Barriers to Mammography Screening among Black Women at a Community Health Center in South Florida, USA.
Barriers to Mammography Screening among Black Women at a Community Health Center in South Florida, USA.
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DOI：
10.18103/mra.v11i4.3814
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发表时间：
2023-04
期刊：
影响因子：
--
通讯作者：
Edwards, Karethy
中科院分区：
文献类型：
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作者：
Jones, Tarsha;Wisdom-Chambers, Karen;Freeman, Katherine;Edwards, Karethy
在美国，黑人/非洲裔美国妇女患乳腺癌的比例不成比例，与白色妇女相比，死亡率高出40%。乳房X光检查被认为是减轻差距的关键工具，但黑人妇女在检查方面遇到障碍，更有可能被诊断为晚期乳腺癌。本研究的目的是评估乳腺X线摄影筛查的相对频率，并检查在我们的护士领导的社区卫生中心接受护理的妇女中筛查的感知和实际障碍。我们进行了一项调查，检查乳房X光检查筛查的频率和对乳腺癌的信念，包括感知的易感性，感知的好处，以及感知的障碍，以冠军健康信念模型为指导。共有30名黑人/非裔美国妇女完成了调查。参与者的平均年龄为54.3岁± 9.17岁（标准差）; 43.3%的人受过高中或更低的教育; 50%的人年收入低于60，000美元; 26.7%的人没有保险; 10%的人接受医疗补助;只有50%的人全职工作。我们发现，只有一半的参与者报告每年进行乳房X光检查16次（53.3%），每6个月1次（3.3%），每2-3年8次（26.6%），5次（16.7%）一生中从未进行乳房X光检查。经常提到的障碍包括：“做乳房X光检查对我来说不方便”;“做乳房X光检查可能会导致乳腺癌”;“我接受的乳腺癌治疗会比癌症本身更糟糕”;“接受乳腺癌治疗会给我带来很多问题”;“其他健康问题会阻止我做乳房X光检查”;担心乳房X光检查的疼痛会让我不去做;而负担不起乳房X光检查会让我不去做。没有医疗保险也是一个障碍。这项研究发现，在佛罗里达的一个社区卫生中心，低收入黑人妇女对年度筛查乳房X线照片的利用率不高，妇女报告了几个障碍。鉴于黑人/非裔美国妇女乳腺癌的高死亡率，我们在我们的卫生系统中纳入了患者导航，以减少乳腺癌筛查和后续护理的障碍，并促进及时获得治疗，从而最终减少乳腺癌健康差距，促进健康公平。
In the United States (US), Black/African American women suffer disproportionately from breast cancer health disparities with a 40% higher death rate compared to White women. Mammography screening is considered a critical tool in mitigating disparities, yet Black women experience barriers to screening and are more likely to be diagnosed with advanced-stage breast cancer. The purpose of this study was to assess the relative frequency of mammography screening and to examine perceived and actual barriers to screening among women who receive care in our nurse-led community health center. We conducted a survey examining frequency of mammography screening and beliefs about breast cancer including perceived susceptibility, perceived benefits, and perceived barriers to mammography screening, guided by the Champion Health Belief Model. A total of 30 Black/African American women completed the survey. The mean age of the participants was 54.3 years ± 9.17 (SD); 43.3% had a high school education or less; 50% had incomes below $60,000 per year; 26.7% were uninsured; 10% were on Medicaid; and only 50% were working full-time. We found that only half of the participants reported having annual mammograms 16 (53.3%), 1 (3.3%) every 6 months, 8 (26.6%) every 2–3 years, and 5 (16.7%) never had a mammogram in their lifetime. Frequently cited barriers included: ‘getting a mammogram would be inconvenient for me’; ‘getting a mammogram could cause breast cancer’; ‘the treatment I would get for breast cancer would be worse than the cancer itself’; ‘being treated for breast cancer would cause me a lot of problems’; ‘other health problems would keep me from having a mammogram’; concern about pain with having a mammogram would keep me from having one; and not being able to afford a mammogram would keep me from having one’. Having no health insurance was also a barrier. This study found suboptimal utilization of annual screening mammograms among low-income Black women at a community health center in Florida and women reported several barriers. Given the high mortality rate of breast cancer among Black/African American women, we have integrated a Patient Navigator in our health system to reduce barriers to breast cancer screening, follow-up care, and to facilitate timely access to treatment, thus ultimately reducing breast cancer health disparities and promoting health equity.