scholarly journals Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Olga Moshkovich ◽  
Lydie Lebrun-Harris ◽  
Laura Makaroff ◽  
Preeta Chidambaran ◽  
Michelle Chung ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Medical Home ◽  
Health Care Services ◽  
Health Belief ◽  
Health Centers ◽  
System Level ◽  
Patient Centered Medical Home ◽  
Patient Centered

Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS) persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs) have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH) transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs) and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

scholarly journals Intimate Stories: Aboriginal Women’s Lived Experiences of Health Services in Northern British Columbia and the Potential of Creative Arts to Raise Awareness About HPV, Cervical Cancer, and Screening

2013 ◽  
Vol 8 (1) ◽  
pp. 18 ◽  
Author(s):  
Virginia L. Russell ◽  
Sarah De Leeuw
Keyword(s):  
Cervical Cancer ◽  
British Columbia ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Health Care Services ◽  
Formal Education ◽  
Cervical Screening ◽  
Sexual Health Care ◽  
Wide Range ◽  
Screening Services

Guided by feminist and community-based participatory methodologies and by efforts to decolonize health research practices, and undertaken with qualitative research methods (interviews, open-ended questionnaires, and analysis of arts-based expressions like storytelling, journaling, and picture-making), this research identified challenges and barriers that (predominantly Aboriginal) women in northern British Columbia faced when trying to access sexual health care services related to HPV and cervical cancer screening. The research also examined the possible effectiveness of creative or arts-based strategies to promote cervical health and screening awareness among young and/or traditionally underserved or marginalized women. We review findings from data gathered over six months during multiple interactions with 22 women from a wide range of ethnic backgrounds. Results confirm that ethnicity, finances, and formal education are determinants in women’s awareness about, access to, and use of cervical screening services, and that experiences of gendered victimization, feelings of disempowerment, and life circumstances all influenced women’s comfort levels with, access to, and use of cervical cancer screening services.

scholarly journals Assessing the Impact of Patient-Centered Medical Home Principles on Hypertension Outcomes Among Patients of HRSA-Funded Health Centers

2018 ◽  
Vol 32 (4) ◽  
pp. 418-425 ◽  
Author(s):  
Nadereh Pourat ◽  
Xiao Chen ◽  
Christopher Lee ◽  
Weihao Zhou ◽  
Marlon Daniel ◽  
...  
Keyword(s):  
Medical Home ◽  
Health Centers ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
The Impact

scholarly journals Challenges to early detection of cervical cancer at primary healthcare level in Resource limited settings; a descriptive study.

2019 ◽  
Author(s):  
Charles Nkurunziza ◽  
Diomede Ntasumbumuyange ◽  
Lisa Bazzett-Matabele
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Descriptive Study ◽  
Health Centers ◽  
Basic Knowledge ◽  
Care Providers ◽  
Cancer Symptoms

Abstract Objectives To assess the healthcare system related factors that cause delayed cervical cancer diagnosis at the primary healthcare level. Methods This was a descriptive study of healthcare providers in outpatient clinics at 10 health centers in Kigali city and the Eastern province of Rwanda. Care providers completed a survey questionnaire. Results Eighty-seven (87) health care providers participated. Of respondents, 85 (97.7%) were nurses and midwives, 81.6% being nurses. Only 15 (17.2%) reported to have received training on visual inspection with acetic acid (VIA) cervical cancer screening; and were distributed in 6/10 of the health centers surveyed. However, 75.9% of respondents reported that there was at least one person trained in VIA at their health center. Necessary basic equipment for cervical cancer evaluation was reported to be generally available. Overall, 49 (56.3%) participants were found to have adequate basic knowledge on cervical cancer symptoms and appropriate next step in the case of symptoms. We found no association between respondents’ knowledge of cervical cancer screening and profession or education level, work experience or reported prior training on VIA (p= 0.592, 0.384, 0.174 and 0.404, respectively). Conclusion There is a large gap in number of care providers with enough skills to perform cervical cancer VIA screening at health centers in Rwanda. As health centers are patients’ first point of contact with the healthcare system, there is a need to empower them in human resources and infrastructure if effective cervical cancer screening and prevention program is to be established.

scholarly journals Accuracy of Self-report for Cervical and Breast Cancer Screening: A Systematic Review and Meta-analysis

2019 ◽  
Author(s):  
Johanna Anderson ◽  
Donald S. Bourne ◽  
Kim A. Peterson ◽  
Katherine M. Mackey
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cervical Cancer Screening ◽  
Medical Records ◽  
Meta Analysis ◽  
Self Report ◽  
System Level

Abstract Background: Guideline-based breast and cervical cancer screenings are fundamental components of high-quality preventive women’s health care services. Accurate measurement of screening rates is vital to ensure all women are adequately screened. Our systematic review and meta-analysis aims to provide an updated synthesis of the evidence on the accuracy of self-reported measures of cervical and breast cancer screening compared to medical records. Methods: To identify studies, we searched MEDLINE®, Cochrane Database of Systematic Reviews, and other sources up to July 2019. Two reviewers sequentially selected studies, abstracted data, and assessed internal validity and strength of the evidence. Adjusted summary numbers for sensitivity and specificity were calculated using a bivariate random-effects meta-analysis. Results: Unscreened women tended to over-report screening among 39 included studies examining the accuracy of self-report for cervical and/or breast cancer screening. The specificity of self-report was 48% (95% CI 41 to 56) for cervical cancer screening and 61% (95% CI 53 to 69) for breast cancer screening while the sensitivity of self-report was much higher at 96% (95% CI 94 to 97) for cervical cancer screening and 96% (95% CI 95 to 98). We have moderate confidence in these findings, as they come from a large number of studies directly assessing the accuracy of self-report compared to medical records and are consistent with findings from a previous meta-analysis. Conclusions: Unscreened women tend to over-report cervical and breast cancer screening, while screened women more accurately report their screening. Future research should focus on assessing the impact of over-reporting on clinical and system-level outcomes.

scholarly journals Knowledge and beliefs regarding cervical cancer screening and HPV vaccination among urban and rural women in León, Nicaragua

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3871 ◽  
Author(s):  
Hannah D. Rees ◽  
Alexandra R. Lombardo ◽  
Caroline G. Tangoren ◽  
Sara J. Meyers ◽  
Vishnu R. Muppala ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Rural Women ◽  
Hpv Vaccine ◽  
Cervical Cancer Prevention ◽  
Health Centers ◽  
Pap Smears ◽  
Immunization Program ◽  
Knowledge And Beliefs

Background In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15–44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women’s beliefs about a potential HPV immunization campaign. Given beliefs’ influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women’s beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Methods Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18–49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19–46. Results The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on quantitative findings: (1) women’s embarrassment due to the intimate nature of the Pap smear and male gender of exam provider discourages screening; (2) women believe Pap smears and cervical cancer are associated with sexual promiscuity, and this association stigmatizes women with the disease; (3) knowledge of cervical cancer prevention is limited to those who regularly attend health centers; and (4) women find screening inconvenient, believing understaffed clinics increase patient wait time, limit time patients spend with clinicians, and delay Pap results. A fifth theme indicates (5) participants’ acceptance of a potential HPV immunization program. Discussion Future interventions should focus on increasing access to information about cervical cancer prevention for women who do not regularly attend health centers. Furthermore, our results suggest that if funding were allocated to make the HPV vaccine accessible in Nicaragua, it would be well received.

Sign in / Sign up

Export Citation Format

Share Document