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Erschienen in: Journal of General Internal Medicine 11/2013

01.11.2013 | Original Research

Decreasing Disparities in Breast Cancer Screening in Refugee Women Using Culturally Tailored Patient Navigation

verfasst von: Sanja Percac-Lima, MD, PHD, Jeffrey M. Ashburner, MPH, Barbara Bond, LICSW, EdD, Sarah A. Oo, MSW, Steven J. Atlas, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 11/2013

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ABSTRACT

BACKGROUND

Patient navigator (PN) programs can improve breast cancer screening in low income, ethnic/racial minorities. Refugee women have low breast cancer screening rates, but it has not been shown that PN is similarly effective.

OBJECTIVE

Evaluate whether a PN program for refugee women decreases disparities in breast cancer screening.

DESIGN

Retrospective program evaluation of an implemented intervention.

PARTICIPANTS

Women who self-identified as speaking Somali, Arabic, or Serbo-Croatian (Bosnian) and were eligible for breast cancer screening at an urban community health center (HC). Comparison groups were English-speaking and Spanish-speaking women eligible for breast cancer screening in the same HC.

INTERVENTION

Patient navigators educated women about breast cancer screening, explored barriers to screening, and tailored interventions individually to help complete screening.

MAIN MEASURES

Adjusted 2-year mammography rates from logistic regression models for each calendar year accounting for clustering by primary care physician. Rates in refugee women were compared to English-speaking and Spanish-speaking women in the year before implementation of the PN program and over its first 3 years.

RESULTS

There were 188 refugee (36 Somali, 48 Arabic, 104 Serbo-Croatian speaking), 2,072 English-speaking, and 2,014 Spanish-speaking women eligible for breast cancer screening over the 4-year study period. In the year prior to implementation of the program, adjusted mammography rates were lower among refugee women (64.1 %, 95 % CI: 49–77 %) compared to English-speaking (76.5 %, 95 % CI: 69 %–83 %) and Spanish-speaking (85.2 %, 95 % CI: 79 %–90 %) women. By the end of 2011, screening rates increased in refugee women (81.2 %, 95 % CI: 72 %–88 %), and were similar to the rates in English-speaking (80.0 %, 95 % CI: 73 %–86 %) and Spanish-speaking (87.6 %, 95 % CI: 82 %–91 %) women. PN increased screening rates in both younger and older refugee women.

