Barriers to Follow-up of Abnormal Papanicolaou Smears in an Urban Community Health Center

McKee, M. Diane; Lurio, Joseph; Marantz, Paul R.; Burton, W Leigh; Mulvihill, Michael

doi:10.1001/archfami.8.2.129

Cited by 77 publications

(92 citation statements)

References 10 publications

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“…Si bien no se observan diferencias estadísticamente significativas entre los grupos (quizá debido al tamaño de la muestra utilizada) su coincidencia con investigaciones que muestran la influencia de la inadecuada comunicación entre los profesionales y las mujeres en los abandonos del proceso de seguimiento y tratamiento (30,(38)(39)(40)(41)(42), permiten pensar que la entrega de los resultados es un elemento clave para el análisis de los abandonos. Diversos estudios han mostrado que las dificultades en la relación entre profesionales y mujeres producen, en algunos casos, que no se interprete adecuadamente el significado de un Pap anormal (39)(40)(41)(42) o que se generen situaciones de estrés y ansiedad que actúan como barreras para la continuidad del tratamiento (40).…”

Section: Discussionunclassified

Análisis de los motivos del abandono del proceso de seguimiento y tratamiento por parte de mujeres con lesiones precursoras de cáncer de cuello uterino en la provincia de Jujuy: implicancias para la gestión

Paolino¹,

Arrossi²

2012

Salud Colectiva

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Section: Discussionunclassified

Análisis de los motivos del abandono del proceso de seguimiento y tratamiento por parte de mujeres con lesiones precursoras de cáncer de cuello uterino en la provincia de Jujuy: implicancias para la gestión

Paolino¹,

Arrossi²

2012

Salud Colectiva

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“…16,[27][28][29] Interpersonal factors associated with delays include inadequate communication or dissatisfaction with providers on test results or procedures. 27,28,30 System factors associated with delays include inconvenient appointment hours and long clinic waits; 29,31 having to seek care at larger hospitals; 32 first diagnostic appointment with radiology rather than a surgical consultancy; 32 and variations in healthcare services/procedures from clinic to clinic. 33 Increasingly, patient navigation programs have been used as a strategy to improve the timely receipt of needed healthcare services.…”

Section: Introductionmentioning

confidence: 99%

Patient Barriers to Follow-Up Care for Breast and Cervical Cancer Abnormalities

Tejeda

Darnell

Cho

et al. 2013

Journal of Women's Health

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Background: Women with breast or cervical cancer abnormalities can experience barriers to timely follow-up care, resulting in delays in cancer diagnosis. Patient navigation programs that identify and remove barriers to ensure timely receipt of care are proliferating nationally. The study used a systematic framework to describe barriers, including differences between African American and Latina women; to determine recurrence of barriers; and to examine factors associated with barriers to follow-up care. Methods: Data originated from 250 women in the intervention arm of the Chicago Patient Navigation Research Program (PNRP). The women had abnormal cancer screening findings and navigator encounters. Women were recruited from a community health center and a publicly owned medical center. After describing proportions of African American and Latina women experiencing particular barriers, logistic regression was used to explore associations between patient characteristics, such as race/ethnicity, and type of barriers. Results: The most frequent barriers occurred at the intrapersonal level (e.g., insurance issues and fear), while institutional-level barriers such as system problems with scheduling care were the most commonly recurring over time (29%). The majority of barriers (58%) were reported in the first navigator encounter. Latinas (81%) reported barriers more often than African American women (19%). Differences in race/ethnicity and employment status were associated with types of barriers. Compared to African American women, Latinas were more likely to report an intrapersonal level barrier. Unemployed women were more likely to report an institutional level barrier. Conclusion: In a sample of highly vulnerable women, there is no single characteristic (e.g., uninsured) that predicts what kinds of barriers a woman is likely to have. Nevertheless, navigators appear able to easily resolve intrapersonal-level barriers, but ongoing navigation is needed to address system-level barriers. Patient navigation programs can adopt the PNRP barriers framework to assist their efforts in assuring timely follow-up care.

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“…Pap smear rates and adherence to follow-up after an abnormal test are also lower in Latina women 5,6 . Differences in screening and abnormal follow-up could be due to language barriers, foreign birth/acculturation, limited education, poverty and lack of insurance [7][8][9][10][11] . All these factors are more common in Latinas and could influence their compliance with recommended care.…”

Section: Introductionmentioning

confidence: 99%

Barriers to Follow-Up of an Abnormal Pap Smear in Latina Women Referred for Colposcopy

et al. 2010

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BACKGROUND: Lower rates of follow-up after an abnormal Pap smear in racial and ethnic minorities may contribute to the higher incidence and mortality rates of cervical cancer seen in these groups. OBJECTIVE: To identify patient-perceived barriers to follow-up after an abnormal Pap smear result among Latina women. DESIGN, PARTICIPANTS AND APPROACH: Qualitative, semi-structured, one-on-one interviews were conducted with patients from an academic hospitalaffiliated urban community health center. Three groups of women were interviewed: new colposcopy clinic patients, patients who had previous colposcopies and patients enrolled in the health center's patient navigator program. Open-ended questions explored their knowledge, beliefs and experiences with colposcopy. Content analysis of transcripts was performed using established qualitative techinques. RESULTS: Of 40 Latina women recruited, 75% spoke only Spanish. The average age was 31.5 (range 18-55). Personal and system barriers identified were categorized into four themes: (1) anxiety/fear of procedure and diagnosis; (2) scheduling/availability of appointments interfering with work and/or child care; (3) inadequate communication about appointments, including lack of explanation regarding diagnosis, procedure and results; and (4) pain. New patients more commonly reported problems with scheduling and communication. Followup patients were more concerned about pain, and navigated women most often reported fear of results but had fewer concerns about inadequate communication. CONCLUSION: Anxiety/fear was the most common personal barrier, while difficulty scheduling appointments and inadequate communication were the major systems barriers identified in these Latina women. Interventions to lower these barriers to colposcopy among Latina women may increase adherence to follow-up of abnormal Pap smears.

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Barriers to Follow-up of Abnormal Papanicolaou Smears in an Urban Community Health Center

Abstract: Effective communication of results is the most important factor related to follow-up after abnormal Papanicolaou smear in this setting. In other settings, other factors may be of greater importance.

Cited by 77 publications

References 10 publications

Análisis de los motivos del abandono del proceso de seguimiento y tratamiento por parte de mujeres con lesiones precursoras de cáncer de cuello uterino en la provincia de Jujuy: implicancias para la gestión

Análisis de los motivos del abandono del proceso de seguimiento y tratamiento por parte de mujeres con lesiones precursoras de cáncer de cuello uterino en la provincia de Jujuy: implicancias para la gestión

Patient Barriers to Follow-Up Care for Breast and Cervical Cancer Abnormalities

Barriers to Follow-Up of an Abnormal Pap Smear in Latina Women Referred for Colposcopy

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