How to Improve Uptake and Access to Breast Cancer Screening for Minority Ethnic Women in Leicester.
Introduction: The existing research in the UK indicates minority ethnic women are less likely than their White British counterparts to access the National Health Service Breast Cancer Screening Programme, (NHSBSP), and specific minority ethnic groups are more likely to experience the most aggressive forms of breast cancer with the poorest chances of survival. Despite, the absence of uptake data by ethnicity, certain factors prevalent in Leicester such as lower general uptake of the NHSBSP than in similar areas, one of the highest minority ethnic populations in the UK, and high levels of deprivation indicate uptake level of the NHSBSP for minority ethnic women will be low. Therefore, solutions to improving uptake should be developed from the perspectives of minority ethnic women. This PhD research aims to identify “how to improve the uptake and access to breast cancer screening for minority ethnic women in Leicester”. Methods – An interpretive research approach using qualitative data collection methods to explore factors influencing attendance and non – attendance at the NHSBSP from 47 years to 70 years of age. Focus groups with women from younger (40 – 55 years) and older age span (56 – 70 years) to explore barriers and solutions to attendance. Using Penchansky and Thomas (1981) model of the dimensions to accessing healthcare, both findings from interviews and focus groups were reviewed to explore how accessible the NHSBSP was for minority ethnic women. Penchansky and Thomas model of access to healthcare was used to assess how accessible the NHSBSP was for minority women from their response. Research Findings – Key themes that emerged from the participants that had attended the NHSBSP and those that had not attended. Knowledge and awareness of breast cancer was high, but knowledge of screening process was very low. Perceptions towards breast cancer changing to it being seen as treatable. Confusion over screening eligibility and pathways. Identification of multiple solutions and facilitators involving various stakeholders. The key similarities between the attending the and none attending women were the lack of knowledge of the screening process and eligibility criteria. The suggestion of wider stakeholders and especially from minority ethnic communities to be involved was from both groups of women. Some variation was identified on barriers across ethnicity as Black – African women were more likely than other groups.to identify previously experienced racist discrimination as a barrier to attendance. Whilst Bangladeshi and Pakistani women strongly challenged the view of religion as a barrier. A consensus emerged amongst attenders and none attenders of importance of using broader and targeted promotional interventions developed and delivered by stakeholders including community groups, ethnic media, GPs, breast clinics and local women living with breast cancer. The application of the access to healthcare model of Penchansky and Thomas demonstrated that the NHSBSP was not accessible to minority ethnic women, as it did not meet criteria for all dimensions of the model. Additionally, the model itself required a new dimension to incorporate findings on importance of strategic involvement of stakeholders. Conclusion: Improving uptake of the NHSBSP for minority ethnic women requires an acknowledgement that solutions can only be implemented by strategic partnerships consisting of multiple stakeholders identified by the participants of this research. There is also a need for producing more target – based interventions that address and inform the differing concerns of attendees and none attendees. The application of the Penchansky and Thomas model highlighted the need for an additional dimension of “audience”, to address requirements of the women to engage with and receive breast cancer information from broader stakeholders (audience). The Penchansky and Thomas model was amended with the incorporation of a newly developed dimension of “audience”.
Networked Digital Library of Theses and Dissertations