Access to Care as a Barrier to Mammography for Black Women

Abstract

Racial disparities in breast cancer screening, morbidity, and mortality persist for Black women. This study examines Black women’s mammography beliefs and experiences with specific focus on barriers to mammography access in an urban city in the South East, United States. This retrospective, qualitative study used Penchansky and Thomas’ conceptualization of health care access as the framework for the data analysis. In-depth, semistructured interviews were conducted with 39 Black women. Structural and personal factors continue to create barriers to mammography among Black women. Barriers to mammography were identified for each of the Penchansky and Thomas five dimensions of access to care: accessibility, affordability, availability, accommodation, and acceptability. Clinical practice strategies to increase mammography screening in Black women must be multifactorial, patient-centered, and culturally congruent. Policy development must address the structural barriers to mammography screening through expansion of health insurance coverage and increased accessibility to health care.

Clinical and psychosocial constructs for breast, cervical, and colorectal cancer screening participation: A systematic review

“…It's followed by the Theoretical Domains Framework & COM-B Model (3 studies), model used for basic research ( Oketch et al, 2019 ; O'Donovan et al, 2021 ; Dharni et al, 2017 ). One study ( Lubi et al, 2021 ) reported using the Social practice theory and another ( Aleshire et al, 2021 ) reported using the Penchansky and Thomas’ conceptualization of health care access. Protection Motivation Theory was used in two studies ( Li et al, 2020 ; Malmir et al, 2018 ) and another two studies ( Marlow et al, 2017 ; Ryan et al, 2019 ) used Precaution Adoption Process Model.…”

Hospitalized Women’s Perspective on Willingness-to-Screen for Cancers in Relation to Life Expectancy

“…It is cited in the literature that women with poor access to health care are disproportionately less educated, belong to racial and ethnic minorities, or are from a low-income group [27]. Often the women from racial and ethnic minorities are diagnosed with breast cancer at more advanced stages and have higher mortality from breast cancer compared to Caucasian women, citing various reasons for this discrepancy including cost and lack of insurance, less access to care, poorer health literacy, language barriers, and cultural beliefs [28][29].…”

The Relationship between Healthcare Providers and Preventive Practices: Narratives on Access to Cancer Screening

“…The analysis was conducted by 3 independent judges and proceeded through two phases. First, the texts were analyzed using predefined categories derived from Penchansky and Thomas’ conceptualization [ 42 ] and Saurman’s integration [ 44 ] about 6 dimensions of healthcare access: accessibility, affordability, availability, accommodation, acceptability, and awareness (a top-down approach); this allowed further unexpected themes to emerge (a bottom-up approach). The steps of analysis are: Using 6 theoretical categories line-by-line coding of all narrative transcripts from which the main groups of themes with common meanings were identified.…”

“…In this work, we refer to the meaning and dimensions of access to healthcare services proposed in the theoretical framework by Penchansky and Thomas [ 42 ]. These authors examined healthcare services in terms of an adaptive relationship between providers and patients.…”

“…In their conceptualization of “access”, five related dimensions have been proposed: affordability, availability, accessibility, accommodation and acceptability [ 42 ].…”