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    Research Grants Awarded

    Improving Access to Breast Health Facilities and Services for Women with Disabilities

    Study Section:
    Population Specific

    Scientific Abstract:
    National statistics indicate that women with disabilities are less likely to have a clinical breast exam and a mammogram than women without disabilities. Research indicates that women with disabilities remain significantly disadvantaged due to lack of accessible facilities and knowledge among service providers about accessibility issues. The objective of this study is to develop and evaluate two model products for improving access and use of breast health services. Specific aims include (1) to develop and pilot test an accessibility checklist and associated resource guidebook specifically designed for breast health care facilities; (2) to track how accessibility of breast health facilities impacts consumer use; and (3) to evaluate the impact of the checklist and guidebook on provider awareness, attitudes, and behaviors as well as consumer use of breast health services. The checklist will list key accessibility aspects that should be provided in breast health facilities, and the guidebook will provide information on how to use the checklist (including diagrams and photos) as well as resources for improving accessibility. Qualitative (focus groups, evaluations) and quantitative (surveys, evaluations) methods will evaluate both products. Prototype content and format will be tested initially in two focus groups consisting of (1) women with disabilities across age, race, ethnicity, disability type, and socio-economic status and (2) breast health service professionals and other relevant clinicians (e.g. accessibility architect). Prototypes will be modified based on focus group input and then pilot-tested with a small sample of Missouri facilities (N=5). Data will be compared between professionals and consumers for each facility as well as between facilities for reliability and validity purposes. Prototypes will be modified as needed and re-tested using the same facilities but different testers. Finalized products will be distributed and evaluated using both consumers (N=75) and breast health service providers (N=75) throughout Missouri. Data will be analyzed and an accessibility scorecard of Missouri breast health facilities will be published as a resource for women with disabilities. The checklist and guidebook will be a resource for replication across the United States. Ultimately, the study will generate a greater understanding of accessibility needs among breast health providers and improve breast health service access and use among women with disabilities .

    Lay Abstract:
    Women with disabilities are less likely to have a clinical breast exam and a mammogram than women without disabilities. They experience many problems such as inaccessible facilities and services, lack of available resources on accessibility, and lack of information about disability among service providers. Positive factors that help women with disabilities include accessible facilities, positive attitudes of providers, and availability of materials in alternative formats (Braille, large print). This study will develop and evaluate two model products for improving access and use of breast health services. Specific aims include using these products to compare breast health facilities on accessibility, and evaluating how these products impact women with disabilities and health professionals. The first is an accessibility checklist and the second is a guidebook. Both will be specially designed for improving breast health care facilities and ultimately, access for women with disabilities. The checklist will list key accessibility aspects that should be provided in breast health facilities. The guidebook will provide information on how to use the checklist (including diagrams and photos) and resources to improve accessibility. Initial content and format will be reviewed by two groups - (1) women with disabilities across age, disability type, race, ethnicity, and socio-economic status and (2) breast health service professionals and other clinicians (e.g. accessibility architect). Initial versions will be changed based on group comments and tested in five Missouri breast health facilities. Data will be collected and compared between women with disabilities and health professionals. Initial versions will be changed and re-tested using the same facilities but different testers. Final products will be mailed and evaluated using women with disabilities and breast health service providers throughout Missouri. Data will be examined and a scorecard of Missouri breast health facilities and accessibility will be published as a resource for Missouri women with disabilities. The checklist and guidebook will be a resource that could be replicated throughout the United States. The study will help breast health providers to understand accessibility needs and improve the access and use of breast health services for women with disabilities.