scholarly journals Factors Influencing Elderly Women’s Mammography Screening Decisions

2011 ◽  
pp. 293-306
Author(s):  
Mara Schonberg ◽  
Ellen McCarthy ◽  
Meghan York ◽  
Roger Davis ◽  
Edward Marcantonio
Keyword(s):  
Mammography Screening ◽  
Factors Influencing

A Mixed-Methods Study of Multi-Level Factors Influencing Mammography Overuse: Implications for De-implementation.

2021 ◽  
Author(s):  
Jessica D. Austin ◽  
Parisa Tehranifar ◽  
Carmen B. Rodriguez ◽  
Laura Brotzman ◽  
Mariangela Agovino ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Older Women ◽  
Survey Data ◽  
Mammography Screening ◽  
Care Delivery ◽  
Interview Data ◽  
Mixed Methods Study ◽  
Spanish Speaking ◽  
Factors Influencing ◽  
Multi Level

Abstract Background There is growing concern that routine mammography screening is overused among older women. Successful and equitable de-implementation of mammography will require a multi-level understanding of the factors contributing to mammography overuse. Methods This explanatory, sequential, mixed-methods study collected survey data (n = 52, 73.1% Hispanic, 73.1% Spanish-speaking) from women ≥ 70 years of age at the time of screening mammography, followed by semi-structured interviews with a subset of older women completing the survey (n = 19, 63.2% Hispanic, 63.2% Spanish-speaking) and providers (n = 5, 4 primary care, 1 obstetrics and gynecology) to better understand multi-level factors influencing mammography overuse and inform potential de-implementation strategies. We conducted descriptive analysis of survey data and content analysis of qualitative interview data. Survey and interview data were examined separately, compared, integrated, and organized according to Norton and Chambers Continuum of Factors Influencing De-Implementation Process. Results Survey findings show that 87.2% of older women believe it is important to plan for an annual mammogram, 80.8% received a provider recommendation, and 78.9% received a reminder in the last 12 months to schedule a mammogram. Per interviews with older women, the majority were unaware of or did not experience overuse and intended to continue mammography screening. Findings from interviews with older women and providers suggest that there are multiple opportunities for older women to obtain a mammogram. Per provider interviews, almost all reported that overuse was not viewed as a priority by the system or other providers. Providers also discussed that variation in mammography screening practices across providers, fear of malpractice, and monetary incentives may be reasons for overuse. Providers identified potential strategies including patient and provider education around harms of screening, leveraging the electronic health record to identify women who may no longer benefit from screening, customizing system-generated reminder letters, and organizing workgroups to develop a standard process of care around mammography screening. Conclusions Multi-level factors contributing to mammography overuse are dynamic and reinforced. To ensure equitable de-implementation, there is a need for more refined theories, models, and frameworks for de-implementation with a strong patient-level component that considers the interplay between multilevel factors and the larger care delivery process.

Factors Influencing Adherence to Mammography Screening Guidelines in Appalachian Women Participating in a Mobile Mammography Program

2011 ◽  
Vol 37 (3) ◽  
pp. 632-646 ◽  
Author(s):  
Ami Vyas ◽  
Suresh Madhavan ◽  
Traci LeMasters ◽  
Elvonna Atkins ◽  
Sara Gainor ◽  
...  
Keyword(s):  
Mammography Screening ◽  
Screening Guidelines ◽  
Appalachian Women ◽  
Mobile Mammography ◽  
Factors Influencing

scholarly journals A mixed-methods study of multi-level factors influencing mammography overuse among an older ethnically diverse screening population: implications for de-implementation

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Jessica D. Austin ◽  
Parisa Tehranifar ◽  
Carmen B. Rodriguez ◽  
Laura Brotzman ◽  
Mariangela Agovino ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Older Women ◽  
Survey Data ◽  
Mammography Screening ◽  
Health Benefit ◽  
Interview Data ◽  
Mixed Methods Study ◽  
Spanish Speaking ◽  
Factors Influencing ◽  
Multi Level

Abstract Background There is growing concern that routine mammography screening is overused among older women. Successful and equitable de-implementation of mammography will require a multi-level understanding of the factors contributing to mammography overuse. Methods This explanatory, sequential, mixed-methods study collected survey data (n= 52, 73.1% Hispanic, 73.1% Spanish-speaking) from women ≥70 years of age at the time of screening mammography, followed by semi-structured interviews with a subset of older women completing the survey (n=19, 63.2% Hispanic, 63.2% Spanish-speaking) and providers (n=5, 4 primary care, 1 obstetrics and gynecology) to better understand multi-level factors influencing mammography overuse and inform potential de-implementation strategies. We conducted a descriptive analysis of survey data and content analysis of qualitative interview data. Survey and interview data were examined separately, compared, integrated, and organized according to Norton and Chambers Continuum of Factors Influencing De-Implementation Process. Results Survey findings show that 87.2% of older women believe it is important to plan for an annual mammogram, 80.8% received a provider recommendation, and 78.9% received a reminder in the last 12 months to schedule a mammogram. Per interviews with older women, the majority were unaware of or did not perceive to have experienced overuse and intended to continue mammography screening. Findings from interviews with older women and providers suggest that there are multiple opportunities for older women to obtain a mammogram. Per provider interviews, almost all reported that reducing overuse was not viewed as a priority by the system or other providers. Providers also discussed that variation in mammography screening practices across providers, fear of malpractice, and monetary incentives may contribute to overscreening. Providers identified potential strategies to reduce overscreening including patient and provider education around harms of screening, leveraging the electronic health record to identify women who may receive less health benefit from screening, customizing system-generated reminder letters, and organizing workgroups to develop standard processes of care around mammography screening. Conclusions Multi-level factors contributing to mammography overuse are dynamic, interconnected, and reinforced. To ensure equitable de-implementation, there is a need for more refined and empirical testing of theories, models, and frameworks for de-implementation with a strong patient-level component that considers the interplay between multilevel factors and the larger care delivery process.

scholarly journals A Mixed-Methods Study of Multi-Level Factors Influencing Mammography Overuse: Implications for De-implementation.

2021 ◽  
Author(s):  
Jessica D. Austin ◽  
Parisa Tehranifar ◽  
Laura Brotzman ◽  
Carmen B. Rodriguez ◽  
Mariangela Agovino ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Older Women ◽  
Survey Data ◽  
Mammography Screening ◽  
Care Delivery ◽  
Interview Data ◽  
Mixed Methods Study ◽  
Spanish Speaking ◽  
Factors Influencing ◽  
Multi Level

Abstract Background There is growing concern that routine mammography screening is overused among older women. Successful and equitable de-implementation of mammography will require a multi-level understanding of the factors contributing to mammography overuse. Methods This explanatory, sequential, mixed-methods study collected survey data (n = 52, 73.1% Hispanic, 73.1% Spanish-speaking) from women ≥ 70 years of age at the time of screening mammography, followed by semi-structured interviews with a subset of older women completing the survey (n = 19, 63.2% Hispanic, 63.2% Spanish-speaking) and providers (n = 5, 4 primary care, 1 obstetrics and gynecology) to better understand multi-level factors influencing mammography overuse and inform potential de-implementation strategies. We conducted descriptive analysis of survey data and content analysis of qualitative interview data. Survey and interview data were examined separately, compared, integrated, and organized according to Norton and Chambers Continuum of Factors Influencing De-Implementation Process. Results Survey findings show that 87.2% of older women believe it is important to plan for an annual mammogram, 80.8% received a provider recommendation, and 78.9% received a reminder in the last 12 months to schedule a mammogram. Per interviews with older women, the majority were unaware of or did not experience overuse and intended to continue mammography screening. Findings from interviews with older women and providers suggest that there are multiple opportunities for older women to obtain a mammogram. Per provider interviews, almost all reported that overuse was not viewed as a priority by the system or other providers. Providers also discussed that variation in mammography screening practices across providers, fear of malpractice, and monetary incentives may be reasons for overuse. Providers identified potential strategies including patient and provider education around harms of screening, leveraging the electronic health record to identify women who may no longer benefit from screening, customizing system-generated reminder letters, and organizing workgroups to develop a standard process of care around mammography screening. Conclusions Multi-level factors contributing to mammography overuse are dynamic and reinforced. To ensure equitable de-implementation, there is a need for more refined theories, models, and frameworks for de-implementation with a strong patient-level component that considers the interplay between multilevel factors and the larger care delivery process.

scholarly journals Factors influencing elderly women's mammography screening decisions: implications for counseling

2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Mara A Schonberg ◽  
Ellen P McCarthy ◽  
Meghan York ◽  
Roger B Davis ◽  
Edward R Marcantonio
Keyword(s):  
Mammography Screening ◽  
Factors Influencing
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