Logo image
Back
Racial and ethnic disparities in mammogram frequency among women with intellectual disabilities: an exploratory mixed methods approach
Dissertation   Open access

Racial and ethnic disparities in mammogram frequency among women with intellectual disabilities: an exploratory mixed methods approach

Evelyn Arana
Doctor of Public Health (Dr.P.H.), Drexel University
Dec 2017
DOI:
https://doi.org/10.17918/etd-7718
pdf
Arana_Evelyn_20171.16 MBDownloadView
PDF Open Access Open Access (License Unspecified)

Abstract

Breast--Cancer Health services accessibility Women's health services People with mental disabilities Public Health
Background: Women with intellectual disabilities (ID) have fewer mammograms compared to women without ID and are diagnosed with breast cancer at later stages. Little information exists on the impact of having an ID and being a member of a racial/ethnic minority group on mammography. This study examined the relationship between mammogram frequency and race/ethnicity among women with ID. Methods: This study used a mixed methods design to explore relationships between mammogram frequency and race/ethnicity among women with ID. Data came from mammogram medical records and in-depth interviews. Mammogram medical record data was collected from years 2010-2013 from a sample of 95 participants. Interviews were conducted in person with a sub-sample of 30 participants, including the women themselves or their caregiver. Multinomial logistic regression was used to model the relationship of mammogram frequency and race/ethnicity while holding possible confounders constant. Qualitative data was analyzed using thematic analysis in Atlas.ti. Results: A total of 95 individuals participated in the study. Participants who live in a state-funded residence, are over age 50 and have a mild or moderate ID impairment are more likely to undergo mammography compared to participants living with family or alone, are 50 years or less, and have a severe ID impairment. Non-Hispanic Black (NHB) women with ID were more likely than non-Hispanic White women with ID to be screened at least biennially than insufficiently. From the qualitative data, the most prominent barriers reported by participants included less health coordination support and lack of accessible mammogram machines. Reported facilitators included having positive mammogram attitudes and receiving support from healthcare professionals. Conclusions: This study provides evidence that mammogram disparities exist among women with ID, which should be explored further in a larger sample. This study highlights the need to implement care coordination services for women with ID who live with family or alone. These results may be considered when planning interventions to enhance the quality of healthcare for this population. Funding: This project was supported by grant number R36HS023966 from the Agency for Healthcare Research and Quality (AHRQ) Health Services Dissertation Grant.

Metrics

37 File views/ downloads
49 Record Views

Details

Logo image