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Attitudes of Colorado health professionals toward breast and cervical cancer screening in Hispanic women.

Abstract A variety of economic, cultural, and communication barriers appear to be involved in breast and cervical cancer screening among Hispanic women. These barriers include culture-based embarrassment both for mammography and for Pap smears and fear and hopelessness concerning a diagnosis of cancer. Cost and access barriers are shared by low-income women from various ethnic and racial groups, as is a purported lack of physician referral. Hispanic women may have the latter problem enhanced by a language barrier between physicians and patients when the physicians do not speak or understand Spanish.
PMID
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Authors

Mayor MeshTerms

Attitude of Health Personnel

Health Knowledge, Attitudes, Practice

Hispanic Americans

Women's Health

Keywords
Journal Title journal of the national cancer institute. monographs
Publication Year Start




PMID- 8562228
OWN - NLM
STAT- MEDLINE
DA  - 19960301
DCOM- 19960301
LR  - 20151119
IS  - 1052-6773 (Print)
IS  - 1052-6773 (Linking)
IP  - 18
DP  - 1995
TI  - Attitudes of Colorado health professionals toward breast and cervical cancer
      screening in Hispanic women.
PG  - 95-100
AB  - BACKGROUND: A variety of economic, cultural, and communication barriers appear to
      be involved in breast and cervical cancer screening among Hispanic women. These
      barriers include culture-based embarrassment both for mammography and for Pap
      smears and fear and hopelessness concerning a diagnosis of cancer. Cost and
      access barriers are shared by low-income women from various ethnic and racial
      groups, as is a purported lack of physician referral. Hispanic women may have the
      latter problem enhanced by a language barrier between physicians and patients
      when the physicians do not speak or understand Spanish. PURPOSE: The goal of this
      project, conducted by the Cancer Education Division of the University of Colorado
      Cancer Center, has been to determine the attitudes and practices among health
      care providers in areas of Colorado with relatively large Hispanic populations
      (concerning screening mammography, clinical breast examination, breast
      self-examination, and Pap testing) and to design interventions to address any
      deficiencies or problems recognized. These studies were coordinated with
      telephone surveys and focus groups involving Hispanic women, directed by E.
      Flores in the Department of Sociology of the University of Colorado at Boulder
      and by C. Chrvala at the Colorado Department of Health. METHODS: Data were
      collected from 520 primary care physicians, nurses, and allied health personnel
      in 11 Colorado counties through focus groups and mailed questionnaires. Responses
      were analyzed by considering a variety of demographic characteristics of the
      respondents and by stratifying the associated practices by percent of Hispanic
      patients. RESULTS: The physicians involved in the focus groups and responding to 
      the questionnaires, as well as their associated nurses and other health care
      personnel, are generally familiar with the breast and cervical cancer-screening
      guidelines as developed and disseminated by several organizations, including the 
      National Cancer Institute and the American Cancer Society. Major barriers to
      screening Hispanic women, as perceived by these health care providers, appear to 
      be cost; lack of transportation, child care, and release from work; fear of
      diagnosis of cancer; patients considering the test unnecessary; discomfort; and
      embarrassment. The prompt use of colposcopy to evaluate patients whose Pap smears
      indicated dysplasia appeared less than optimal, especially among internists.
      CONCLUSIONS: Familiarity with guidelines for breast and cervical cancer screening
      is widespread among Colorado physicians and associated health care personnel,
      including those with high percentages of Hispanic patients in their practices.
      Increased continuing education efforts may be indicated concerning the
      application of colposcopy to the evaluation of women with abnormal Pap smears and
      concerning the application of computer technology to cancer-screening reminder
      systems. IMPLICATIONS: Educational approaches to primary care professionals may
      improve the effectiveness of breast and cervical cancer screening, although a
      variety of other approaches will also be necessary to decrease barriers to
      screening of Hispanic women.
FAU - Bakemeier, R F
AU  - Bakemeier RF
AD  - Department of Medicine, University of Colorado School of Medicine, Denver, USA.
FAU - Krebs, L U
AU  - Krebs LU
FAU - Murphy, J R
AU  - Murphy JR
FAU - Shen, Z
AU  - Shen Z
FAU - Ryals, T
AU  - Ryals T
LA  - eng
GR  - CA46934/CA/NCI NIH HHS/United States
GR  - CA52903/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Natl Cancer Inst Monogr
JT  - Journal of the National Cancer Institute. Monographs
JID - 9011255
SB  - IM
MH  - Adult
MH  - Aged
MH  - Allied Health Personnel/psychology
MH  - *Attitude of Health Personnel
MH  - Breast Neoplasms/ethnology/*prevention & control/psychology
MH  - Breast Self-Examination/psychology/statistics & numerical data
MH  - Colorado/epidemiology
MH  - Communication Barriers
MH  - Female
MH  - Focus Groups
MH  - *Health Knowledge, Attitudes, Practice
MH  - Health Promotion
MH  - Health Surveys
MH  - *Hispanic Americans/psychology
MH  - Humans
MH  - Male
MH  - Mammography/psychology/statistics & numerical data
MH  - Mass Screening/economics/*psychology/statistics & numerical data
MH  - Middle Aged
MH  - Nurses/psychology
MH  - Papanicolaou Test
MH  - Physical Examination/psychology/statistics & numerical data
MH  - Physicians/psychology
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/statistics & numerical data
MH  - Surveys and Questionnaires
MH  - Telephone
MH  - Uterine Cervical Neoplasms/ethnology/*prevention & control/psychology
MH  - Vaginal Smears/psychology/statistics & numerical data
MH  - *Women's Health
EDAT- 1995/01/01
MHDA- 1995/01/01 00:01
CRDT- 1995/01/01 00:00
PST - ppublish
SO  - J Natl Cancer Inst Monogr. 1995;(18):95-100.

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