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22.10.2018 | Original Research

A Qualitative Study of Spanish-Speakers’ Experience with Dense Breast Notifications in a Massachusetts Safety-Net Hospital

verfasst von: Christine M. Gunn, PhD, Amy Fitzpatrick, MD, Sarah Waugh, MPH, Michelle Carrera, BA, Nancy R. Kressin, PhD, Michael K. Paasche-Orlow, MD, MPH, Tracy A. Battaglia, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 2/2019

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Abstract

Background

Legislation requiring mammography facilities to notify women if they have dense breast tissue found on mammography has been enacted in 34 US states. The impact of dense breast notifications (DBNs) on women with limited English proficiency (LEP) is unknown.

Objective

This study sought to understand Spanish-speaking women’s experience receiving DBNs in a Massachusetts safety-net hospital.

Design

Eligible women completed one audio-recorded, semi-structured interview via telephone with a native Spanish-speaking research assistant trained in qualitative methods. Interviews were professionally transcribed verbatim and translated. The translation was verified by a third reviewer to ensure fidelity with audio recordings.

Participants

Nineteen Spanish-speaking women ages 40–74 who received mammography with a normal result and recalled receiving a DBN.

Approach

Using the verified English transcripts, we conducted a content analysis to identify women’s perceptions and actions related to receiving the notification. A structured codebook was developed. Transcripts were independently coded and assessed for agreement with a modification of Cohen’s kappa. Content codes were grouped to build themes related to women’s perceptions and actions after receiving a DBN.

Key Results

Nineteen Spanish-speaking women completed interviews. Nine reported not receiving the notification in their native language. Four key themes emerged: (1) The novelty of breast density contributed to notification-induced confusion; (2) women misinterpreted key messages in the notification; (3) varied actions were taken to seek further information; and (4) women held unrealized expectations and preferences for follow-up.

Conclusions

Not having previous knowledge of breast density and receiving notifications in English contributed to confusion about its meaning and inaccurate interpretations of key messages by Spanish speakers. Tools that promote understanding should be leveraged in seeking equity in risk-based breast cancer screening for women with dense breasts.

Williams KP, Templin TN, Hines RD. Answering the call: a tool that measures functional breast cancer literacy. J Health Commun. 2013;18(11):1310–25. https://doi.org/10.1080/10810730.2013.778367 CrossRefPubMed

Elder JP, Ayala GX, Parra-Medina D, Talavera GA. Health communication in the Latino community: issues and approaches. Ann Rev Public Health. 2009;30:227–51. https://doi.org/10.1146/annurev.publhealth.031308.100300 CrossRef

Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826–34. https://doi.org/10.1097/MLR.0b013e31819a5acc CrossRefPubMed

Karliner LS, Ma L, Hofmann M, Kerlikowske K. Language barriers, location of care, and delays in follow-up of abnormal mammograms. Med Care. 2012;50(2):171–8. https://doi.org/10.1097/MLR.0b013e31822dcf2d CrossRefPubMedPubMedCentral

Calderón JL, Beltrán RA. Pitfalls in Health Communication: Healthcare Policy, Institution, Structure, & Process. Medscape Gen Med. 2004;6(1):9.

Diamond LC, Wilson-Stronks A, Jacobs EA. Do hospitals measure up to the national culturally and linguistically appropriate services standards? Med Care. 2010;48(12):1080–7. https://doi.org/10.1097/MLR.0b013e3181f380bc CrossRefPubMed

National Standards on Culturally and Linguistically Appropriate Services (CLAS) in Health Care. U.S. Department of Health and Human Services Office of the Secretary; 2000. p. 80865–79.

Estrada RD, Messias DK. A Scoping Review of the Literature: Content, Focus, Conceptualization and Application of the National Standards for Culturally and Linguistically Appropriate Services in Health Care. J Health Care Poor Underserved. 2015;26(4):1089–109. https://doi.org/10.1353/hpu.2015.0134 CrossRefPubMed

Liang L, Brach C. Health Literacy Universal Precautions Are Still a Distant Dream: Analysis of U.S. Data on Health Literate Practices. Health Lit Res Pract. 2017;1(4):e216-e30.CrossRefPubMedPubMedCentral

10.

Dense Breast Info, Inc. 2017. http://densebreast-info.org/legislation.aspx#. Accessed May 30, 2017.

11.

Melnikow J, Fenton JJ, Whitlock EP, Miglioretti DL, Weyrich MS, Thompson JH, et al. Supplemental Screening for Breast Cancer in Women With Dense Breasts: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2016;164(4):268–78. https://doi.org/10.7326/M15-1789 CrossRefPubMedPubMedCentral

12.

Sprague BL, Stout NK, Schechter C, van Ravesteyn NT, Cevik M, Alagoz O, et al. Benefits, Harms, and Cost-Effectiveness of Supplemental Ultrasonography Screening for Women With Dense BreastsSupplemental Ultrasonography Screening for Women With Dense Breasts. Ann Int Med. 2015;162(3):157–66. https://doi.org/10.7326/M14-0692 CrossRefPubMed

13.

