Implementing women's cancer screening programs in American Indian and Alaska Native populations.
Implementing women's cancer screening programs in American Indian and Alaska Native populations.
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DOI：
10.1080/07399330390227481
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发表时间：
2003-09-01
影响因子：
1.4
通讯作者：
Kenyon, Kathryn
中科院分区：
文献类型：
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作者：
Lantz, Paula M;Orians, Carlyn E;Kenyon, Kathryn
国家乳腺癌和宫颈癌早期检测方案向部落和部落组织提供资金，利用为州卫生部门制定的方案模式实施全面的癌症筛查方案。我们进行了一个多站点的案例研究，使用参与式研究过程来描述如何5部落计划实施筛查服务，并确定用于解决在提供服务的挑战，美国印第安人和阿拉斯加原住民妇女的战略。我们分析了141名关键知情人的半结构化访谈数据，16个焦点小组，132名符合计划条件的妇女和计划文件。报告揭示了提供服务方面的若干挑战，包括在忙碌环境中实施筛查方案、获得乳房X光检查、提供文化敏感的护理以及在农村和偏远地区提供诊断/治疗服务。被认为成功应对计划挑战的策略包括在每个临床环境中确定计划的“拥护者”或主要支持者，使用移动的乳房X线摄影，使用女性提供者，以及提高筛查点提供诊断服务的能力。研究结果应该引起国际受众的兴趣，包括那些针对土著妇女或因文化、地理隔离和/或社会经济地位而被边缘化的群体的健康相关方案的工作人员。
The National Breast and Cervical Cancer Early Detection Program provides funding to tribes and tribal organizations to implement comprehensive cancer screening programs using a program model developed for state health departments. We conducted a multiple-site case study using a participatory research process to describe how 5 tribal programs implemented screening services, and to identify strategies used to address challenges in delivering services to American Indian and Alaska Native women. We analyzed data from semistructured interviews with 141 key informants, 16 focus groups with 132 program-eligible women, and program documents. Several challenges regarding the delivery of services were revealed, including implementing screening programs in busy acute-care environments, access to mammography, providing culturally sensitive care, and providing diagnostic/treatment services in rural and remote locations. Strategies perceived as successful in meeting program challenges included identifying a "champion" or main supporter of the program in each clinical setting, using mobile mammography, using female providers, and increasing the capacity to provide diagnostic services at screening sites. The results should be of interest to an international audience, including those who work with health-related programs targeting indigenous women or groups that are marginalized because of culture, geographic isolation, and/or socioeconomic position.