Cervical screening participation and access facilitators and barriers for people with intellectual disability: a systematic review and meta-analysis.

Autor:	Power R; Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia., David M; The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.; School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia., Strnadová I; Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia.; Disability Innovation Institute, University of New South Wales, Sydney, NSW, Australia., Touyz L; The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia., Basckin C; Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia., Loblinzk J; Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia.; Self Advocacy Sydney, Sydney, NSW, Australia., Jolly H; Family Planning Australia, Sydney, NSW, Australia., Kennedy E; The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia., Ussher J; Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia., Sweeney S; Family Planning Australia, Sydney, NSW, Australia., Chang EL; Family Planning Australia, Sydney, NSW, Australia., Carter A; Sexual Health and Reproductive Equity Research Group, UNSW Kirby Institute, Sydney, NSW, Australia., Bateson D; The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.
Jazyk:	angličtina
Zdroj:	Frontiers in psychiatry [Front Psychiatry] 2024 Jul 26; Vol. 15, pp. 1379497. Date of Electronic Publication: 2024 Jul 26 (Print Publication: 2024).
DOI:	10.3389/fpsyt.2024.1379497
Abstrakt:	Background: The World Health Organisation's vision of eliminating cervical cancer as a public health problem is achievable, but elimination must be achieved equitably, including for people with intellectual disability. A better understanding of cervical screening within the context of the lives of people with intellectual disability is needed. This study systematically reviewed research on the rates of cervical screening participation among people with intellectual disability, and facilitators and barriers that affect participation. Method: Six electronic databases were systematically searched: MEDLINE, CINAHL, Scopus, PsycINFO, Embase and Pro-Quest Central Social Sciences Collection. Empirical studies published between 1986 and 2023, in English language peer-reviewed journals were eligible for inclusion. Further articles were identified through forward and backward citation tracking, and hand-searching the index lists of two key journals. Two authors screened the studies, extracted the data and collated study outcomes using a standardised software program. A meta-analysis was performed using the DerSimonian and Laird method to estimate pooled effect sizes in prevalence rates and odds ratios (ORs). The socio-ecological model (SEM) was used as a framework to thematically analyse facilitators and barriers impacting participation in cervical screening. Results: Sixty-three articles met the inclusion criteria. Of these, 42 reported on rates of cervical screening participation and 24 reported on facilitators or barriers to cervical screening for people with intellectual disability. Overall, the studies reported a screening prevalence of 35% (95% CI: 26% to 45%), indicating that just over a third of people with intellectual disability have had cervical screening. The pooled odds ratio of 0.30 (95% CI: 0.23 to 0.41) indicated that people with intellectual disability are significantly less likely to have a cervical screening test compared with people without intellectual disability. Most studies examined individual and interpersonal factors impacting cervical screening. These included: (i) fear and anxiety among people with intellectual disability, (ii) misassumptions preventing screening participation, (iii) the role of support people, (iv) the need for education, (v) accessible information, and time to prepare for screening, (vi) patient-provider communication including challenges obtaining informed consent, and (vii) healthcare provider lack of confidence. Conclusion: Future research, policy and practice efforts must address barriers to cervical screening participation among people with intellectual disability and ensure these efforts are co-produced and community-led. This is critical to ensuring equity in global and local efforts to eliminate cervical cancer. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Power, David, Strnadová, Touyz, Basckin, Loblinzk, Jolly, Kennedy, Ussher, Sweeney, Chang, Carter and Bateson.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu