Deaf Women's Health: Adherence to Breast and Cervical Cancer Screening Recommendations. American Journal of Preventive Medicine

Summary (Abstract)

Introduction
No prevalence studies on cancer screening adherence among Deaf women have been conducted in the past decade. Current data on breast and cervical cancer screening are needed from Deaf women who adhered or did not adhere to the U.S. Preventative Services Task Force screening guidelines. The objectives of this study were to assess whether disparities for cancer screening adherence persist for Deaf women compared with the general population and whether racial and ethnic disparities for adherence exist among Deaf women.

Methods
Data for adherence to Pap (n=529, Deaf women; n=1,119, hearing women) and mammogram screening (n=324, Deaf women; n=1,086, hearing women) were drawn from the Health Information National Trends Survey in American Sign Language (Deaf women; February–August 2017 and October 2017–May 2018) and the Health Information National Trends Survey 5, Cycle 1, data set (hearing women; January–May 2017). Data were analyzed in 2018. Propensity score model of the weighed samples estimated the probability of adherence among the entire sample and within the sample of Deaf women for each screening test.

Results
About 78% (n=415) of age-eligible Deaf women and 85% (n=956) of age-eligible hearing women adhered to Pap screening recommendations (p<0.001). For breast cancer screening, the adherence rates for 245 Deaf women and 891 hearing women were 76% and 82%, respectively (p<0.01). After adjusting for correlates, for Deaf women, disparities remained for cervical cancer screening but not breast cancer screening. Race and ethnicity were not associated with cancer screening adherence.

Conclusions
This is a call to action for targeted, accessible health promotion interventions for age-eligible Deaf women to increase adherence to cervical cancer screening.

Video Transcript
[Transcript: Black background with white letters: Deaf Women’s Health: Adherence to Breast and Cervical Cancer Screening Recommendations. White letters: Kushalnagar, P., Engleman, A., & Simons, A. (2019) Deaf Women’s Health: Adherence to Breast and Cervical Cancer Screening Recommendations. American Journal of Preventive Medicine. DOI: 10.1016/j.amepre.2019.04.017 On the upper center, there is a black, blue and orange circle logo with three people lined up vertically. White letters after the logo say: DEAF HEALTH COMMUNICATION AND QUALITY OF LIFE CENTER. Next scene: A Japanese woman with black colored hair is wearing a black shirt with a blue background. On the bottom left, there is a black, blue and orange circle logo with three people lined up vertically. White letters after the logo says: DEAF HEALTH COMMUNICATION and QUALITY OF LIFE CENTER. This logo will stay visible for the entire duration of the video. Ai Takayama is standing in the center. AI TAKAYAMA: “The Deaf Health Research Center just published a paper on deaf women and their adherence to the national women health screening standard.” Ai Takayama moves to the left as an image of the journal article shows up on the right. The image disappears. AI TAKAYAMA: “For mammograms which are used to screen for breast cancer.” Both text and the image show up at the same time. An illustrated picture of a woman taking a mammogram exam shows up on the right. The patient woman is light skinned and brown haired woman dressed in a hospital patient gown taking a mammography screening with a dark skinned and dark brown haired woman dressed in doctor gown. There is a machine compressing the right breast as the light skinned woman looks at the doctor. Below the image, there is a white text saying “FOR BREAST CANCER” Both text and the image disappear at the same time. AI TAKAYAMA: “And for Pap smear screening which is used to screen for cervical cancer. “ Both text and the image appear at the same time. An illustrated picture of a woman taking a pap smear exam shows up on the right. In the image there are three images. The first image is on the top left part- a light skinned patient woman is shown below waist in a sideway view with legs open in preparation for the exam. The second image is on the right and slightly lower part. There is a square with an image of pink colored cervix labelled “Cervix” and there is a special shaped brush on the middle of the cervix. The brush has arrows around the handle, showing that the brush is being rotated. On the top right part of the image there is a black text saying “Pap Test”. The third image shows a vertical bisection view of female anatomy with various body parts labeled. Black text “Uterus” with a line to the uterus. Black text “Cervix” with line to the cervix. Black text “Rectum” with line to the rectum. Black text “Vagina” with line to vagina. There is a metallic looking apparatus inserted in the vagina labeled with black text “speculum”. A white brush is inserted in the speculum, into the vagina, touching the cervix. Holding the brush is a hand with surgical gloves, with white coloring forearm. Below the image, there is a white text saying “FOR CERVICAL CANCER”. AI TAKAYAMA: “The research center surveyed a number of deaf women on whether or not they followed the standard.” Both text and the image appear at the same time. Same illustrated mammogram image shows up on the right. Below the image, on the left side white text saying “DEAF WOMEN” appears. White text saying “76%” appears under the “DEAF WOMEN” text. Below the image and on the right side of the text saying “DEAF WOMEN”, white text saying “HEARING WOMEN” appears. White text saying “82%” appears under the “HEARING WOMEN” text. A white colored “equal” symbol appears between the white texts “76%” and “82%”. Green colored check appears on the right top of the “equal” symbol. AI TAKAYAMA: “By the numbers, we discovered that about 76% deaf women and 82% hearing women adhered to the standard breast cancer screening guideline. After doing analyses with age, race, and education as covariates, study results showed that the adherence rates in both groups are about the same for mammography screening. Deaf women are not at disparity compared with hearing women.” Both text and the image disappear at the same time. Both text and image appear at the same time. Same illustrated pap smear screening image shows up on the right. Below the image, on the left side white text saying “DEAF WOMEN” appears. White text saying “78%” appears under the “DEAF WOMEN” text. Below the image and on the right side of the text saying “DEAF WOMEN”, white text saying “HEARING WOMEN” appears. White text saying “85%” appears under the “HEARING WOMEN” text. A white colored “equal” symbol appears between the white texts “78%” and “85%”. Red colored cross appears on the “equal” symbol. AI TAKAYAMA: “For cervical cancer screening adherence, about 78% deaf women and 85% hearing women had adhered to the Pap smear screening guidelines. After doing statistical analyses with age, race, and education as covariates, deaf women are at disparity for cervical cancer screening adherence compared to hearing women. Both text and the image disappear at the same time. Ai Takayama moves to the center. AI TAKAYAMA: “We need to create accessible health education programs for deaf women that will encourage them to get screened for cervical cancer through Pap smear testing.” Next scene: Film Director: Gideon Firl, B.A. Film Editor: Dimitri Foreman, B.A. Narrator: Ai Takayama, Graduate Assistant Grant Acknowledgement: This project was made possible with funding from the National Institutes of Health (R01DC014463 awarded to Poorna Kushalnagar, Ph.D.) Tan colored Gallaudet symbol with blue text saying “GALLAUDET UNIVERSITY”]

Author(s)

Kushalnagar, P., Engelman, A., & Simons, A

Publication Date

2019

Journal

American Journal of Preventive Medicine

Volume

57

Issue

3

DOI

10.1016/j.amepre.2019.04.017
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