Does utilization of Patient Navigation enhance compliance follow up and treatment after an abnormal mammograp in low income minority female age 40-75 ( please change to empirical Topic )

Follow Up after Abnormal Mammography
Student’s Name
Institutional Affiliation
Abstract
Breast cancer is one of the most diagnosed disorders among men and women in developing countries. According to statistics, African American women from low-income areas and with low education attainment encounter higher mortality rates resulting from cancer than the white counterparts. Besides, women from low economic backgrounds have substantially lower survival rates than their peers from affluent families. Underutilization of mammography and delays in diagnosis are the major factors that have resulted in the variation of mortality rates in both developed and developing countries. For that reason, current research focuses on early detection and prevention of breast cancer. Arguably, screening mammography is one of the most effective strategies for detecting breast cancer at an early stage, thus facilitating the reduction of associated risks at later stages.
Keywords: Breast cancer, diagnosis, women, mammography, mortality, developing countries, underutilization, and screening
Keywords: Breast cancer, Low-income Minority Women, Patient Navigation, Mammograms.
Follow up after Abnormal Mammography
Overview
The research on the use of patient navigation in enhancing compliance follow up and treatment after abnormal mammography targets the connectedness between screening and follow up for the underserved population in low-income minority areas According to Fair, Wujcik, Lin, Zheng, Egan, Grau, and Wallston (2010, p.71), health belief scales are relevant in conducting research in the healthcare sector. I modified health belief scales while referring to the annual screening of breast cancer and diagnostic follow up. I utilized a cohort study design in conducting the study. Equally, I performed statistical analysis to assess the relationship between abnormal mammography, psychosocial determinants, and other socio-demographic factors. In the research, women with low internal health locus of the various control scores were more likely to have a higher mean internal health locus than their counterparts with higher mean internal health locus. Besides, women with lower educational attainment had higher fatalism scores than those with higher educational attainment.
The government collaborates with policymakers in examining the etiologic and psychosocial risk factors of breast cancer. The ultimate objective is addressing the health needs of the medically underserved and low-income minority. Diagnostic mammography is an effective mechanism of promoting early identification and risk reduction of breast cancer. Policymakers recommend the need for screening mammography use among the medically underserved women in developing countries (Fair et al., 2010, p.71). If a woman is ready to receive mammography and take preventive action, medical practitioners presume that her beliefs compel her to weigh the options of minimizing her susceptibility to breast cancer.
Multiple studies illustrate that women from developing countries are susceptible to breast cancer at a later stage than those from developed countries. The advanced stage for the former emanates from underutilization of mammography services and delays in diagnostic testing relative to the latter. Therefore, the current research focuses on early identification and prevention of breast cancer. People living with cancer might compromise their survival rates if they fail to adhere to inconclusive mammograms within the stipulated timeframe. Equally, attitudes on seeking health services and access can delay the screening for breast cancer among women from the low-income minority.
Researchers have focused on psychosocial determinants as the main determining factors for mammography screening behaviors among low-income women. However, few studies have focused on inadequate follow up of diagnostic tests for the follow up of abnormal mammography in the population. The factors that predict initial screening for mammography are different from those that determine the women in a society that are likely to come back for a second mammogram if the results for the test are ambiguous. For that reason, it is imperative to conduct a study on the differences of abnormal mammography follow up perceptions among the women at high risks.
Purpose Statement
The primary purpose of the project was to assess the relationship between abnormal screening mammography and psychosocial determinants for the medically underserved population in the low-income minority.
Data
The Return after Mammography Study (RAMS) was a form of cohort research based on a hospital set up. The study was useful in assessing the factors that affect the medically underserved women’s follow up for incomplete mammography testing. The patients were the medically underserved women from the minority racial groups with the performance of mammography at St Elizabeth hospital in Washington, D.C (Markossian, Damell, & Calhoun, 2012, p.19). The hospital is one of the primary healthcare for patients who have breast cancer. Most patients at the healthcare center are minority groups, including African Americans, Latinos, and other minority groups. Statistics illustrate that 75 percent of patients in low-income minorities cannot afford to pay for their medical services. I identified eligible subjects from retrospective reviews of medical review. I abstracted the Mammography Reporting System (MRS) for the date of abnormal mammography finding and the time that patients returned to the healthcare center for follow up.
