Understanding & Enhancing Women with Disabilities' Use of Cancer Screening

Background: The impact of cancer screening on the reduction of cancer disparities is well-documented. Yet, accessibility of these services is woefully inadequate for women with disabilities. Women with significant disabilities are 57% less likely to receive Pap tests and 56% less like to receive mammograms compared to their non-disabled peers. There is a critical need to understand the root causes of these disparities and redress them through targeted programs. Patient navigation programs have been used successfully to reduce disparities in a variety of underserved communities. The patient navigator model has not been implemented to meet the needs of people with disabilities; in spite of community identified needs for strategies to help overcome the myriad barriers to care. Women with disabilities may benefit from well-targeted patient navigator services. Specific Aims Aim 1: Compare cancer screening rates between women with and without disabilities while adjusting for individual traits (race/ethnicity, age, and socioeconomic status) and social factors (access to health care, urbanicity, and social support) using data from the 2008 and 2010 Behavioral Risk Factor Surveillance Study. Aim 2: Identify financial, structural, physical and cognitive barriers to breast and cervical cancer screening experienced by women with disabilities. Aim 3: Develop a community-driven patient navigator model to enhance cancer screening aong women with disabilities. Study Design: This study will use a mixed methods community-based participatory research approach. Aim 1: We will conduct a secondary analysis of the 2008 and 2010 Illinois BRFSS to evaluate the contribution of individual traits and social factors on disparities in disabled women’s use of breast and cervical cancer screening. Aim 2: We will conduct focus groups with 90 women with disabilities to examine barriers to cancer screening. Findings will be presented to stakeholders in a town hall setting. Aim 3: We will convene a working group of consumer advocates (women with disabilities), disability health care researchers, and experts in patient navigation to develop a community-driven model of patient navigation that addresses the needs of women with disabilities. Relevance to Cancer: This proposal addresses disparities in cervical and breast cancer screening