Annual adult health screening: barriers, challenges and effectiveness

Although it has been well-established that screening for early detection and intervention practices has been associated with favorable outcomes, there have been many concerns about the potential of these approaches to cause harm to the patients. In addition, evidence also shows some associated barriers and challenges to these approaches that need to be considered by healthcare authorities when planning for such approaches. The present literature review discusses annual adult health screening programs' effectiveness, barriers, and challenges. There is no doubt that these screening programs can help identify undiagnosed disorders among many patients with various conditions, like diabetes mellitus, hypertension, and different cancers. Moreover, the effectiveness of these screening programs can be best highlighted by the premarital screening program in Saudi Arabia, which targets high-risk couples for developing certain conditions and infections. However, it should be noted that there are many barriers and challenges to conducting health screening campaigns, like cultural and economic factors. Other challenges might also include the rates of false-positive tests, overdiagnosis, and knowledge about the screening programs.

Training and Employment for Correctional Populations

Education and employment are both moderate risk factors for recidivism. There is a well-documented relationship between low educational achievement and antisocial behaviors. Education programming in correctional facilities is crucial for improving the educational attainment of incarcerated and re-integrating populations. A brief discussion situates policy reform efforts against a backdrop of extensive research that has documented the interaction between employment and increased educational attainment as pivotal to reducing an individual’s propensity to recidivate. The policies then focus on three pillars that reduce employment barriers for returning citizens: workforce training, educational upgrading, and regulatory employment barriers. In the short-term, policymakers should study and address systemic remedial educational needs in tandem with increasing access to and occupational skills-based training that builds a skill base congruent with the current labor market for incarcerated students. In the mid-term, it is essential to match policy support with the intersecting barriers faced by returning citizens. As an example of federal policies that can help center the public workforce development system around the need to improve quality employment outcomes for returning citizens, the DOL’s dormant pilot Linking to Employment Activities Pre-Release (LEAP). Finally, policymakers should target other consequential screening barriers, such as the accuracy of criminal records that employers can check and have been shown to adversely affect employment prospects.

Understanding Cervical Cancer Screening Barriers among Migrant Women: A Qualitative Study with Healthcare and Community Workers in Portugal

Cervical cancer screening (CCS) has been proven to reducing mortality of cervical cancer; yet migrant women show a lower participation in screening compared to non-migrants. This study explores the perspectives of healthcare workers and community workers on the factors influencing the CCS participation of migrant women living in Portugal. A qualitative study with online focus groups was conducted. Healthcare workers experienced in CCS and community workers working with migrant communities were purposively sampled. A semi-structured guide was used covering the participation of migrant women in CCS, barriers, and strategies to overcome them. Data were analyzed using content analysis. Participants considered that migrant women have low participation in CCS related to insufficient knowledge, low risk perception, and lack of interest on preventive care. Other barriers such as difficulties in accessing the healthcare services, relationship with healthcare workers, language, and cultural differences were highlighted. Promoting continuity of care, disseminating culturally tailored information, and use of self-sampling methods were suggested to improve participation in CCS. Inequalities in access to CCS among migrant women are mostly caused by information gaps and healthcare system-related barriers. Building a migrant-friendly healthcare system that creates opportunities for healthcare workers to establish relationships with their patients and delivering culturally and linguistically adapted information may contribute to overcoming those barriers and increasing the participation of migrant women in screening.

Addressing Cancer Screening Inequities by Promoting Cancer Prevention Knowledge, Awareness, Self-Efficacy, and Screening Uptake Among Low-Income and Illiterate Immigrant Women in France

Objective: Cancer screening rates are suboptimal for disadvantaged populations in France, yet little evidence exists on their cancer-related knowledge and screening barriers. The main objective of this study was to examine cancer-related knowledge, awareness, self-efficacy, and perceptions of screening barriers among low-income, illiterate immigrant women in France following an 8-weeks cancer educational intervention.Methods: Semi-structured qualitative interviews were conducted with 164 female participants in the Ain department of France between January 2019 and March 2020. Adopting the Health Belief Model as an intervention and analytic framework, salient themes were identified using qualitative thematic analysis.Results: Increased levels of perceived susceptibility to and perceived severity of cancer contributed to higher motivation to get screened. Barriers to screening included low French proficiency, shame surrounding illiteracy, and constant worries due to precarious living conditions. Perceived benefits (e.g., valuing one’s health and health-promoting behaviors), cues to action from a trusted source, and greater self-efficacy (e.g., more autonomous in healthcare-seeking) outweighed perceived barriers, including cultural barriers.Conclusions: Implications include developing audience-responsive targeted cancer screening communication strategies and educational materials to increase screening rates and reduce cancer and cancer screening inequities.