I abstracted mammography results from the clinic notes of the radiologist for the medical record reports. Besides, I defined abnormal mammography based on the Breast Imaging Reporting and Data System (BIRAIDS). The eligibility criteria for the participation in the research were women aged 40-75, residents of Canada, and having abnormal results of BIRAIDS requiring a diagnostic follow up before the next screening. I included women with a comprehensive understanding of the English language.
Diagnostic follow up is effective in resolving BIRAIDS-0 results. In the study, researchers defined timely diagnostic resolution to BIRAIDS-0 results as effective procedures, including ultrasonography and biopsy. I identified a timely diagnostic resolution to BIRAIDS as a valid procedure. The research participants, who had inadequate access to medical attention and follow-up, had a diagnostic tenacity within six months of abnormal index finding. However, researchers had to determine the disposition of follow up before the survey interview. I removed women with a prior history of cancer from the research sample.
Sample
I identified a total of 40 low-income minority women with abnormal BIRAIDS-0 results in a screening mammogram done from June 2019-September, 2019. However, eleven percent of the women were illegible to participate because of residency restrictions, inability to provide consent of participation, being too ill to partake, and age. Therefore, the research only involved 109 eligible women who met the eligibility requirements. I could not reach 40 participants as a result of changed phone numbers, changed addresses, no answering telephone calls, and disconnected telephone calls. Notably, 18 percent of the women refused to participate, while 10 percent only completed part of the research interview. Complete information was only available to a total of seventy-six women. I needed to ensure that 4.6 calls reached to the participants within two months.
Instrumentation
I adapted self-efficacy for mammography follow up, perceived barriers and benefits, variables for HBM related to information about breast cancer, and related risk factors for the current study. I modified HBM scales by rephrasing relevant items to replace all the pertinent details that seemed preferable for following up on mammography. Equally, I utilized a five-point Likert scale ranging from 1-5 to measure self-efficacy and other perceived barriers. Furthermore, I used the post structured questionnaire and patient log to conduct investigations about the compliance of follow up and treatment following mammogram reports. The perceived benefits and susceptibility were useful in measuring the likelihood of acquiring breast cancer with an internal consistency of the various test items on the scale of the current research. The research involved the use of a self-efficacy scale that included a total of six questions to assess the level of confidence in returning for mammography tests.
Data Collection
The International Review Board-approved study procedures before the implementation of the research. I identified and recruited BIRAIDS-0 patients who were eligible for the study. Importantly, I sent an invitation letter to all the women who would participate in the research. I provided a toll-free number that the participants would call should they decide to opt-out from the study. Furthermore, I utilized interviews in investigating breast cancer and screening mammography. The epidemiologic survey instrument was a useful tool during the collection of data from the twenty subjects.
Variables
The variables for HBM related to insight about risk factors of breast cancer, self-efficacy, perceived barriers, and follow up for mammography. I modified HBM scales in the research through rephrasing relevant items referring to mammography follow up for the findings of abnormal mammography rather than a screening test. Notably, I adapted variables assessing health locus of control, external health locus controller, and spiritual health locus mechanism from a previous questionnaire of screening mammography. I compared the pathways of diagnostic evaluation through the use of multinomial logistic regression. I utilized log-linear regression in estimating relative risk screen-film versus digital screening mammograms. I stratified the common diagnostic pathways resulting from a positive screening mammogram into diagnostic imaging.
Project Design
The study included both active and passive domains of spiritual health locus of control. The former was a belief that a supreme power empowers people in taking care of themselves. On the contrary, the latter is a belief that a higher power is in control of an individual’s health levels. I obtained clinical variables and socio-demographic factors, such as marital status, race, and ethnicity, from a review of medical charts.
Results
I conducted a total of 6 interviews with follow-ups for mammograms. Equally, I scored breast cancer knowledge as either correct or incorrect. The women in the research had above average scores in awareness about breast cancer. However, I identified no significant difference between women with adequate and inadequate benefits regarding benefits, b...