How do Breast Imaging Centers Communicate Results to Women with Limited English Proficiency and Other Barriers to Care?
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Research suggests that women with Limited English Proficiency (LEP) and ethnic minority women are at increased risk of being inadequately informed of their mammogram result. The purpose of this study is to explore breast imaging centers’ communication practices and assess how these centers accommodate women with low literacy and LEP. A 35-question survey was distributed to a national association of more than 700 breast health centers. Descriptive analysis of the overall sample and Fisher’s exact or Chi squared testing to distinguish differences between subgroups were performed. Respondents from 206 centers completed questionnaires. 29 % of respondents stated that more than a quarter of their patients were black, 27 % of respondents stated that more than a quarter of their patients were Hispanic/Latina, and 13 % of respondents stated that more than a quarter of their patients had LEP. Overall, 18 % of respondents reported they do not routinely telephone patients with results, 15 % do not have multilingual staff or translators available to answer questions, and 69 % send result letters in English only. Of note, 69 % use patient navigators. Centers reported systemic strengths and barriers to clear communication of mammography results. Our findings are consistent with past investigations identifying a general need to improve the communication of breast imaging results and suggesting that result notification letters alone are inadequate in ensuring that every woman understands her personal results and follow-up plan.
KeywordsCancer screening Mammography Breast imaging Breast cancer Limited English proficiency Minority health Cancer disparities
Dr. Marcus receives grant support from the American Cancer Society (ACS CCCDA-09-216-01) and the Ford Foundation (1095-0885). The authors thank the following individuals for sharing their expertise and their invaluable assistance with the study: Marsha Stevens, Dorothy Parker, and the UMiami/Sylvester Comprehensive Cancer Center Disparities and Community Outreach Core; Dr. Beth Jones; Dr. Bernard Roos; Dr. Ada Patricia Romilly; Ms. Margaret Roelans; Dr. Barbara Rabinowitz; and members of the National Consortium of Breast Centers, Inc.
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