Barriers to Cervical Cancer Screening and Satisfaction with Self-Sampling among Black Women in Michigan: a Mixed Methods Study
Main Article Content
Elizabeth Haro, MPH
http://orcid.org/0000-0003-3595-5432
Emma A. Butcher, MPH
http://orcid.org/0000-0002-3729-4159
Martha L Alves, MSW, MPH
http://orcid.org/0000-0001-6772-6306
Christelle El Khoury, MD
http://orcid.org/0000-0002-2562-4800
Alexandra Vinson, PhD
http://orcid.org/0000-0002-9062-7899
Diane M Harper, MD MPH MS
http://orcid.org/0000-0001-7648-883X
http://orcid.org/0000-0003-3595-5432
Emma A. Butcher, MPH
http://orcid.org/0000-0002-3729-4159
Martha L Alves, MSW, MPH
http://orcid.org/0000-0001-6772-6306
Christelle El Khoury, MD
http://orcid.org/0000-0002-2562-4800
Alexandra Vinson, PhD
http://orcid.org/0000-0002-9062-7899
Diane M Harper, MD MPH MS
http://orcid.org/0000-0001-7648-883X
Abstract
Background. In recent years, cervical cancer screening among Black women in the United States has declined, followed by increased incidence and mortality. We aim to evaluate the individual, sociocultural, and structural barriers to cervical cancer screening in relationship to the exam technique barriers.
Methods. Participants received cervical cancer self-screening kits in the mail. They returned their samples and a quantitative survey developed from the Health Information National Trends Survey (HINTS) modules designed to address the known individual, sociocultural, and structural barriers to screening. We established the fourteen attributes of cervical cancer screening techniques from prior work. Participants then shared their experiences in a semi-structured qualitative interview informed by the Theoretical Domains Framework (TDF) to explore the answers to the survey questions. We coded themes from the interviews. Women were grouped as younger (30-45 years) and older (46-65 years).
Results. Of the 41 women completing the study, 21 were in the younger age group (mean 37.3, SD 4.7), and 20 were in the older age group (56.5 (5.5)). All participants self-identified as African American/Black and were due for cervical cancer screening. Women indicated that individual, sociocultural, and structural barriers influenced their cervical cancer screening, but the most significant barrier was the speculum-based technique itself. Three positive attributes and eight negative attributes significantly differed by screening technique, favoring the self-screening technique.
Conclusions. The self-screening technique for screening for cervical cancer is feasible and acceptable to this group of Black women.
Keywords:
mixed methods, HINTS, Theoretical Domain Framework, Barriers to cervical cancer screening, patient preferences for physician characteristics, speculum exam, self-sampling for cervical cancer screening, African American, Black, women, under-screened, adult, HPV
Article Details
How to Cite
HARO, Elizabeth et al.
Barriers to Cervical Cancer Screening and Satisfaction with Self-Sampling among Black Women in Michigan: a Mixed Methods Study.
Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5209>. Date accessed: 21 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i4.5209.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Campbell MK, Hudson MA, Resnicow K, Blakeney N, Paxton A, Baskin M. Church-based health promotion interventions: evidence and lessons learned. Annu Rev Public Health. 2007;28:213-34. doi:10.1146/annurev.publhealth.28.021406.144016
3. Davis DT, Bustamante A, Brown CP, et al. The urban church and cancer control: a source of social influence in minority communities. Public Health Rep. Jul-Aug 1994;109(4):500-6.
