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Disparities in cervical cancer in Black women: patient-perceived discrimination as a barrier to follow up care after an abnormal pap smear
Dissertation   Open access

Disparities in cervical cancer in Black women: patient-perceived discrimination as a barrier to follow up care after an abnormal pap smear

Kristin Williams
Doctor of Health Science (D.H.Sc.), Drexel University
May 2022
DOI:
https://doi.org/10.17918/00001510
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Abstract

Patient compliance Cervix uteri--Cancer Physician and patient Race discrimination Discrimination in medical care Outcome assessment (Medical care)
Background- Black women are two times more likely to die from cervical cancer than White women, despite Black women having higher cervical screening rates than White women. One of the factors contributing to the racial disparity in cervical cancer mortality has been Black women's decreased likelihood to adhere to medical recommendations for follow-up after an abnormal Pap smear. Over the past decade, there has been attention placed on clinical provider implicit bias as a contributing factor to racial disparities that exist within healthcare. Though implicit bias has been recognized as a barrier to adherence to medical recommendations, there have been no studies to date that have explored patient perceived experiences of provider bias as a possible factor in adherence to follow-up recommendations after an abnormal Pap smear for Black women. Methods- A cross-sectional study design was used to determine a significant predictive relationship between perceived discrimination and intention to follow-up after an abnormal Pap smear among black women in comparison to other races. Seven predictors of discrimination along with intention to follow-up after an abnormal Pap smear were measured via survey. Results- 250 subjects were surveyed to capture their experiences of patient-perceived discrimination and their intention to follow-up after an abnormal Pap smear result. Black women did not indicate a significant relationship between patient perceived discrimination and intention to follow-up after an abnormal Pap smear when compared to other races. Conclusion- Despite results, Black women still continue to experience a disparity in cervical cancer outcomes, with literature supporting a decrease in follow-up after an abnormal Pap smear. Additional studies should be conducted to explore the role that patient perceived discrimination plays in patient follow-up after an abnormal Pap smear result.

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