Increasing Breast Health Access for Women With Disabilities
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Women with disabilities have been neglected in breast cancer statistics; national, state, and local screening initiatives; screening services; and education. To address these gaps, this project pursued 5 questions: (1) What is the prevalence of barriers to breast screening among women with physical disabilities? (2) Are these barriers, differences in types and seventy of functional limitation, and age and ethnicity associated with differences in screening utilization? (3) To what extent do the outreach, education, and service delivery strategies employed to date by the Breast Health Access for Women with Disabilities (BHAWD) coalition reduce barriers to screening? (4) What changes are needed in BHAWD strategies and in health policy to increase access to breast screening for women with disabilities? (5) What are the prospects for disseminating the BHAWD program to other California communities?
 
 
 
 
 
 
 
 Secondary analysis of the 1994 National Health Interview Survey and its Disability Followback found that over 19% of U.S. women age 20 and older have at least one physical limitation and that over 15 million have disabilities that complicate taking the actions involved in breast screening: mobility limitations that make it difficult to keep medical appointments are most common. Regardless of how disability was defined (Activities of Daily Living, Instrumental Activities of Daily Living, Functional Limitations, or having a mobility problem), the likelihood that women had had a clinical breast exam (CBE) and a mammogram (age 40+ only) within the last 2 years decreased as the number of their disabilities increased (p
 
 
 
 
 
 A local survey of 312 women with disabilities provided more detailed information about ways in which specific limitations impede access to breast screening and showed that screening utilization also is associated with attitudes, perceptions, and access issues related to screening rates in the general population. Despite these obstacles, within the past year 73% of the sample had had a CBE; 60% of women age 40+ had a mammogram, as had a surprising 53% of younger women. However, in both age groups, about 18% said that their last mammogram had been done because of a breast problem rather than as part of a routine check-up. Only 22% of the local women surveyed had heard of BHAWD and of these, just 43% had visited the BHAWD clinic: on average, these women had more disabilities than those who had never heard of BHAWD. 
 
 
 
 
 
 
 
 These and other data, including a collaborative assessment of lessons learned from the program's experience to date, informed BHAWD's strategic planning, leading to new initiatives and grant support. A survey of 45 disability and screening providers revealed few other activities to increase access to breast screening for women with disabilities in other California regions and considerable interest in the BHAWD program. Dissemination activities have been successfully initiated and further collaborative research is being planned.