Screening Mammography Follow-Up for Women with Disabilities

Grant #: Research Grant
PI Name: Yankaskas B
Title: Screening Mammography Follow-Up for Women with Disabilities
Institute: Susan G. Komen Breast Cancer Foundation

Background. To date, no study has examined women with disabilities who have been screened for breast cancer and not returned, or what changes would facilitate their return to screening.

Objective. The goal of this pilot study is to develop and test a method to identify women of screening age with physical and sensory disabilities and a questionnaire to identify amenable-to-change barriers in screening mammography for these women.

Specific Aims. 1. Estimate what proportion of women with disabilities, who have not returned for screening mammography in ≥ 3 years, can be identified and will volunteer to participate in a survey on their experience with screening. 2. Identify the barriers to remaining in screening for women with disabilities. 3. Identify specific practice-level interventions that will reduce the likelihood that women with disabilities will be lost to screening. 4. Estimate the proportion of women who participate in our survey who will agree to participate in a long term study of screening mammography in women with disabilities.

Study Design. The study will identify potential participants from the Carolina Mammography Registry (CMR), a community-based screening mammography project. Phase I will sample 11,000 eligible women from 10 randomly selected CMR practices to identify women with disabilities. Included women will not have had mammography for ≥ 3 years prior to the study period. Phase II will include focus groups to inform design of a questionnaire to be sent to participants who were identified in Phase 1. The questionnaire will be pre-tested with input from stake holders (radiologists, technologists, eligible women, and researchers). The investigators will use state-of-the-art methods in all phases of the project, including an introductory letter, incentives, and follow-up mailings to non-respondents. Data will be analyzed using complex survey design methods appropriate for these types of data. Results will be compared to literature on women without disabilities. Feedback will be provided to relevant patient and professional stake holders.

Potential Outcomes and Benefits. The investigators will learn if they can identify women with disabilities who have ceased screening and learn what interventions may return them to screening. A larger study will be planned to improve conditions problematic for women with disabilities. The goal is to improve return rates to screening mammography for this population.