title: Barriers to breast abnormality follow-up: minority, low-income patients' and their providers' view.
abstract: Little is known about the factors associated with delayed or incomplete adherence to recommendations for follow-up when breast abnormalities are seen in minority women. This study examines barriers to follow-up in a cohort of predominantly minority women, with input from providers, using quantitative and qualitative methods. We conducted telephone interviews with 535 women and inperson, unstructured interviews with 31 providers from three medical facilities in the Los Angeles area. Most patient respondents were <50 years old (59.6%), Latina (84.2%), and unmarried (60.9%); half (49.1%) had six or fewer years of education, and most were foreign-born (83.4%). Data from patient and provider groups identified race/ethnicity, country of birth, financial issues, fear of pain, and difficulty navigating the healthcare system as barriers to follow-up, though certain provider-identified barriers did predict adherence among women. System barriers, not individual patient characteristics, were more salient factors in the follow-up of breast abnormalities.
authors.affiliation: University of California, San Francisco, Division of General Internal Medicine, Department of Medicine, San Francisco, CA 94143-0856, USA. ckaplan@itsa.ucsf.edu
authors.forename: Celia Patricia
authors.initials: CP
authors.lastname: Kaplan
authors.forename: Merrill
authors.initials: M
authors.lastname: Eisenberg
authors.forename: Pamela I
authors.initials: PI
authors.lastname: Erickson
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.forename: Susan
authors.initials: S
authors.lastname: Duffey
mesh_terms: D000367:Age Factors; D001940:Breast / Q000002:abnormalities*; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D015141:Los Angeles; D008327:Mammography; D008875:Middle Aged; D008913:Minority Groups; D010349:Patient Compliance; D017060:Patient Satisfaction; D011203:Poverty; D011369:Professional-Patient Relations; D012959:Socioeconomic Factors