Project Description:
Breast and Cervical Cancer Screening: Perceived barriers identified by low-income women with developmental disabilities Health disparities in cancer morbidity and mortality, as well as health service utilization, have been identified as important public health problems. The National Cancer Institute (NCI) indicates that lower rates of cancer screening and early detection are among the factors contributing to more advanced disease at diagnosis and higher cancer death rates among the underserved. Depending on the definition used, 19.9 to 28.6 million women in the United States have disabilities. 1 Healthy People 2010 reports that women with disabilities lack access to health services and medical care. Access to primary care and health screening services may be very limited. Health screening services for female cancers, such as pelvic examinations and mammograms, may be particularly difficult to obtain. Women with disabilities may encounter attitudinal, environmental, economic and
informational barriers to receiving health services. 2-4 According to a 2005 report by the State of Alaska, Department of Health and Social Services, Women's, Children's and Family Health Section, the Healthy Alaskan goals for the proportion of women ages 18 and older having received a Pap test in the previous three years and the proportion of women ages 40 or older having received a mammogram in the previous two years have not been met. 11 The Alaska Comprehensive Cancer Control Plan 2005-2010 includes the goal of reducing the mortality rate of cancer in Alaska due to lack of primary care services. 12 Among low-income women, having a disability is likely to intensify problems with access to cancer screening and result in more advanced cancer at diagnosis and lower survival rates. This creates enormous personal, family and societal costs. Using a community-based approach, the purpose of this exploratory study is to examine if low-income women with developmental disabilities living in the Anchorage area have reduced access to and participation in secondary prevention services for breast and cervical cancer. The goal of this study is to identify and understand barriers to cancer screening in order to increase access to these services for women with developmental disabilities. The study aims to accomplish the following: 1) determine the frequency of pelvic exams and mammograms among low-income women with developmental disabilities; 2) Explore how socioeconomic status, ethnicity, living situation, location of health care providers, insurance status, type of disability and
severity of disability affect access to and participation in pelvic examinations and mammograms among low-income women with developmental disabilities; 3) Examine specifically how external factors, e.g. informational barriers, attitudinal barriers, and environmental barriers) affect access to and participation in cancer screening services among low-income women with developmental disabilities; 4) Understand the personal reasons low-income women with developmental disabilities report for not participating, or participating in cancer screening; and 5)Following completion of this pilot study and the determination of its key findings, submit an external grant proposal to the National Cancer Institute (NIH), in order to examine access to and use of cervical and breast cancer screening services among women with developmental disabilities more fully.
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances, Geographic Areas, Urban, Specific Groups
