{"id":{"repo_id":"queens","oai_identifier":"oai:queensu.scholaris.ca:1974/34261"},"canonical_url":"https://search.dev.ndltd.org/etd/queens/oai:queensu.scholaris.ca:1974/34261","repository":{"repo_id":"queens","name":"Queens University","base_url":"https://qspace.library.queensu.ca/server/oai/request"},"display":{"title":"The impact of having intellectual or developmental disabilities on breast cancer treatment: A convergent mixed-methods study","abstract":"Background: People with intellectual or developmental disabilities (IDD) are more likely to die with and from breast cancer. Exploring how people living with IDD receive or do not receive guideline-recommended treatment for breast cancer can help inform strategies for improving patient-centred care. Methods: This mixed methods project includes three studies: (1) A population-based retrospective cohort study in Ontario among females diagnosed with breast cancer (2007- 2018) using routinely collected provincial health data comparing receipt of guideline-recommended treatment between people with IDD and those without these disabilities; (2) a second population-based retrospective cohort study exploring factors associated with receipt of guideline-recommended treatment among females with breast cancer and IDD; and (3) a critical realist case study exploring how one female breast cancer patient with IDD received guideline-recommended care using interviews and thematic analysis with a critical realist lens. Results of the three studies were integrated using joint display figures. Results: The largest cohort in the first study included 100,679 individuals with breast cancer; 369 individuals with IDD were identified. People with IDD were significantly less likely to receive guideline-recommended surgical resection, radiation, and chemotherapy. Females with breast cancer and IDD were more likely to receive mastectomy but less likely to receive breast conserving surgery than those without IDD. The largest cohort in the second objective included 365 females with IDD and breast cancer. Factors associated with receipt of guideline-recommended treatment included age, stage at diagnosis and consults, such as having a family interview. In objective 3, the female with IDD in the breast cancer case study received guideline-recommended care. Themes facilitating treatment included attitudes, relationships, access to shared-decision making and accommodations, and advocacy. Integration of the studies provided a deeper understanding into why individuals with IDD may be less likely to receive guideline-recommended breast cancer treatment. Conclusion: People with IDD experience guideline-recommended breast cancer treatment inequities relative to those without IDD. These findings can help us develop strategies that can target gaps in the patient-centred care delivered to breast cancer patients with IDD to improve the stark survival disparities experienced by this patient group.","abstract_html":"Background: People with intellectual or developmental disabilities (IDD) are more likely to die with and from breast cancer. Exploring how people living with IDD receive or do not receive guideline-recommended treatment for breast cancer can help inform strategies for improving patient-centred care. Methods: This mixed methods project includes three studies: (1) A population-based retrospective cohort study in Ontario among females diagnosed with breast cancer (2007- 2018) using routinely collected provincial health data comparing receipt of guideline-recommended treatment between people with IDD and those without these disabilities; (2) a second population-based retrospective cohort study exploring factors associated with receipt of guideline-recommended treatment among females with breast cancer and IDD; and (3) a critical realist case study exploring how one female breast cancer patient with IDD received guideline-recommended care using interviews and thematic analysis with a critical realist lens. Results of the three studies were integrated using joint display figures. Results: The largest cohort in the first study included 100,679 individuals with breast cancer; 369 individuals with IDD were identified. People with IDD were significantly less likely to receive guideline-recommended surgical resection, radiation, and chemotherapy. Females with breast cancer and IDD were more likely to receive mastectomy but less likely to receive breast conserving surgery than those without IDD. The largest cohort in the second objective included 365 females with IDD and breast cancer. Factors associated with receipt of guideline-recommended treatment included age, stage at diagnosis and consults, such as having a family interview. In objective 3, the female with IDD in the breast cancer case study received guideline-recommended care. Themes facilitating treatment included attitudes, relationships, access to shared-decision making and accommodations, and advocacy. Integration of the studies provided a deeper understanding into why individuals with IDD may be less likely to receive guideline-recommended breast cancer treatment. Conclusion: People with IDD experience guideline-recommended breast cancer treatment inequities relative to those without IDD. These findings can help us develop strategies that can target gaps in the patient-centred care delivered to breast cancer patients with IDD to improve the stark survival disparities experienced by this patient group.","abstract_has_math":false,"creators":["Hansford, Rebecca Lila Whelan"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":"Public Health Sciences","school":null,"contributors":[],"advisors":["Mahar, Alyson"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-01-09","date_published":"2025-01-09","updated_at":"2026-07-27T20:35:23Z","subjects":["intellectual or developmental disabilities","breast cancer treatment","health services research","convergent mixed methods study design"],"languages":["eng"],"rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"rights_urls":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/1974/34261","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.department","label":"Department","values":["Public Health Sciences"]},{"key":"dc:contributor.supervisor","label":"Supervisor","values":["Mahar, Alyson"]},{"key":"dc:creator","label":"Author","values":["Hansford, Rebecca Lila Whelan"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-01-09T14:45:15Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-01-09T14:45:15Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-01-09"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["intellectual