title: Barriers to cervical cancer screening and follow-up care among Black Women in Massachusetts.
abstract: OBJECTIVE
  To explore factors that might lead to delays in appropriate cervical cancer screening and diagnosis among Black women in Massachusetts.
  
  
  METHODS
  Qualitative using focus groups.
  
  
  METHODS
  Hospitals, health centers, and community-based organizations in Boston, Massachusetts.
  
  
  METHODS
  Sixty-four participants including Black, non-Hispanic women from the general population and cervical cancer survivors, community leaders in women's health, and health care providers.
  
  
  METHODS
  Six focus groups. Data were analyzed using methods based on grounded theory.
  
  
  RESULTS
  Findings from interviews revealed that inadequate information and education of providers and patients create barriers to appropriate screening and treatment practices for Black women. Fear, cultural beliefs, and compounding factors related to poverty, gender roles, and health system barriers create delays to screening and follow-up care. Also, unconscious bias, therapeutic delays, and miscommunication are important factors affecting continuity of care.
  
  
  CONCLUSIONS
  These results suggest a need for comprehensive, culturally specific cervical cancer prevention education initiatives and interventions for Black women and strategies to improve patient-provider relationships.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Nolan
authors.forename: Tajan Braithwaite
authors.initials: TB
authors.lastname: Renderos
authors.forename: Jane
authors.initials: J
authors.lastname: Hynson
authors.forename: Xue
authors.initials: X
authors.lastname: Dai
authors.forename: Wendy
authors.initials: W
authors.lastname: Chow
authors.forename: Anita
authors.initials: A
authors.lastname: Christie
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Mangione
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D003144:Communication Barriers; D057210:Delayed Diagnosis / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities / Q000458:organization & administration*; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration; D008404:Massachusetts; D008875:Middle Aged; D018570:Risk Assessment; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000517:prevention & control* / Q000628:therapy; D016387:Women's Health; D055815:Young Adult
keywords: African American women; cervical cancer prevention; diagnostic delay; health services use; treatment delay