Date Presented 04/05/19
Women with disabilities receive mammograms at lower rates than nondisabled women, and research has shown that these lower rates have not changed over time. Little is known about the barriers women with disabilities face to mammography. This study illuminates the barriers to mammography that collaborative advocacy between OT practitioners and women with disabilities can address as IADLs, along with self-advocacy as intervention and outcome, to improve the health and well-being of women with disabilities.
Primary Author and Speaker: Sarah Mbiza
Additional Authors and Speakers: Barbara Kornblau, Debora Oliveira
PURPOSE: Women with disabilities often receive mammograms at lower rates than nondisabled women, and research based on National Health Inventory Survey (NHIS) data has shown that these lower rates have not changed over time[ODS1] (Iezzoni, et. al., 2015; Chevarley, et. al, 2006). Little is known about the[ODS2] barriers women with disabilities face in today’s world when they go through mammography breast health screening -- nearly 30 years after the passage of the Americans with Disabilities Act. This study examined the experiences of women with disabilities in mammography and breast cancer screening, focusing on, among other things, the physical, attitudinal, and other barriers they may face. The Occupational Therapy Framework recognizes health management and maintenance as an Instrumental Activity of Daily Living (IADL), and self-advocacy as both an occupational therapy intervention and an outcome. The Framework also speaks of the role of advocacy efforts on the part of the occupational therapy practitioner, and asserts that “[t]he outcomes of advocacy and self-advocacy support health, well-being, and occupational participation at the individual or systems level.”
DESIGN: This descriptive study was done in collaboration with the American Association on Health and Disabilities (AAHD). Eighty-eight women who self-identify as women with disabilities, over the age of 40, who live in the U.S. were recruited with the assistance of AAHD, through its email lists, and Twitter and Facebook pages, as well as other disability-specific Facebook groups.
METHOD AND RESULTS: Data was collected via an online survey using SurveyMonkey, and descriptive statistics were compiled. Of significance was that 37% of women reported that lack of physical access was a barrier. Over 32% reported other reasons such as parking and staff attitudes, and 30% expressed discomfort due to their disability during the mammogram process. Data will be further analyzed using a one-way analysis of variance (ANOVA) on various ethnic/racial groups' access concerns, as well as awareness of the need for the screenings.
CONCLUSION: Women with disabilities continue to face numerous barriers to mammography and breast cancer screening despite legal and policy changes that have flowed from the Americans with Disabilities Act. Self-advocacy is a powerful tool that women with disabilities can use to advocate to eliminate the barriers to their breast health needs.
IMPACT STATEMENT: This study provides information about barriers to mammography and breast cancer screening that collaborative advocacy, between OT practitioners and women with disabilities. OTs can address IADLs, and self-advocacy as intervention and outcome, to improve the health and well-being of women with disabilities.
References
Chevarley F, Thierry J, Gill C, Ryerson A, Nosek M. Health preventive care and health care access among women with disabilities in the 1994–1995 National Health Interview Survey, Supplement on Disability. Womens Health Issues. 2006;16: 297–312. doi:10.1016/j.whi.2006.10.002
Iezzoni, L. I., Kurtz, S. G., & Rao, S. R. (2015). Trends in mammography over time for women with and without chronic disability. Journal of Women’s Health, 24(7), 593–601. http://doi.org/10.1089/jwh.2014.5181
Todd, A., & Stuifbergen, A. (2012). Breast cancer screening barriers and disability. Rehabilitation Nursing : The Official Journal of the Association of Rehabilitation Nurses, 37(2), 74–79. http://doi.org/10.1002/RNJ.00013
Taylor. J. (2016, February 17). Women with disabilities are more likely to die of breast cancer - here’s why. Mic. Retreived from https://mic.com/articles/134979/women-with-disabilities-are-more-likely-to-die-of-breast-cancer-here-s-why