or developmental disabilities","breast cancer treatment","health services research","convergent mixed methods study design"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Attribution-NonCommercial-NoDerivatives 4.0 International"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://creativecommons.org/licenses/by-nc-nd/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/1974/34261"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: People with intellectual or developmental disabilities (IDD) are more likely to die with and from breast cancer. Exploring how people living with IDD receive or do not receive guideline-recommended treatment for breast cancer can help inform strategies for improving patient-centred care. Methods: This mixed methods project includes three studies: (1) A population-based retrospective cohort study in Ontario among females diagnosed with breast cancer (2007- 2018) using routinely collected provincial health data comparing receipt of guideline-recommended treatment between people with IDD and those without these disabilities; (2) a second population-based retrospective cohort study exploring factors associated with receipt of guideline-recommended treatment among females with breast cancer and IDD; and (3) a critical realist case study exploring how one female breast cancer patient with IDD received guideline-recommended care using interviews and thematic analysis with a critical realist lens. Results of the three studies were integrated using joint display figures. Results: The largest cohort in the first study included 100,679 individuals with breast cancer; 369 individuals with IDD were identified. People with IDD were significantly less likely to receive guideline-recommended surgical resection, radiation, and chemotherapy. Females with breast cancer and IDD were more likely to receive mastectomy but less likely to receive breast conserving surgery than those without IDD. The largest cohort in the second objective included 365 females with IDD and breast cancer. Factors associated with receipt of guideline-recommended treatment included age, stage at diagnosis and consults, such as having a family interview. In objective 3, the female with IDD in the breast cancer case study received guideline-recommended care. Themes facilitating treatment included attitudes, relationships, access to shared-decision making and accommodations, and advocacy. Integration of the studies provided a deeper understanding into why individuals with IDD may be less likely to receive guideline-recommended breast cancer treatment. Conclusion: People with IDD experience guideline-recommended breast cancer treatment inequities relative to those without IDD. These findings can help us develop strategies that can target gaps in the patient-centred care delivered to breast cancer patients with IDD to improve the stark survival disparities experienced by this patient group."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["PhD"]},{"key":"dc:title","label":"Title","values":["The impact of having intellectual or developmental disabilities on breast cancer treatment: A convergent mixed-methods study"]}]}],"canonical_facts":{"dc:contributor.department":["Public Health Sciences"],"dc:contributor.supervisor":["Mahar, Alyson"],"dc:creator":["Hansford, Rebecca Lila Whelan"],"dc:date.accessioned":["2025-01-09T14:45:15Z"],"dc:date.available":["2025-01-09T14:45:15Z"],"dc:date.issued":["2025-01-09"],"dc:description.abstract":["Background: People with intellectual or developmental disabilities (IDD) are more likely to die with and from breast cancer. Exploring how people living with IDD receive or do not receive guideline-recommended treatment for breast cancer can help inform strategies for improving patient-centred care. Methods: This mixed methods project includes three studies: (1) A population-based retrospective cohort study in Ontario among females diagnosed with breast cancer (2007- 2018) using routinely collected provincial health data comparing receipt of guideline-recommended treatment between people with IDD and those without these disabilities; (2) a second population-based retrospective cohort study exploring factors associated with receipt of guideline-recommended treatment among females with breast cancer and IDD; and (3) a critical realist case study exploring how one female breast cancer patient with IDD received guideline-recommended care using interviews and thematic analysis with a critical realist lens. Results of the three studies were integrated using joint display figures. Results: The largest cohort in the first study included 100,679 individuals with breast cancer; 369 individuals with IDD were identified. People with IDD were significantly less likely to receive guideline-recommended surgical resection, radiation, and chemotherapy. Females with breast cancer and IDD were more likely to receive mastectomy but less likely to receive breast conserving surgery than those without IDD. The largest cohort in the second objective included 365 females with IDD and breast cancer. Factors associated with receipt of guideline-recommended treatment included age, stage at diagnosis and consults, such as having a family interview. In objective 3, the female with IDD in the breast cancer case study received guideline-recommended care. Themes facilitating treatment included attitudes, relationships, access to shared-decision making and accommodations, and advocacy. Integration of the studies provided a deeper understanding into why individuals with IDD may be less likely to receive guideline-recommended breast cancer treatment. Conclusion: People with IDD experience guideline-recommended breast cancer treatment inequities relative to those without IDD. These findings can help us develop strategies that can target gaps in the patient-centred care delivered to breast cancer patients with IDD to improve the stark survival disparities experienced by this patient group."],"dc:description.degree":["PhD"],"dc:identifier.uri":["https://hdl.handle.net/1974/34261"],"dc:language.iso":["eng"],"dc:rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"dc:rights.uri":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"dc:subject":["intellectual or developmental disabilities","breast cancer treatment","health services research","convergent mixed methods study design"],"dc:title":["The impact of having intellectual or developmental disabilities on breast cancer treatment: A convergent mixed-methods study"],"dc:type":["thesis"]},"updated_at":"2026-07-27T20:35:23Z"}