Social Determinants of Breast Cancer Screening in Urban Primary Care Practices: A Community-Engaged Formative Study
| Autor: | Bruce R. DeForge, Shiraz I. Mishra, Laura Grant, Beth Barnet, Shana O. Ntiri |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Gerontology Community-Based Participatory Research Health Knowledge Attitudes Practice Health (social science) Urban Population Health Behavior Psychological intervention Community-based participatory research Breast Neoplasms Health Services Accessibility Social support Breast cancer screening Maternity and Midwifery Humans Medicine Mammography Social determinants of health Early Detection of Cancer Qualitative Research Aged Primary Health Care medicine.diagnostic_test business.industry Public Health Environmental and Occupational Health Social Support Obstetrics and Gynecology Hispanic or Latino Focus Groups Middle Aged Focus group Black or African American Socioeconomic Factors Population Surveillance Baltimore Female business Qualitative research |
| Zdroj: | Women's Health Issues. 22:e429-e438 |
| ISSN: | 1049-3867 |
| DOI: | 10.1016/j.whi.2012.06.004 |
| Popis: | Background The recent decline in the breast cancer mortality rate can be attributed to intensive screening and early detection efforts. However, studies have documented a decline in self-reported recent mammography use and interventions to enhance mammography utilization have yielded modest improvements. To address the root causes of breast cancer disparities and improve mammography use, interventions need to address multiple layers of patient, provider, and health system factors. Objective Using community-based participatory research principles, we sought to learn from women receiving care through urban primary care practices about issues surrounding mammography screening and strategies to increase screening. Methods We conducted five focus groups among 41 eligible women who were predominantly African American, recruited using nonprobability purposive sampling methods from urban community health centers in Baltimore, Maryland. Data are reported from three focus groups (n = 28) that provided usable data. We used the social determinants of health perspective to conduct a qualitative content analysis and interpretation of the data. Results Major obstacles to obtaining a screening mammogram were individual-level (i.e., pain from the procedure) and structural-level factors (i.e., cost, geography, convenience). Strategies to overcome obstacles could include the creation of structural mechanisms whereby women can receive a host of services during one visit to a healthcare professional’s office. Important promoters of screening behavior included social-level factors such as social support, hope, and positive treatment outcomes. Conclusion The social determinants of health perspective provided a unique perspective to frame barriers and promoters of mammography utilization and insights to develop interventions aimed at improving cancer control among women receiving care at urban primary care health centers. |
| Databáze: | OpenAIRE |
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