Understanding Barriers to Participation in Mammography by Women with Disabilities

Barr, Judith K.; Giannotti, Tierney E.; Hoof, Thomas J. Van; Mongoven, Jennifer; Curry, Maureen

doi:10.4278/ajhp.22.6.381

Cited by 33 publications

(36 citation statements)

References 9 publications

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“…It is already well known that functional limitations as such constitute a barrier to cancer screening use [11], [16]. People with mobility limitations encounter logistic and/or architectural obstacles such as access to buildings, machines and examination tables [11], [40]. A telephone survey [41] recently conducted among 256 physicians in the US confirmed a lack of accessibility to care—especially gynecological care—among people with a mobility impairment.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Obesity and Mobility Disability in Access to Breast and Cervical Cancer Screening in France: Results from the National Health and Disability Survey

2014

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ObjectivesWe aimed to disentangle the effects of obesity and mobility limitation on cervical and breast cancer screening among community dwelling women.MethodsThe data source was the French national Health and Disability Survey - Household Section, 2008. The Body Mass Index (BMI) was used to categorize obesity status. We constructed a continuous score of mobility limitations to assess the severity of disability (Cronbach's alpha = 0.84). Logistic regressions were performed to examine the association between obesity, mobility limitations and the use of Pap test (n = 8 133) and the use of mammography (n = 7 561). Adjusted odds ratios were calculated (AOR). Interaction terms between obesity and the disability score were included in models testing for effect modifications.ResultsCompared with non-obese women, the odds of having a Pap test in the past 3 years was 24% lower in obese women (AOR = 0.76; 95% CI: 0.65 to 0.89), the odds of having a mammogram in the past 2 years was 23% lower (AOR = 0.77; 95% CI: 0.66 to 0.91). Each time the disability score was 5 points higher, the odds of having a Pap test decreases by 20% (AOR = 0.96; 95% CI: 0.94 to 0.98), the odds of having a mammogram decreases by 25% (AOR = 0.95; 95% CI: 0.94 to 0.97). There was no significant interaction between obesity and disability score.ConclusionObesity and mobility limitation are independently associated with a lower likelihood of cervical and breast cancer screening. Protective outreach and follow-up are necessary to reduce inequalities and thus to reduce health disparities in these vulnerable and high-risk populations of obese women with disabilities.

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Section: Discussionmentioning

confidence: 99%

The Effects of Obesity and Mobility Disability in Access to Breast and Cervical Cancer Screening in France: Results from the National Health and Disability Survey

2014

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“…However, similar rises have not been observed for women with ID (Center for Disease Control, 2011;Sullivan et al, 2004). Barriers to mammography have been noted for women with disabilities of all kinds (Courtney-Long, Armour, Frammartino, & Miller, 2011), and women with ID have additional unique, disability-specific barriers (Barr, Giannotti, Van Hoof, Mongoven, & Curry, 2008;Wilkinson, Deis Bowen & Bokhour, 2011). Women with ID who live with their families are least likely, out of all women with ID, to receive regular mammography (Wilkinson, Lauer, Fruend, & Rosen, 2011).…”

Section: Introductionmentioning

confidence: 85%

More Than Just a Mammogram: Breast Cancer Screening Perspectives of Relatives of Women With Intellectual Disability

Greenwood¹,

Dreyfus²,

Wilkinson³

2014

Intellectual and Developmental Disabilities

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Women with intellectual disability (ID) have similar rates of breast cancer as the general public, but higher breast cancer mortality and lower rates of regular screening mammography. Screening rates are lowest among women who live with their families. Though women with ID often make decisions in partnership with their relatives, we lack research related to family member perspectives on mammography. We conducted a qualitative study of family members of women with ID, with an interview guide focused on health care decision making and experiences, and breast cancer screening barriers, facilitators, and beliefs as related to their loved ones. Sixteen family members underwent semistructured interviews. Important themes included mammography as a reference point for other social and cultural concerns, such as their loved one's sexuality or what it means to be an adult woman; fear of having to make hard decisions were cancer to be diagnosed acting as a barrier to screening; a focus on quality of life; and desire for quality health care for their loved one, though quality care did not always equate to regular cancer screening. Adults with ID are valued members of their families, and their relatives are invested in their well-being. However, families fear the potentially complicated decisions associated with a cancer diagnosis and may choose to forgo screening due to misinformation and a focus on quality of life. Effective interventions to address disparities in mammography should focus on adults with ID and their families together, and incorporate the family context.

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“…Additionally, some persons might have difficulty communicating their needs or wishes to clinicians. For persons with physical limitations, preventive care opportunities might be limited by poor wheelchair access, ill-equipped exam rooms and diagnostic technology, and other structural impediments (Barr, Giannotti, Van Hoof, Mongoven, & Curry, 2008;Kroll, Jones, Kehn, & Neri, 2006;Lawthers, Pransky, Peterson, & Himmelstein, 2003). These barriers contribute to the underuse of preventive and active care services by persons with disabilities (Coyle & Santiago, 2002;Diab & Johnston, 2004;Havercamp, Scandlin, & Roth, 2004;Iezzoni, McCarthy, Davis, & Siebens, 2000;Lewis, Lewis, Leake, King, & Lindemann, 2002;Turk, Geremski, Rosenbaum, & Weber, 1997).…”

mentioning

confidence: 94%

Case Managers' and Independent Living Counselors' Perspectives on Health Promotion Activities for Individuals with Physical and Developmental Disabilities

James

Shireman

2010

Journal of Social Work in Disability & Rehabilitation

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A fundamental component of maximizing the quality of life for individuals with disabilities is quality health care. We describe the perspectives of case managers and independent living counselors on the role of health promotion as a component of targeted case management services. Respondents held health promotion as an essential element of maximizing the quality of life for individuals with disabilities, although they spent more time on social services as compared to medical services. Their confidence in assisting the individuals they serve with respect to health promotion and disease management activities was demonstrably weaker than their reported knowledge levels for most items. Barriers to accessing those services might create this apparent disconnect between knowledge and confidence.

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Understanding Barriers to Participation in Mammography by Women with Disabilities

Abstract: Despite frequent use of health care and personal strategies to facilitate mammography screening, women with disabilities reported barriers to getting mammograms. Findings suggest a multifaceted approach to address these barriers.

Cited by 33 publications

References 9 publications

The Effects of Obesity and Mobility Disability in Access to Breast and Cervical Cancer Screening in France: Results from the National Health and Disability Survey

The Effects of Obesity and Mobility Disability in Access to Breast and Cervical Cancer Screening in France: Results from the National Health and Disability Survey

More Than Just a Mammogram: Breast Cancer Screening Perspectives of Relatives of Women With Intellectual Disability

Case Managers' and Independent Living Counselors' Perspectives on Health Promotion Activities for Individuals with Physical and Developmental Disabilities

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