Breast Cancer Screening Barriers from the Womans Perspective: a Meta-synthesis

Azami-Aghdash, Saber; Ghojazadeh, Morteza; Sheyklo, Sepideh Gareh; Daemi, Amin; Kolahdouzan, Kasra; Mohseni, Mohammad; Moosavi, Ahmad

doi:10.7314/apjcp.2015.16.8.3463

Cited by 74 publications

(56 citation statements)

References 29 publications

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“…Lastly, our study examined organizational efforts to enhance rural outreach to underserved women. Our analysis did not examine the effects of well-documented patient-level barriers (cultural, psychosocial, structural) that may have hindered rural women's ability to engage the BSPAN network [34][35][36][37][38].…”

Section: Limitationsmentioning

confidence: 99%

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Lee

Higashi

Inrig

et al. 2016

Behav. Med. Pract. Policy Res.

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Rural mammography screening remains suboptimal despite reimbursement programs for uninsured women. Networks linking non-clinical community organizations and clinical providers may overcome limited delivery infrastructure in rural areas. Little is known about how networks expand their service area. To evaluate a hub-andspoke model to expand mammography services to 17 rural counties by assessing county-level delivery and local stakeholder conduct of outreach activities. We conducted a mixed-method evaluation using EMR data, systematic site visits (73 interviews, 51 organizations), 92 patient surveys, and 30 patient interviews. A two-sample t test compared the weighted monthly average of women served between hub-and spoke-led counties; nonparametric trend test evaluated time trend over the study period; Pearson chi-square compared sociodemographic data between hub-and spoke-led counties. From 2013 to 2014, the program screened 4603 underinsured women. Counties where local Bspoke^organizations led outreach activities achieved comparable screening rates to hub-led counties (9.2 and 8.7, respectively, p = 0.984) and did not vary over time (p = 0.866). Qualitative analyses revealed influence of program champions, participant language preference, and stakeholders' concerns about uncompensated care. A program that leverages local organizations' ability to identify and reach rural underserved populations is a feasible approach for expanding preventive services delivery. KeywordsRural, Breast cancer, Healthdisparities, Health services delivery, Mixed methods, Program implementation BACKGROUND Despite the Affordable Care Act's emphasis on preventive services, many rural communities face significant challenges in linking women to the full continuum of breast cancer screening services (e.g., screening and diagnostic mammography, breast biopsy, and referral to cancer treatment) [1]. Rural populations, when adjusted for age, are more likely than their urban counterparts to lack health insurance [2], such that women are significantly less likely to meet

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Section: Limitationsmentioning

confidence: 99%

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Lee

Higashi

Inrig

et al. 2016

Behav. Med. Pract. Policy Res.

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“…In the procrastination health model, procrastination is suggested to result in less frequent practice of health-promoting behaviors [30, 31]. Azami-Aghdash et al (2015) reported that procrastination was as a key obstacle to screening of breast cancer [32]. In a follow-up survey, Keely et al (2010) demonstrated that there is a neglected obstacle that affect postpartum diabetes screening rates, despite the perceived importance of screening by the patients [33].…”

Section: Discussionmentioning

confidence: 99%

Barriers to postpartum screening for type 2 diabetes: a qualitative study of women with previous gestational diabetes

et al. 2017

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IntroductionRisk of developing type 2 diabetes is increased in women with previous gestational diabetes mellitus (GDM). Postpartum glycemic screening is recommended in women with recent GDM. But this screening rate is low and the reasons are unclear. The aim of this study was to explore the experiences of Iranian women with recent GDM on barriers of postpartum screening for diabetes.MethodsThis qualitative study was conducted in Tehran, Iran in 2016. Semi-structured interview was used for data collection. 22 women with recent GDM were interviewed. These women gave birth in Tehran hospitals at a minimum of 6 months before interview. The missed screening defined as not attending to laboratory for Fasting Blood Sugar and/or Oral Glucose Tolerance Test, 6 week to 6 month after their child birthing. The data was analyzed by content analysis method.ResultsThemes and sub-themes that illustrated the barriers to postpartum diabetes screening were: inadequate education (about developing diabetes in the future, implementation of the screening, and glucometer validity in diagnosis of diabetes), perceiving the screening as difficult (feeling comfortable with the glucometer, poor laboratory conditions, issues related to the baby/babies, and financial problems), improper attitudes toward the screening (unwilling to get diagnosed, not giving priority to oneself, having false beliefs) and procrastination (gap to intention and action, self-deception and self-regulation failure).ConclusionWomen with recent GDM reported several barriers for postpartum diabetes screening. This study help to develop the evidence-based interventions for improving this screening rate.

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“…To our knowledge, procrastination was the main barrier in Keely's study as well. Also, in a few studies, procrastination was reported as a key barrier to breast cancer screening (28,29).…”

Section: Discussionmentioning

confidence: 99%

Procrastination as a Key Factor in Postpartum Screening for Diabetes: A Qualitative Study of Iranian Women with Recent Gestational Diabetes

Rafii

Rahimparvar

Keramat

et al. 2017

Iran Red Crescent Med J

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Background: Women with previous gestational diabetes mellitus (GDM) are at elevated risk for developing Type 2 diabetes. Despite the recommendation for postpartum diabetes screening for these women, the rate of screening is low. Objectives: The present study aimed at conducting an in-depth exploration of the experiences of Iranian women with recent GDM in the process of diabetes screening. Methods: This grounded theory qualitative study was conducted in Tehran, Iran, from 2013 to 2016. In this study, 22 women with recent GDM, who gave birth at least 6 months before the interview, were selected by purposeful sampling method; then, to achieve saturation, the participants were followed using theoretical sampling method. The participants were asked about their postpartum experiences, specially about the process of attendance/not attendance in diabetes screening at 6 weeks to 6 months after child birth, using semi-structured interviews. Data were analyzed using Corbin and Strauss method (2008). Results: Three main categories were extracted as postpartum diabetes screening process in women with a recent GDM: to be aware, to be sensitive, and to perceive severity of the threat. Also, the outcomes have been classified into 4 levels: selective screening, accidental screening, primary lack of screening, and secondary lack of screening. In our study, the participants had a range of procrastination in screening, from no procrastination in selective screening to high procrastination in secondary lack of screening. Sometimes, the participants had the intention to be screened but they took no action, did not do the screening due to self-deception, or perceived screening as lacking immediate reward (3 main features of procrastination). Thus, due to procrastination, they did not do the screening. Screening in the range of procrastination, as the core category, was the most obvious concept that implicitly existed in all the data. Conclusions: Even when sensitivity and perceiving a threat about diabetes were activated in women with recent GDM, they did not undertake screening due to procrastination. Procrastination is an important and missed factor in screening. Conducting further studies is recommended to develop evidence-based strategies to decrease women's procrastination in screening.

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Breast Cancer Screening Barriers from the Womans Perspective: a Meta-synthesis

Cited by 74 publications

References 29 publications

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Barriers to postpartum screening for type 2 diabetes: a qualitative study of women with previous gestational diabetes

Procrastination as a Key Factor in Postpartum Screening for Diabetes: A Qualitative Study of Iranian Women with Recent Gestational Diabetes

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