Freer P, Slanetz P, Haas J, Tung N, Hughes K, Armstrong K, et al. Breast cancer screening in the era of density notification legislation: summary of 2014 Massachusetts experience and suggestion of an evidence-based management algorithm by multi-disciplinary expert panel. Breast Cancer Res Treat. 2015;153(2):455–64. https://doi.org/10.1007/s10549-015-3534-9 CrossRefPubMedPubMedCentral

14.

Price ER, Hargreaves J, Lipson JA, Sickles EA, Brenner RJ, Lindfors KK, et al. The California Breast Density Information Group: A Collaborative Response to the Issues of Breast Density, Breast Cancer Risk, and Breast Density Notification Legislation. Radiology. 2013;269(3):887–92. https://doi.org/10.1148/radiol.13131217 CrossRefPubMed

15.

Charles C, Gafni A, Whelan T. Shared Decision-Making in the Medical Encounter: What does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681–92.CrossRefPubMed

16.

Marcus EN, Sanders LM, Pereyra M, Del Toro Y, Romilly AP, Yepes M, et al. Mammography result notification letters: are they easy to read and understand? J Women’s Health. 2011;20(4):545–51. https://doi.org/10.1089/jwh.2010.2330 CrossRef

17.

Marcus E, Koru-Sengul T, Miao F, Yepes M, Sanders L. How do breast imaging centers communicate results to women with limited English proficiency and other barriers to care? J Immigr Minor Health. 2014;16(3):401–8. https://doi.org/10.1007/s10903-012-9771-7 CrossRefPubMedPubMedCentral

18.

Derose KP, Baker DW. Limited English proficiency and Latinos’ use of physician services. Med Care Res Rev. 2000;57(1):76–91. https://doi.org/10.1177/107755870005700105 CrossRefPubMed

19.

Karliner LS, Kaplan C, Juarbe T, Pasick R, Perez-Stable EJ. Poor patient comprehension of abnormal mammography results. J Gen Intern Med. 2005;20(5):432–7. https://doi.org/10.1111/j.1525-1497.2005.40281.x CrossRefPubMedPubMedCentral

20.

Gunn C, Battaglia T, Paasche-Orlow M, West A, Kressin N. Women’s Perceptions of Dense Breast Notifications: “So what is that supposed to mean?”. Patient Educ Couns. 2018 (in press).

21.

Rhodes DJ, Radecki Breitkopf C, Ziegenfuss JY, Jenkins SM, Vachon CM. Awareness of breast density and its impact on breast cancer detection and risk. J Clin Oncol. 2015;33(10):1143–50. https://doi.org/10.1200/jco.2014.57.0325 CrossRefPubMedPubMedCentral

22.

Rosenstock IM. Why People Use Health Services. Milbank Mem Fund Q. 1966;44(3):94–127. https://doi.org/10.2307/3348967 CrossRef

23.

Becker M. The health belief model and personal health behavior Thorofare: CB Slack; 1974.

24.

MAXQDA, software for qualitative data analysis. Berlin, Germany: VERBI Software - Consult - Sozialforschung GmbH; 1989–2018.

25.

Ando H, Cousins R, Young C. Achieving saturation in thematic analysis: development and refinement of a codebook. Compr Psychol. 2014;3(4):1–7.

26.

Burla L, Knierim B, Barth J, Liewald K, Duetz M, Abel T. From Text to Codings: Intercoder Reliability Assessment in Qualitative Content Analysis. Nurs Res. 2008;57(2):113–7.CrossRefPubMed

27.

Eccleston P, Werneke U, Armon K, Stephenson T, MacFaul R. Accounting for overlap? An application of Mezzich’s κ statistic to test interrater reliability of interview data on parental accident and emergency attendance. J Adv Nurs. 2001;33(6):784–90. https://doi.org/10.1046/j.1365-2648.2001.01718.x CrossRefPubMed

28.

Klinger EV, Carlini SV, Gonzalez I, Hubert SS, Linder JA, Rigotti NA, et al. Accuracy of race, ethnicity, and language preference in an electronic health record. J Gen Intern Med. 2015;30(6):719–23. https://doi.org/10.1007/s11606-014-3102-8 CrossRefPubMed

29.

Hasnain-Wynia R, Baker DW. Obtaining Data on Patient Race, Ethnicity, and Primary Language in Health Care Organizations: Current Challenges and Proposed Solutions. Health Serv Res. 2006;41(4 Pt 1):1501–18. https://doi.org/10.1111/j.1475-6773.2006.00552.x CrossRefPubMedPubMedCentral

30.

Wynia MK, Ivey SL, Hasnain-Wynia R. Collection of Data on Patients’ Race and Ethnic Group by Physician Practices. N Engl J Med. 2010;362(9):846–50. https://doi.org/10.1056/NEJMsb0910799 CrossRefPubMed

31.

Daniel L. Improving the Delivery of Care to Limited English Proficiency Patients. JOGNN. 2015;44:S6-S40.CrossRef

32.

