What Women Want: Patient Recommendations for Improving Access to Breast and Cervical Cancer Screening and Follow-up

Abstract

BACKGROUND The patient voice remains underrepresented in clinical and public health interventions. To inform interventions that strive to improve access to breast and cervical cancer screening and follow-up among low-income populations, we explored recommendations from low-income women pursuing health care in the safety net. METHODS Semi-structured interviews were conducted among women receiving follow-up care for an abnormal breast or cervical cancer screening result or a positive cancer diagnosis in federally qualified health centers (FQHCs), free clinics, or an academic cancer center in the Chicago metropolitan area. FINDINGS Of the 138 women interviewed in the parent study, 52 women provided recommendations for improving access to screening and follow-up care. Most were between 41 and 65 years old (62%) and African American (60%) or White (25%). Recommendations included strengthening community-based health education with more urgent messaging, strategic partnerships, and active learning experiences to increase patient engagement, which women regarded as a key driver of access. Women also suggested increasing access by way of changes to health care delivery systems and policy, including more direct patient-provider and patient-clinic communications, addressing delays caused by high patient volume, combining preventive services, expanding insurance coverage, and adjusting screening guidelines. CONCLUSIONS This exploratory study demonstrates important insights from the patient lens that may help to increase the acceptability and efficacy of community and clinical interventions aimed at improving access to breast and cervical cancer screening and follow-up. Further research is needed to identify appropriate integration of patient input into interventions, practice, and policy change.

Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

“…As has been shown [ 38 ], one of the most powerful factors to increase participation to cancer screening programme is the advice of a health professional who explains the process, the risks and the benefits. In the case of vulnerable women, such an intervention requires consideration of the different cultural, social and religious characteristics along with changes to the healthcare delivery systems.…”

Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery

“…However, patient-centered research topics should be considered a priority. The literature demonstrates that patients desire an active role in treatment decision making and planning, [67][68][69][70] but systemic, practice-level, attitudinal, and other barriers exist. [70][71][72] Future research topics include not only patient engagement in treatment planning but also patient/ caregiver involvement in the delivery of interdependent tasks as a care team member and whether the 4R approach can facilitate this involvement.…”

Association Between Social Engagement and Cancer Screening Utilization in a Community-Dwelling Chinese American Older Population

“…Furthermore, addressing various barriers in combination may be the best way to facilitate cancer screening utilization. For health care providers, these findings may provide in-depth evidence to support clinical professionals facilitating cancer-screening services such as building up community partnership education programs ( Ragas et al, 2014 ). This study would present new thoughts to policy-makers in formulating relevant policies in cancer screening among Chinese American population.…”