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    Research Grants Awarded

    Elucidating the Barriers and Facilitators to Breast Cancer Screening: Gaining Perspectives of Women with Disabilities and their Health Care Providers

    Study Section:
    Population Specific

    Scientific Abstract:
    Background : Over 20% of US women live with at least one disability. As these women have an equal or greater chance as other women of developing breast cancer, barriers to screening put them at risk for late diagnosis and poor health outcomes. For women in North Central Florida, rural residence compounded by physical disability poses barriers to screening. To address these barriers, we must clarify the functional significance that physical disability plays into accessing and providing preventive care. Objectives (research questions) : 1) What behavioral and environmental factors are barriers and facilitators for women with physical disabilities and their providers while pursuing/receiving or performing/recommending breast cancer screening (mammography, CBE, BSE)? and 2) How feasible and beneficial is it for women with physical disabilities to use the Photovoice method to “Photo-Map” a health care visit? Aims : 1) To understand the factors that impact breast cancer screening from the perspective of women with physical disabilities and their health care providers; and 2) To a ssess the feasibility and benefits of using a research method that places cameras in the hands of participants, enabling them to visually document the barriers and facilitators to breast cancer screening . Design : We will : a) Conduct 30 in-depth telephone interviews with each - women with disabilities and health care providers to systematically gather data about factors that impact breast cancer screening; b) Analyze data using qualitative techniques with the goal of organizing facto rs into a program planning framework; and c) Conduct interactive findings forums with interview participants enabling them to hear study findings, assess their trustworthiness, and use the framework to set priorities for future research and interventions. We will also train and provide cameras to 6 women who will visually document and communicate their barriers and facilitators to breast health screening. Outcomes : This study will generate a program planning framework to organize the factors that impact breast screening for women with disabilities so that research and interventions can be identified and tailored to this special population. Through testing the Photovoice method, we will understand Photo-Mapping’s ability to serve as an empowering research and educational tool, along with its capacity to capture and relay aspects of screening that might be missed through traditional interviews.

    Lay Abstract:
    Background : Approximately one out of every five US women lives with at least one disability. As these women have an equal or greater chance as other women of developing breast cancer, personal attitudes and beliefs, along with environmental obstacles to screening (e.g., inaccessible healthcare facilities) put them at risk for late diagnosis and poor health outcomes. For women with disabilities in North Central Florida, rural living may pose barriers to screening (e.g., lack of public transportation and community services). To begin to address these barriers, this study’s objective/aim is to better understand how living with disability impacts how easy or difficult it is for rural women to receive regular breast cancer screenings (including mammography, clinical breast exam and breast self exam) as nationally recommended. Design : To achieve this objective, we will conduct telephone interviews with 30 women with disabilities and 30 health care providers to gain their perspectives about the factors that make breast cancer screening easy or difficult. After analyzing the interviews, we will invite participants to come together during an interactive findings forum where they will: hear and discuss what was learned from the information they provided, assess how well the findings reflect what they told us, and use the findings to set priorities for future research and interventions. We will also conduct a small study t o assess the feasibility and benefits of using an innovative research method, Photovoice, as another way for women with disabilities to voice their perspectives. In using Photovoice, 6 women will be trained and given digital cameras so that they can take photographs that literally “show and tell” the things that make seeking and receiving breast cancer screening easy or difficult during an actual health care visit. Potential Outcomes : Findings from this study will help enhance our understanding about the factors that impact breast cancer screening for rural women with disabilities. Such information will help researchers, health care providers, and women with disabilities to join forces in developing a research agenda and interventions that are appropriate and sensitive. By assessing the use of Photovoice, we will gain insight into how empowering and useful this method is as a research and educational tool, along with its capability to enable women with disabilities to take control of how their lives are shown, discussed, and relayed to others.