CONCLUSION

Linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East and Bosnia.
Literatur
1.
Zurück zum Zitat Deavenport A, Modeste N, Marshak HH, et al. Closing the gap in mammogram screening: an experimental intervention among low-income Hispanic women in community health clinics. Health Educ Behav. 2011;38(5):452–61.PubMedCrossRef Deavenport A, Modeste N, Marshak HH, et al. Closing the gap in mammogram screening: an experimental intervention among low-income Hispanic women in community health clinics. Health Educ Behav. 2011;38(5):452–61.PubMedCrossRef
2.
Zurück zum Zitat Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151(10):727–37.PubMedCrossRef Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151(10):727–37.PubMedCrossRef
3.
Zurück zum Zitat Cho YI, Johnson TP, Barrett RE, et al. Neighborhood changes in concentrated immigration and late stage breast cancer diagnosis. J Immigr Minor Health. 2010;13(1):9–14.CrossRef Cho YI, Johnson TP, Barrett RE, et al. Neighborhood changes in concentrated immigration and late stage breast cancer diagnosis. J Immigr Minor Health. 2010;13(1):9–14.CrossRef
4.
Zurück zum Zitat Dai D. Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place. 2010;16(5):1038–52.PubMedCrossRef Dai D. Black residential segregation, disparities in spatial access to health care facilities, and late-stage breast cancer diagnosis in metropolitan Detroit. Health Place. 2010;16(5):1038–52.PubMedCrossRef
5.
Zurück zum Zitat Bradley CJ, Given CW, Roberts C. Disparities in cancer diagnosis and survival. Cancer. 2001;91(1):178–88.PubMedCrossRef Bradley CJ, Given CW, Roberts C. Disparities in cancer diagnosis and survival. Cancer. 2001;91(1):178–88.PubMedCrossRef
6.
Zurück zum Zitat Flores G. Language barriers to health care in the United States. N Engl J Med. 2006;355(3):229–31.PubMedCrossRef Flores G. Language barriers to health care in the United States. N Engl J Med. 2006;355(3):229–31.PubMedCrossRef
7.
Zurück zum Zitat Goel MS, Wee CC, McCarthy EP, et al. Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care. J Gen Intern Med. 2003;18(12):1028–35. PMC1494963.PubMedCrossRef Goel MS, Wee CC, McCarthy EP, et al. Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care. J Gen Intern Med. 2003;18(12):1028–35. PMC1494963.PubMedCrossRef
8.
Zurück zum Zitat Kandula NR, Wen M, Jacobs EA, et al. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences or access to care? Cancer. 2006;107(1):184–92.PubMedCrossRef Kandula NR, Wen M, Jacobs EA, et al. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences or access to care? Cancer. 2006;107(1):184–92.PubMedCrossRef
9.
Zurück zum Zitat Porter P. “Westernizing” women’s risks? Breast cancer in lower-income countries. N Engl J Med. 2008;358(3):213–6.PubMedCrossRef Porter P. “Westernizing” women’s risks? Breast cancer in lower-income countries. N Engl J Med. 2008;358(3):213–6.PubMedCrossRef
11.
Zurück zum Zitat Barnes DM, Harrison CL. Refugee women’s reproductive health in early resettlement. J Obstet Gynecol Neonatal Nurs. 2004;33(6):723–8.PubMedCrossRef Barnes DM, Harrison CL. Refugee women’s reproductive health in early resettlement. J Obstet Gynecol Neonatal Nurs. 2004;33(6):723–8.PubMedCrossRef
12.
Zurück zum Zitat Dohan D, Levintova M. Barriers beyond words: cancer, culture, and translation in a community of Russian speakers. J Gen Intern Med. 2007;22(Suppl 2):300–5. PMC2078549.PubMedCrossRef Dohan D, Levintova M. Barriers beyond words: cancer, culture, and translation in a community of Russian speakers. J Gen Intern Med. 2007;22(Suppl 2):300–5. PMC2078549.PubMedCrossRef
13.
Zurück zum Zitat Carroll J, Epstein R, Fiscella K, et al. Knowledge and beliefs about health promotion and preventive health care among somali women in the United States. Health Care Women Int. 2007;28(4):360–80.PubMedCrossRef Carroll J, Epstein R, Fiscella K, et al. Knowledge and beliefs about health promotion and preventive health care among somali women in the United States. Health Care Women Int. 2007;28(4):360–80.PubMedCrossRef
14.
Zurück zum Zitat Kawar LN. Jordanian and Palestinian immigrant women’s knowledge, affect, cultural attitudes, health habits, and participation in breast cancer screening. Health Care Women Int. 2009;30(9):768–82.PubMedCrossRef Kawar LN. Jordanian and Palestinian immigrant women’s knowledge, affect, cultural attitudes, health habits, and participation in breast cancer screening. Health Care Women Int. 2009;30(9):768–82.PubMedCrossRef
15.
Zurück zum Zitat Kobetz E, Menard J, Barton B, et al. Barriers to breast cancer screening among Haitian immigrant women in Little Haiti, Miami. J Immigr Minor Health. 2010;12(4):520–6.PubMedCrossRef Kobetz E, Menard J, Barton B, et al. Barriers to breast cancer screening among Haitian immigrant women in Little Haiti, Miami. J Immigr Minor Health. 2010;12(4):520–6.PubMedCrossRef
16.
Zurück zum Zitat Koh C, Nelson JM, Cook PF. Evaluation of a patient navigation program. Clin J Oncol Nurs. 2011;15(1):41–8.PubMedCrossRef Koh C, Nelson JM, Cook PF. Evaluation of a patient navigation program. Clin J Oncol Nurs. 2011;15(1):41–8.PubMedCrossRef
