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Related Concept Videos

Barriers to Effective Communication II01:21

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The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Barriers to Effective Communication I01:30

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A communication barrier is any distortion or interruption during a conversation, resulting in miscommunication of the message. A good communicator should know these barriers and continuously check for the listener's understanding by obtaining feedback.
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Barriers to the Equitable Implementation of Risk-Based Cervical Cancer Management Guidelines.

Cheryl R Clark1, Jacquelyn M Lykken2,3, Patricia M Chen2

  • 1Division of General Internal Medicine & Primary Care, Brigham and Women's Hospital, Boston, MA, USA. crclark@bwh.harvard.edu.

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This summary is machine-generated.

Many patients lack the cervical cancer screening history needed for risk-based management. This highlights potential inequities in care, particularly for those with insurance instability or without primary care access.

Keywords:
Cervical cancer screeningHealth equityPopulation health

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Area of Science:

  • Gynecologic Oncology
  • Public Health
  • Health Services Research

Background:

  • The 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines offer risk-based management for abnormal cervical cancer screening results.
  • It remains unclear if populations facing primary care inequities possess the necessary prior screening history to benefit from these risk-based management strategies.

Purpose of the Study:

  • To determine the prevalence and associations of unknown cervical cancer screening history among individuals with abnormal screening results.

Main Methods:

  • A retrospective, multi-center, population-based study was conducted across three diverse healthcare systems in Washington state, Massachusetts, and Dallas County, Texas.
  • Data included females aged 25-65 with an abnormal Pap cytology or positive Human Papillomavirus (HPV) test between 2010 and 2019 (n=63,739).
  • Unknown screening history was defined as missing or insufficient documentation in administrative data and electronic health records.

Main Results:

  • Over a third of patients (38.3%) had an unknown screening history prior to their abnormal test.
  • Patients with a primary care provider at the time of their abnormal test had a lower prevalence of unknown history (PR 0.74).
  • Uninsured individuals or those with multiple insurance transitions had a higher prevalence of unknown history compared to commercially insured patients (PR 1.13).

Conclusions:

  • Historical screening data essential for ASCCP risk-based guideline implementation were frequently absent in three large health systems.
  • These findings underscore the need to address potential management inequities for patients with missing data.
  • Barriers to primary care access require greater attention to ensure equitable cervical cancer surveillance and care delivery.