title: Contextual factors associated with uptake of breast and cervical cancer screening: A systematic review of the literature.
abstract: 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.
authors.affiliation: c School of Psychology , University of Ottawa , Ottawa , Ontario , Canada.
authors.forename: Natasha
authors.initials: N
authors.lastname: Plourde
authors.affiliation: a Women's College Research Institute , Toronto , Ontario , Canada.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Brown
authors.affiliation: b Women's Mental Health Program , Women's College Hospital , Toronto , Ontario , Canada.
authors.forename: Simone
authors.initials: S
authors.lastname: Vigod
authors.affiliation: c School of Psychology , University of Ottawa , Ottawa , Ontario , Canada.
authors.forename: Virginie
authors.initials: V
authors.lastname: Cobigo
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data*
keywords: Breast cancer; Pap test; cervical cancer; contextual factors; mammography screening