Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach

Abstract

Although women with intellectual disabilities have the same breast cancer incidence rate as women without intellectual disabilities, they have fewer mammograms and higher mortality rates. Qualitative inquiry was employed to explore barriers and facilitators to mammography among this population. In-depth qualitative interviews were conducted with 30 women with intellectual disabilities and their caregivers in Philadelphia during 2015–2016. Thematic analysis was conducted using inductive and deductive coding. While results provide further evidence for prior research on barriers to mammography among women with intellectual disabilities (e.g. being unprepared, fear of the exam), this study generated novel barriers such as lack of breast ultrasound awareness, sedation failing to work, and lack of mammogram education in adult day programs, and novel facilitators such as extended family support and positive attitudes. Results support the need to address barriers and promote facilitators to improve the breast cancer screening experience among women with intellectual disabilities.

Keywords:

• Intellectual disability
• disparities
• mammograms
• women’s health

Disclosure statement

No conflict of interest to report.

Additional information

Funding

This project was supported by grant number R36HS023966 from the Agency for Healthcare Research and Quality (AHRQ) Health Services Dissertation Grant. The Drexel University Institutional Review Board approved the study protocol. Dr. Arana-Chicas would like to give special thanks to Particia Graves, Director of Nursing at the Philadelphia Coordinated Health Care, for her help in identifying organizations in Philadelphia that serve individuals with intellectual disabilities. This research was conducted while Dr. Arana-Chicas was a DrPH Candidate at the Dornsife School of Public Health at Drexel University.