Jorgensen S, Thorlby R, Weinick R, Ayanian J. Responses of Massachusetts hospitals to a state mandate to collect race, ethnicity and language data from patients: a qualitative study. BMC Health Serv Res. 2010;10:352.CrossRefPubMedPubMedCentral

33.

Gunn C, Battaglia T, Paasche-Orlow M, West A, Kressin N. Women’s Perceptions of Dense Breast Notifications: “So what is that supposed to mean?”. Patient Educ Couns. 2018;101(6):1123–9. https://doi.org/10.1016/j.pec.2018.01.017 CrossRefPubMed

34.

Kressin N, Gunn C, Battaglia T. Content, Readability, and Understandability of Dense Breast Notifications by State JAMA. 2016;315(16):1786–7.CrossRefPubMed

35.

Schmidt E, Schopf AC, Farin E. What is competent communication behaviour of patients in physician consultations? - Chronically-ill patients answer in focus groups. Psychol Health Med. 2017;22(8):987–1000. https://doi.org/10.1080/13548506.2016.1248450 CrossRefPubMed

36.

Elder JP, Ayala GX, Campbell NR, Slymen D, Lopez-Madurga ET, Engelberg M, et al. Interpersonal and print nutrition communication for a Spanish-dominant Latino population: Secretos de la Buena Vida. Health Psychol. 2005;24(1):49–57. https://doi.org/10.1037/0278-6133.24.1.49 CrossRefPubMed

37.

Heinrich C, Karner K. Ways to optimize understanding health related information: the patients’ perspective. Geriatr Nurs. 2011;32(1):29–38. https://doi.org/10.1016/j.gerinurse.2010.09.001 CrossRefPubMed

38.

O’Neill SC, Leventhal KG, Scarles M, Evans CN, Makariou E, Pien E, et al. Mammographic Breast Density as a Risk Factor for Breast Cancer: Awareness in a Recently Screened Clinical Sample. Women’s Health Issues. 2014;24(3):e321–e6. https://doi.org/10.1016/j.whi.2014.02.005 CrossRefPubMedPubMedCentral

39.

Orom H, Kiviniemi MT, Underwood W, Ross L, Shavers VL. Perceived Cancer Risk: Why Is It Lower Among Nonwhites than Whites? Cancer Epidemiol Biomark Prev. 2010;19(3):746–54. https://doi.org/10.1158/1055-9965.epi-09-1085 CrossRef

40.

Trinh L, Ikeda DM, Miyake KK, Trinh J, Lee KK, Dave H, et al. Patient awareness of breast density and interest in supplemental screening tests: comparison of an academic facility and a county hospital. J Am Coll Radiol. 2015;12(3):249–55. https://doi.org/10.1016/j.jacr.2014.10.027 CrossRefPubMed

41.

Manning M, Purrington K, Penner L, Duric N, Albrecht TL. Between-race differences in the effects of breast density information and information about new imaging technology on breast-health decision-making. Patient Educ Couns. 2016;99(6):1002–10. https://doi.org/10.1016/j.pec.2016.01.010 CrossRefPubMedPubMedCentral

42.

Anderson EE, Hoskins KJ. Individual Breast Cancer Risk Assessment in Underserved Populations: Integrating Empirical Bioethics and Health Disparities Research. J Health Care Poor Underserved. 2012;23(4):34–46.CrossRefPubMed

43.

Yabroff RK, Zapka J, Klabunde CN, Yuan G, Buckman DW, Haggstrom D, et al. "Systems Strategies to Support Cancer Screening in U.S. Primary Care Practice." Cancer Epidemiol Biomakers Prev. 2011;20(12):2471–2479.

44.

Schrager S and Burnside E. "Breast Cancer Screening in Primary Care: A Call for Development and Validation of Patient-Oriented Shared Decision-Making Tools." J Women's Health. 2018. https://doi.org/10.1089/jwh.2017.6775

45.

Horny M, Cohen AB, Duszak R, Jr., Christiansen CL, Shwartz M, Burgess JF, Jr. Dense Breast Notification Laws: Impact on Downstream Imaging After Screening Mammography. Med Care Res Rev. 2018:1077558717751941. https://doi.org/10.1177/1077558717751941

Titel: A Qualitative Study of Spanish-Speakers’ Experience with Dense Breast Notifications in a Massachusetts Safety-Net Hospital
verfasst von: Christine M. Gunn, PhD
Amy Fitzpatrick, MD
Sarah Waugh, MPH
Michelle Carrera, BA
Nancy R. Kressin, PhD
Michael K. Paasche-Orlow, MD, MPH
Tracy A. Battaglia, MD, MPH
Publikationsdatum: 22.10.2018
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 2/2019
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-018-4709-y

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A Qualitative Study of Spanish-Speakers’ Experience with Dense Breast Notifications in a Massachusetts Safety-Net Hospital

Abstract

Background

Objective

Design

Participants

Approach

Key Results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Background

Objective

Design

Participants

Approach

Key Results

Conclusions

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