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Regular Mammography Screening: The Realities for Women with Disabilities
Although the numbers of women receiving breast cancer screening continue to rise, there remain groups that lag behind the general population. Two characteristics associated with lower breast cancer screening are disability status and legal marital status. However, little is known about the breast cancer screening experiences of legally unmarried disabled women 40 to 75 years. Our project team is comprised of university-based researchers and representatives from the disability community. Our objectives are to explore factors affecting the screening experiences of unmarried disabled women and to compare them with those of non-disabled women. The specific aims are to: (1) document how health care system [e.g., programs, services, providers] and environmental factors [e.g., transportation, facility locations] facilitate or impede routine breast cancer screening for disabled women; (2) explore the differential impact of the health care system and environmental factors on routine breast screening for women with different types of disabilities [sensory, physical, mental]; and (3) identify the facilitators and barriers to regular mammography among unmarried disabled women as compared to unmarried non-disabled women, matched for age and health insurance status.
We will complete the project in two phases. Phase I will include semi-structured individual interviews with disabled women. To ensure representation of unmarried women with different types of disability and experiences with mammography, we will interview women from six strata defined by type of disability and receipt of regular mammography [yes vs no]. We also will conduct a focus group discussion with providers of services for disabled women. In Phase II, we will conduct a prospective cohort study of disabled and non-disabled women to compare factors associated with regular mammography. Participants will be women originally recruited for a study of attitudes and experiences of unmarried women with health care in general and cancer screenings in particular. Women who partner with men and women who partner with women will be included in both phases of the project.
Most previous studies have focused primarily on barriers faced by women with disabilities. We will address the facilitators of routine screening as well as the barriers. By examining health care system and environmental factors that help to facilitate screening, study results will contribute to the development of strategies to promote regular mammography screening in communities in which women with disabilities are underserved.
Previous studies have shown that unmarried women are less likely than married women to obtain breast cancer screening, and other studies have found that the rates of screening for disabled women are lower than for non-disabled women. However, little is known about the experiences of unmarried disabled women 40 to 75 years despite the fact that they may be a particularly underserved population. We have formed a team of university-based researchers and representatives from the disability community in Rhode Island to identify factors affecting breast cancer screening among unmarried disabled women. The specific aims are to: (1) document the experiences of unmarried disabled women with health care system (e.g., programs, services, provider characteristics) as well as other factors (e.g., transportation, facility locations) that promote or discourage regular cancer screening; (2) explore factors affecting routine screening for women with different types of disability [sensory, physical, mental]; and (3) compare the experiences of disabled and non-disabled women with regular mammography screening while matching for age and insurance status.
We propose a two-phase study. In Phase I, we will conduct qualitative interviews with women with disabilities concerning their breast cancer screening experiences. Unmarried women with different types of disabilities and experiences with mammography will be included. We will select six groups, defined by type of disability and receipt of regular mammography [yes vs no]. We will also conduct a focus group of service providers for disabled women. In Phase II, we will conduct quantitative interviews with disabled and non-disabled women and compare their experiences with regular mammography screening. We will draw Phase II participants from women originally recruited for a study of attitudes and experiences of legally unmarried women with breast, cervical, and colorectal cancer screenings. Participants in both phases of the study will include both women who partner with men and women who partner with women.
Numerous studies have identified barriers to mammography. By addressing health care system characteristics and other factors that encourage regular screening, our study results can help health care providers, policy makers, and members of the disability community to develop novel strategies to serve the needs of women with disabilities.