Perspectives of Mobile Versus Fixed Mammography in Santa Clara County, California: A Focus Group Study

Abstract

Objective: Our aim was to examine underserved women’s perceptions on mobile versus fixed mammography in Santa Clara, California through a focus group study.Background: Research has shown that medically underserved women have higher breast cancer mortality rates correlated with under-screening and a disproportional rate of late-stage diagnosis. The Community Health Partnership in Santa Clara County, California runs the Community Mammography Access Project (CMAP) that targets nearly 20,000 medically underserved women over the age of 40 in the county through the collaborative effort of an existing safety net of healthcare providers. However, little data exists on the advantages or disadvantages of mobile mammography units from the patient perspective. Methods: We assessed underserved women’s perspectives on mammography services in Santa Clara County through two focus groups from women screened at mobile or fixed site programs. Patients were recruited from both CMAP clinics and a county hospital, and focus group data were analyzed using content analysis.Results: We found that women from both the mobile and fixed sites shared similar motivating factors for getting a mammogram. Both groups recognized that screening was uncomfortable but necessary for good health and had positive feedback about their personal physicians. However, mobile participants, in particular, appreciated the atmosphere of mobile screening, reported shorter wait times, and remarked on the good communication from the clinic staff and empathetic treatment they received. However, mobile participants also expressed concern about the quality of films at mobile sites due to delayed initial reading of the films. Conclusions: Mobile mammography offers a unique opportunity for women of underserved populations to access high satisfaction screenings, and it encourages a model similar to CMAP in other underserved areas. However, emphasis should be placed on providing a warm and welcoming environment for patients and ensuring the quality of mammography images.

The scope and impact of mobile health clinics in the United States: a literature review

“…Oftentimes, individuals become disenfranchised from their healthcare sources due to lack of trust in a system seemingly not designed for the clients’ best interest – MHCs, by their patient-centric design, are well positioned to regain the trust of these individuals and reconnect them to regular health providers. Qualitative research has found that patients value MHCs’ informal setting, familiar environment, convenient location and staff who “are easy to talk to” [ 25 , 32 , 44 , 45 ]. Because MHCs make the effort to physically drive into communities, community members feel that the clinics are reaching out to care about them, inspiring them to take more charge of their own health [ 4 ].…”

“…Disruptions of privacy are sometimes avoided by designing movable partitions within the vehicle or scheduling patients who speak different languages for the same time slot [ 7 , 42 ]. Space constraints can also impact service quality – one mobile mammography unit reported that the clinic’s size only permitted the use of portable machines, resulting in a lower intrinsic quality of their imaging compared to county hospitals and leading to dissatisfaction among some of their clients [ 45 ]. Even though spatial constraints can post challenges, the tight space within which MHCs operate is also documented to contribute to a positive restructuring of patient-provider relationships [ 42 ].…”

Mobile Mammography Participation Among Medically Underserved Women: A Systematic Review

“…Furthermore, some Hispanic women, such as those employed in the cattle and harvesting industries, may be more likely to move around to find work and thus be less likely to return for repeat screenings ( 23 , 27 ). Concerns about image quality and poor service could also discourage women from revisiting mobile clinics ( 12 ). Further examination of women’s perceptions of mobile mammography showed that although some users initially had negative views about the quality of mobile mammography services, users often reported more positive experiences than women at fixed clinics ( 12 ).…”

“…Concerns about image quality and poor service could also discourage women from revisiting mobile clinics ( 12 ). Further examination of women’s perceptions of mobile mammography showed that although some users initially had negative views about the quality of mobile mammography services, users often reported more positive experiences than women at fixed clinics ( 12 ). Providing patient navigation and appointment reminders may help promote attendance at mobile mammography clinics ( 12 ).…”

“…Further examination of women’s perceptions of mobile mammography showed that although some users initially had negative views about the quality of mobile mammography services, users often reported more positive experiences than women at fixed clinics ( 12 ). Providing patient navigation and appointment reminders may help promote attendance at mobile mammography clinics ( 12 ). Thus, efforts should be made to educate communities about the quality of mobile mammography services to improve participation and retention.…”