Identifying Local Facilitators and Barriers to Screening Mammography Within a Rural Acute Care Hospital Service Area

Area of Science:

• Public Health
• Oncology
• Rural Health Disparities

Background:

• Rural women experience higher rates of advanced-stage breast cancer diagnosis compared to urban women.
• Lower mammogram screening rates are a potential contributing factor to late-stage diagnosis in rural populations.
• This study investigates factors influencing mammogram screening decisions in a rural Wisconsin community.

Purpose of the Study:

• To identify facilitators and barriers to mammogram screening among women in a rural area.
• To understand the decision-making process for mammogram screening in this demographic.
• To inform strategies for improving breast cancer screening rates in rural settings.

Main Methods:

• An observational, cross-sectional, mixed-methods study was conducted.
• Data were collected through virtual interviews with hospital staff, virtual focus groups with community members, and surveys of women aged 40 and older.
• Qualitative data were analyzed for themes, and survey responses were reported descriptively.

Main Results:

• Hospital staff and community members identified similar facilitators (e.g., clinician recommendation) and barriers (e.g., insurance concerns).
• Among 282 survey respondents, the primary reasons for initial mammograms were doctor recommendation (70%), family history (19%), and personal decision (18%).
• Top reasons for not screening annually included procrastination (23%), perceived lack of problems (17%), and pandemic-related issues (15%).

Conclusions:

• Enhancing patient education and supporting clinician screening recommendations can improve mammogram uptake.
• Future research should prioritize engaging women who are not currently connected with the healthcare system.
• Addressing insurance barriers and procrastination are crucial for increasing rural breast cancer screening rates.