. 102783. Date of Electronic Publication: 2024 Jun 01 (Print Publication: 2024).
DOI:	10.1016/j.pmedr.2024.102783
Abstrakt:	Introduction: The COVID-19 pandemic posed serious challenges to cancer screening delivery, including cervical cancer. While the impact of the pandemic on deferred screening has been documented, less is known about how clinicians experienced barriers to screening delivery, and, in particular, the role of pre-pandemic barriers to changes reported during the pandemic. Methods: Survey of clinicians who performed ≥ 10 cervical cancer screening tests in 2019 from Mass General Brigham, Kaiser Permanente Washington, and Parkland Health, the healthcare systems participating in the Population-based Research to Optimize the Screening Process (PROSPR II) consortium (administered 10/2020-12/2020, response rate 53.7 %). Results: Prior to the pandemic, clinicians commonly noted barriers to the delivery of cervical cancer screening including lack of staff support (57.6%), interpreters (32.5%), resources to support patients with social barriers to care (61.3%), and discrimination or bias in interactions between staff and patients (31.2%). Clinicians who reported experiencing a given barrier to care before the pandemic were more likely than those who did not experience one to report worsening during the pandemic: lack of staff support (odds ratio 4.70, 95% confidence interval 2.94-7.52); lack of interpreters (8.23, 4.46-15.18); lack of resources to support patients in overcoming social barriers (7.65, 4.41-13.27); and discrimination or bias (6.73, 3.03-14.97). Conclusions: Clinicians from three health systems who deliver cervical cancer screening commonly reported barriers to care. Barriers prior to the pandemic were associated with worsening of barriers during the pandemic. Addressing barriers to cervical cancer screening may promote resilience of care delivery during the next public health emergency. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors. Published by Elsevier Inc.)
Databáze:	MEDLINE
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