Social and Cultural Barriers to Papanicolaou Test Screening in an Urban Population

Behbakht, Kian; Lynch, Anne M.; Teal, Stephanie; DeGeest, Koen; Massad, Stewart L.

doi:10.1097/01.aog.0000143881.53058.81

Cited by 115 publications

(83 citation statements)

References 23 publications

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“…Underuse of other preventive screening has been associated with lower education levels and lack of knowledge regarding risk. 17 The same may be true regarding osteoporosis screening, as women at intermediate or high risk of fracture often perceive themselves as lower risk. 18 Socioeconomic barriers that have been linked to reduced cancer screenings may also contribute to lower osteoporosis screening rates.…”

Section: Discussionmentioning

confidence: 99%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

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BACKGROUND:The United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with dual-energy x-ray absorptiometry (DXA) for women aged ≥ 65 years and younger women with increased risk. BChoosing Wisely^initiatives advise avoiding DXA screening in women younger than 65 years without osteoporosis risk factors. OBJECTIVE: We aimed to determine the extent to which DXA screening is used in accordance with USPSTF recommendations within a regional health system. DESIGN: This was a retrospective longitudinal cohort study within 13 primary care clinics in the Sacramento, CA region. PATIENTS: The study included 50,995 women aged 40-85 years without prior osteoporosis screening, diagnosis, or treatment attending primary care visits from 2006 to 2012, observed for a mean of 4.4 years. MAIN MEASURES: We examined incidence of DXA screening. Covariates included age, race/ethnicity, and osteoporosis risk factors (body mass index<20, glucocorticoid use, secondary osteoporosis, prior high-risk facture, rheumatoid arthritis, alcohol abuse, and current smoking). KEY RESULTS: Among previously unscreened women for whom the USPSTF recommends screening, 7-year cumulative incidence of DXA screening was 58.8 % among women aged 60-64 years with ≥ 1 risk factor (95 % CI: 51.9-65.8 %), 57.8 % for women aged 65-74 years (95 % CI: 55.6-60.0 %), and 42.7 % for women aged ≥ 75 years (95 % CI: 38.7-46.7 %). Among women for whom the USPSTF does not recommend screening, 7-year cumulative incidence was 45.5 % among women aged 50-59 years (95 % CI 44.1-46.9 %) and 58.6 % among women aged 60-64 years without risk factors (95 % CI 55.9-61.4 %). CONCLUSIONS: DXA screening was underused in women at increased fracture risk, including women aged ≥ 65 years. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors. Interventions may be needed to augment the value of population screening for osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

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“…10 In addition, her literacy skills were potentially complicated by language barriers -it is unclear if she is fluent in English from the history provided. As part of the case, students were also assigned a set of required readings [11][12][13] and participated in a facilitated small group discussion. Before the small group discussion, each student was asked to prepare written responses to the following questions: 1) what are some potential barriers to patient adherence and preventative health screening?…”

Section: Data Collectionmentioning

confidence: 99%

Medical students' recognition of health literacy in a single embedded curricular activity

et al. 2013

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Objectives: To explore medical students' recognition of health literacy as a barrier to care and social determinant of health within a single embedded curricular activity. Methods: Data was collected from 262 second-year medical students' responses to the following questions: what are some potential barriers to patient adherence and preventative health screening? What aspects of a social history would you include in your patient interview to ensure emphasis on the social determinants of health? All narrative responses were analyzed using both frequency analysis and qualitative content analysis methods. Results: Students' responses revealed three themes: the impact of low health literacy on health, the correlation between health literacy and literacy, and health care provider strategies for addressing health literacy. The majority of students 61.5% (n=161) recognized health literacy as a barrier to optimal health outcomes; however, an equal number of students 66.8% (n=175) failed to identify the manner in which health literacy serves as a social determinate of health. Conclusion: While students may recognize health literacy as a barrier to care, they may need more formalized instruction and evaluation on understanding the ways in which it is a social determinant of health. It is therefore essential for medical educators to incorporate this topic more intentionally into medical school curricula to ensure the understanding of health literacy within the clinical context to facilitate meaningful adaptations that can potentially decrease health disparities.

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“…Bu fırsatı kullanmayan kadınlarda, özel-likle serviks kanseri daha sık görülmektedir 19 . Yapılan çalışmalar kadınların jinekolojik muayene ile ilgili dü-şüncelerinin jinekolojik muayene ve Pap test yaptırma-yı etkilediğini ortaya koymuştur 8,20 . Karaca ve arkadaş-ları (2008) çalışmasında, kadınların %92,8'inin daha önce en az 1 kez jinekolojik muayene oldukları bulunmuştur 21 .…”

Section: Bulgular Ve Tartışmaunclassified

The Study of the Knowledge levels and Awareness of the academicians who are not in the field of health in relation to Cervical Cancer

Karabulutlu¹,

Pasinlioğlu²

2016

Kafkas J Med Sci

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Social and Cultural Barriers to Papanicolaou Test Screening in an Urban Population

Abstract: We have identified factors and beliefs that are barriers to Pap test screening in urban cervical cancer patients. Further studies should evaluate effects of addressing cultural, cognitive, and financial barriers on Pap test compliance.

Cited by 115 publications

References 23 publications

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Medical students' recognition of health literacy in a single embedded curricular activity

The Study of the Knowledge levels and Awareness of the academicians who are not in the field of health in relation to Cervical Cancer

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