17.
Zurück zum Zitat Ellis BH, MacDonald HZ, Lincoln AK, et al. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.PubMedCrossRef Ellis BH, MacDonald HZ, Lincoln AK, et al. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.PubMedCrossRef
18.
Zurück zum Zitat Wissink L, Jones-Webb R, DuBois D, et al. Improving health care provision to Somali refugee women. Minn Med. 2005;88(2):36–40.PubMed Wissink L, Jones-Webb R, DuBois D, et al. Improving health care provision to Somali refugee women. Minn Med. 2005;88(2):36–40.PubMed
19.
Zurück zum Zitat Shah SM, Ayash C, Pharaon NA, et al. Arab American immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health. 2008;10(5):429–36.PubMedCrossRef Shah SM, Ayash C, Pharaon NA, et al. Arab American immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health. 2008;10(5):429–36.PubMedCrossRef
21.
Zurück zum Zitat Freeman HP, Muth BJ, Kerner JF. Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract. 1995;3(1):19–30.PubMed Freeman HP, Muth BJ, Kerner JF. Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract. 1995;3(1):19–30.PubMed
22.
Zurück zum Zitat Paskett ED, Harrop JP, Wells KJ. Patient navigation: an update on the state of the science. CA Cancer J Clin. 2011;61(4):237–49.PubMedCrossRef Paskett ED, Harrop JP, Wells KJ. Patient navigation: an update on the state of the science. CA Cancer J Clin. 2011;61(4):237–49.PubMedCrossRef
23.
Zurück zum Zitat Phillips CE, Rothstein JD, Beaver K, et al. Patient navigation to increase mammography screening among inner city women. J Gen Intern Med. 2010;26(2):123–9.PubMedCrossRef Phillips CE, Rothstein JD, Beaver K, et al. Patient navigation to increase mammography screening among inner city women. J Gen Intern Med. 2010;26(2):123–9.PubMedCrossRef
24.
Zurück zum Zitat Robinson-White S, Conroy B, Slavish KH, et al. Patient navigation in breast cancer: a systematic review. Cancer Nurs. 2010;33(2):127–40.PubMedCrossRef Robinson-White S, Conroy B, Slavish KH, et al. Patient navigation in breast cancer: a systematic review. Cancer Nurs. 2010;33(2):127–40.PubMedCrossRef
25.
Zurück zum Zitat Wells KJ, Battaglia TA, Dudley DJ, et al. Patient navigation: state of the art or is it science? Cancer. 2008;113(8):1999–2010.PubMedCrossRef Wells KJ, Battaglia TA, Dudley DJ, et al. Patient navigation: state of the art or is it science? Cancer. 2008;113(8):1999–2010.PubMedCrossRef
26.
Zurück zum Zitat Percac-Lima S, Milosavljevic B, Oo SA, et al. Patient navigation to improve breast cancer screening in Bosnian refugees and immigrants. J Immigr Minor Health. 2012;14(4):727–30.PubMedCrossRef Percac-Lima S, Milosavljevic B, Oo SA, et al. Patient navigation to improve breast cancer screening in Bosnian refugees and immigrants. J Immigr Minor Health. 2012;14(4):727–30.PubMedCrossRef
28.
Zurück zum Zitat Donelan K, Mailhot JR, Dutwin D, et al. Patient perspectives of clinical care and patient navigation in follow-up of abnormal mammography. J Gen Intern Med. 2011;26(2):116–22. PMC3019311.PubMedCrossRef Donelan K, Mailhot JR, Dutwin D, et al. Patient perspectives of clinical care and patient navigation in follow-up of abnormal mammography. J Gen Intern Med. 2011;26(2):116–22. PMC3019311.PubMedCrossRef
29.
Zurück zum Zitat U. S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151(10):716–26. W-236.CrossRef U. S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151(10):716–26. W-236.CrossRef
30.
Zurück zum Zitat Murphy SN, Chueh HC. A security architecture for query tools used to access large biomedical databases. Proc AMIA Symp. 2002;552–6. PMC2244204. Murphy SN, Chueh HC. A security architecture for query tools used to access large biomedical databases. Proc AMIA Symp. 2002;552–6. PMC2244204.
31.
Zurück zum Zitat Dietrich AJ, Tobin JN, Cassells A, et al. Telephone care management to improve cancer screening among low-income women: a randomized, controlled trial. Ann Intern Med. 2006;144(8):563–71.PubMedCrossRef Dietrich AJ, Tobin JN, Cassells A, et al. Telephone care management to improve cancer screening among low-income women: a randomized, controlled trial. Ann Intern Med. 2006;144(8):563–71.PubMedCrossRef
32.
Zurück zum Zitat Saadi A, Bond B, Percac-Lima S. Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. J Immigr Minor Health. 2012;14(4):633–9.PubMedCrossRef Saadi A, Bond B, Percac-Lima S. Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. J Immigr Minor Health. 2012;14(4):633–9.PubMedCrossRef
Metadaten
Titel
Decreasing Disparities in Breast Cancer Screening in Refugee Women Using Culturally Tailored Patient Navigation
verfasst von
Sanja Percac-Lima, MD, PHD
Jeffrey M. Ashburner, MPH
Barbara Bond, LICSW, EdD
Sarah A. Oo, MSW
Steven J. Atlas, MD, MPH
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 11/2013
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-013-2491-4

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