Plourde Natasha, Brown Hilary K, Vigod Simone, Cobigo Virginie
c School of Psychology , University of Ottawa , Ottawa , Ontario , Canada.
a Women's College Research Institute , Toronto , Ontario , Canada.
Women Health. 2016 Nov-Dec;56(8):906-25. doi: 10.1080/03630242.2016.1145169. Epub 2016 Jan 26.
Existing research on barriers to breast and cervical cancer screening uptake has focused primarily on socio-demographic characteristics of individuals. However, contextual factors, such as service organization, as well as healthcare providers' training and practices, are more feasibly altered to increase health service use. The objective of the authors in this study was to perform a critical systematic review of the literature to identify contextual factors at the provider- and system-level that were associated with breast and cervical cancer screening uptake. Studies published from 2000 to 2013 were identified through PubMed and PsycInfo. Methodologic quality was assessed, and studies were examined for themes related to provider- and system-level factors associated with screening uptake. Thirteen studies met the inclusion criteria. Findings revealed a positive association between patients' receipt of provider recommendation and uptake of breast and cervical cancer screening. Uptake was also higher among patients of female providers. Facilities with flexible appointment times and reminders had higher mammography and Pap test uptake. Similarly, greater organizational commitment to quality and performance had higher breast and cervical cancer screening rates. Knowledge provided in this review could be used in future research to inform the development of public health policy and clinical programs to improve screening uptake.
现有关于乳腺癌和宫颈癌筛查普及障碍的研究主要集中在个体的社会人口学特征上。然而，诸如服务组织以及医疗服务提供者的培训和实践等背景因素更易于改变，以增加医疗服务的使用。本研究作者的目的是对文献进行批判性系统综述，以确定在医疗服务提供者和系统层面与乳腺癌和宫颈癌筛查普及相关的背景因素。通过PubMed和PsycInfo检索了2000年至2013年发表的研究。评估了方法学质量，并审查了与筛查普及相关的医疗服务提供者和系统层面因素的主题研究。13项研究符合纳入标准。研究结果显示，患者接受医疗服务提供者的建议与乳腺癌和宫颈癌筛查的普及之间存在正相关。女性医疗服务提供者的患者的筛查普及率也更高。预约时间灵活且有提醒服务的机构，其乳房X线摄影和巴氏试验的普及率更高。同样，对质量和绩效的组织承诺度更高的机构，其乳腺癌和宫颈癌筛查率也更高。本综述中提供的知识可用于未来的研究，为制定公共卫生政策和临床项目提供信息，以提高筛查普及率。