4. Eng E, Hatch J, Callan A. Institutionalizing social support through the church and into the community. Health Educ Q. Spring 1985;12(1):81-92. doi:10.1177/109019818501200107
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11. Bellinger JD, Millegan W, Abdalla AE. "I'm not ashamed to talk on it!": African-American women's decisions about cervical cancer prevention and control in South Carolina. Womens Health Issues. Mar-Apr 2015;25(2):120-7. doi:10.1016/j.whi.2014.10.006
12. Blake SC, Andes K, Hilb L, et al. Facilitators and barriers to cervical cancer screening, diagnosis, and enrollment in Medicaid: experiences of Georgia's Women's Health Medicaid Program enrollees. J Cancer Educ. Mar 2015;30(1):45-52. doi:10.1007/s13187-014-0685-z
13. Nolan J, Renderos TB, Hynson J, et al. Barriers to cervical cancer screening and follow-up care among Black Women in Massachusetts. J Obstet Gynecol Neonatal Nurs. Sep-Oct 2014;43(5):580-588. doi:10.1111/1552-6909.12488
14. Sage SK, Hawkins-Taylor C, Crockett RA, Sr., Balls-Berry JE. "Girl, just pray ...": Factors That Influence Breast and Cervical Cancer Screening Among Black Women in Rochester, MN. J Natl Med Assoc. Oct 2020;112(5):454-467. doi:10.1016/j.jnma.2019.02.006
15. Matthews AK, Berrios N, Darnell JS, Calhoun E. A qualitative evaluation of a faith-based breast and cervical cancer screening intervention for African American women. Health Educ Behav. Oct 2006;33(5):643-63. doi:10.1177/1090198106288498
16. Agenor M, Bailey Z, Krieger N, Austin SB, Gottlieb BR. Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication. Women Health. 2015;55(6):717-36. doi:10.1080/03630242.2015.1039182
17. MDHHS Cervical Cancer Screening in Michigan. April 2019. . Accessed December 6, 2023, https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder3/Folder97/Folder2/Folder197/Folder1/Folder297/Cervical_Cancer.pdf?rev=7b233ce5134048f1985edb7c52f96542
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19. National Cancer Institute Health Information National Trends Survey: All HINTS Questions. Accessed December 6, 2023, https://hints.cancer.gov/view-questions/all-hints-questions.aspx
20. Thompson Burdine J, Thorne S, Sandhu G. Interpretive description: A flexible qualitative methodology for medical education research. Med Educ. Mar 2021;55(3):336-343. doi:10.1111/medu.14380
21. O'Donovan B, Mooney T, Rimmer B, et al. Advancing understanding of influences on cervical screening (non)-participation among younger and older women: A qualitative study using the theoretical domains framework and the COM-B model. Health Expect. Dec 2021;24(6):2023-2035. doi:10.1111/hex.13346
22. Phillips CJ, Marshall AP, Chaves NJ, et al. Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc. 2015;8:139-46. doi:10.2147/JMDH.S78458
23. Bahreini M, Safaie A, Mirfazaelian H, Jalili M. How much change in pain score does really matter to patients? Am J Emerg Med. Aug 2020;38(8):1641-1646. doi:10.1016/j.ajem.2019.158489
24. Kounali D, Button KS, Lewis G, et al. How much change is enough? Evidence from a longitudinal study on depression in UK primary care. Psychol Med. Jul 2022;52(10):1875-1882. doi:10.1017/S0033291720003700
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27. Hoyo C, Yarnall KS, Skinner CS, Moorman PG, Sellers D, Reid L. Pain predicts non-adherence to pap smear screening among middle-aged African American women. Prev Med. Aug 2005;41(2):439-45. doi:10.1016/j.ypmed.2004.11.021
28. Prather C, Fuller TR, Jeffries WLt, et al. Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity. Health Equity. 2018;2(1):249-259. doi:10.1089/heq.2017.0045
29. Coughlin SS, King J. Breast and cervical cancer screening among women in metropolitan areas of the United States by county-level commuting time to work and use of public transportation, 2004 and 2006. BMC Public Health. Mar 19 2010;10:146. doi:10.1186/1471-2458-10-146
30. Zeno EE, Brewer NT, Spees LP, et al. Racial and ethnic differences in cervical cancer screening barriers and intentions: The My Body My Test-3 HPV self-collection trial among under-screened, low-income women. PLoS One. 2022;17(10):e0274974. doi:10.1371/journal.pone.0274974
31. Dale HE, Polivka BJ, Chaudry RV, Simmonds GC. What young African American women want in a health care provider. Qual Health Res. Nov 2010;20(11):1484-90. doi:10.1177/1049732310374043
32. Anhang R, Goodman A, Goldie SJ. HPV communication: review of existing research and recommendations for patient education. CA Cancer J Clin. Sep-Oct 2004;54(5):248-59. doi:10.3322/canjclin.54.5.248
33. Scarinci IC, Litton AG, Garces-Palacio IC, Partridge EE, Castle PE. Acceptability and usability of self-collected sampling for HPV testing among African-American women living in the Mississippi Delta. Womens Health Issues. Mar-Apr 2013;23(2):e123-30. doi:10.1016/j.whi.2012.12.003
34. Brown DR, Wilson RM, Boothe MA, Harris CE. Cervical cancer screening among ethnically diverse black women: knowledge, attitudes, beliefs, and practices. J Natl Med Assoc. Aug 2011;103(8):719-28. doi:10.1016/s0027-9684(15)30411-9