Breast Cancer Screening Guidelines Based on the Woman’s Education, Income, and Insurance
thesisposted on 11.06.2014, 00:00 authored by Yolanda A. Coleman
Women who have less than a high school education, who are low- income, or have no health insurance are the least likely to participate in a recent mammogram. A qualitative descriptive research design was used to interview physicians and advanced practice nurses to examine what guidelines and criteria were used to screen women of different education, income, and insurance statuses. The sample included 10 physicians and 10 advanced practice nurses from obstetrics and gynecology and family practice specialty. Five physicians were obstetricians/gynecologists, and five were family practice physicians. The advanced practice nurses include seven obstetrics/gynecology advanced practice nurses and three family practice nurses. Seven (70%) of the physicians reported using United States Preventive Services Task Force guidelines, while six (60%) of the advanced practice nurses reported using American Cancer Society’s guidelines. No response related to general criteria or personal judgment was reported by 50% of the sample. Fourteen (70%) of the 20 participants reported that they would not screen a woman differently based on education. Fourteen (70%) of the participants reported that they would refer and/or give resources to a woman who does not have any insurance. Eleven (55%) of the 20 participants reported that there was no difference in how they would screen low-income women compared to high-income women. The findings of this study indicate that healthcare providers used guidelines albeit different ones by physicians and the advanced practice nurses. The findings also indicate that healthcare providers do not screen women differently based on education and income. Healthcare providers need to realize that they have a key role in becoming more vigilant in increasing mammography utilization among less educated, low-income, and uninsured women.