Barriers to colorectal cancer screening in community health centers: A qualitative study

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Barriers to colorectal cancer screening in community health centers: A qualitative study

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dc.contributor.author Lasser, Karen E
dc.contributor.author Ayanian, John Zaven
dc.contributor.author Fletcher, Robert H.
dc.contributor.author Good, Mary Jo DelVecchio
dc.date.accessioned 2011-05-17T00:13:09Z
dc.date.issued 2008
dc.identifier.citation Lasser, Karen E., John Z. Ayanian, Robert H. Fletcher, and Mary-Jo DelVecchio Good. 2008. Barriers to colorectal cancer screening in community health centers: A qualitative study. BMC Family Practice 9: 15. en_US
dc.identifier.issn 1471-2296 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:4889596
dc.description.abstract Background: Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers. Methods: We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8), Spanish (n = 2), Portuguese (n = 5), Portuguese Creole (n = 1), and Haitian Creole (n = 7). We audiotaped and transcribed the interviews, and then identified major themes in the interviews. Results: Four themes emerged: 1) Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2) Unscreened patients identified lack of symptoms as the reason they had not been screened; 3) A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4) Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important. Conclusion: Further study of these barriers is warranted. en_US
dc.language.iso en_US en_US
dc.publisher BioMed Central en_US
dc.relation.isversionof doi:10.1186/1471-2296-9-15 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2373875/pdf/ en_US
dash.license LAA
dc.title Barriers to colorectal cancer screening in community health centers: A qualitative study en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal BMC Family Practice en_US
dash.depositing.author Ayanian, John Zaven
dc.date.available 2011-05-17T00:13:09Z
dash.affiliation.other SPH^Health Policy and Management en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other HMS^Health Care Policy en_US
dash.affiliation.other HMS^Emeritus en_US

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