Barriers to breast cancer prevention of socioeconomically disadvantaged and minority women

Barriers to implementing a breast cancer awareness program with a focus on primary, secondary and tertiary prevention are related to the socioeconomical, cultural and environmental determinants of health in a community. Lower socioeconomic status is related to poorer health and shorter life expectancy due partly to an association with unhealthy lifestyle behaviours such as smoking, drinking, physical inactivity and eating an unhealthy diet. Women of lower socioeconomic status, and ethnic and minority women are more vulnerable and have more barriers to quality preventative programs and to healthcare in general (Ahmed, & Shahid, 2012).

Barriers may include the vulnerable group’s cultural attitudes, beliefs and health practices. Vulnerable women often do not seek out health care until they have pain because of their lack of knowledge on the importance of preventative care or early detection. Attending educational classes on breast cancer prevention may seem unimportant to them in relation to their other obligations (family or work), they may fear learning about cancer, the diagnosis and the treatment, and they may fear and mistrust the health care system itself. As well, there may also be inadequate health policies related to breast cancer and breast cancer prevention and awareness programs (Ilaboya, Gibson, & Musoke, 2018).

Other barriers may include insufficient facilities with knowledgeable and trained healthcare personnel to provide the interventions, lack of cancer support groups, and lack of knowledge by the target population and the community about available breast cancer prevention programs and lack of funding for programs (Joffe, et al., 2018).

Still other barriers may include language and literacy difficulties to implementation of programs and distance from facilities (Ahmed & Shahid, 2012).

Strategies

Overcoming these barriers may be difficult but there are interventions and strategies that may provide solutions. Taking cultural beliefs and attitudes into consideration and including the target population and community when formulating intervention programs could improve participation and make the programs more culturally acceptable. Communicating with private, public and volunteer cancer awareness organizations to enlist them in educational programs and support groups could help with funding and make the programs more successful, providing the target population with psychosocial support. Ensuring that clear public policy on breast cancer prevention and screening programs is available throughout all Canadian communities could equalize some of the health disparities (Ahmed & Shahid, 2012).

To overcome language and literacy barriers, outreach programs with ethnically diverse and specially trained healthcare workers could be used to contact the target population individually at home to explain about the programs and to encourage participation, and then to make telephone calls as reminders (Harkins, et al., 2010).

Finally, to improve access to healthcare services, screening programs and educational activities, interventions could be implemented such as; amending hours of operation to better meet the needs of the participants, providing services (educational sessions, physical activity programs, and mobile mammography vans) in various locations (community centres, sports centres, schools, church halls) to reduce the distance for participants and to ensure better compliance (The Community Preventive Services Task Force (CPSTF), n. d.).

Elizabeth

References

Ahmed, S., & Shahid, R. K. (2012). Disparity in cancer care: a Canadian perspective. Current Oncology, 19(6). Retrieved from https://current-oncology.com/index.php/oncology/article/view/1177/1066

Harkins, C., Shaw, R., Gillies, M., Sloan, H., MacIntyre, K., Scoular, A., Morrison, C., MacKay, F., Cunningham, H., Docherty, P., Paul MacIntyre, P., & Findlay, I. N. (2010). Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study. BMC Public Health, 10(391). Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-10-391

Ilaboya, D., Gibson, L., & Musoke, D. (2018). Perceived barriers to early detection of breast cancer in Wakiso District, Uganda using a socioecological approach. Globalization and Health, 14(9). Retrieved from https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0326-0

Joffe, M., Ayeni, O., Norris, S. A., McCormack, V. A., Ruff, P., Das, I., … Cubasch, H. (2018). Barriers to early presentation of breast cancer among women in Soweto, South Africa. PloS one, 13(2), e0192071. doi:10.1371/journal.pone.0192071 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796726/

The Community Preventive Services Task Force (CPSTF). (n. d.). Cancer screening: Reducing structural barriers for clients – breast cancer. The Community Guide. Retrieved from https://www.thecommunityguide.org/findings/cancer-screening-reducing-structural-barriers-clients-breast-cancer