Innovative Research-Based Educational Tools/Resources to Improve the Breast Cancer Screening Experience for Women With Disabilities

August 2012 Vol 3, No 4
Linda Muraca, RN, MN
Mount Sinai Hospital
M. Bianca Seaton, MSc, PhD(c)
Mount Sinai Hospital
Mary Agnes Beduz, RN, MN, PhD
Mount Sinai Hospital
Julie Devaney, MA
Mount Sinai Hospital
Jan Angus, RN, MN, PhD
Faculty of Nursing, University of Toronto
Nancy Barry, BA
Centre for Independent Living
Samira Chandani
Cancer Support Network
Laura McDonald, BASc
Toronto Central LIHN
Fran Odette, MSW
Springtide Resources. All, Toronto, Canada

Background: Women with disabilities (WWD) have the same biological risk of developing breast cancer as nondisabled women but are less likely to participate in regular cancer screening. A previous community-based needs assessment conducted by our research team in Ontario, Canada, consented 24 WWD in 4 urban- and 1 suburban-situated focus groups to learn about their experiences with facilitators and barriers to cancer screening. The WWD shared stories of dehumanizing experiences with healthcare providers (HPs), stressing that negative encounters were powerful deterrents to a return screening. A key recommendation from the WWD was to provide best-practice educational opportunities for HPs about how to create enabling screening environments.

Methods: Our research team subsequently conducted focus groups with 43 mammography technologists, radiologists, and reception staff from 3 academic teaching hospitals in Ontario, Canada, to learn about their attitudes, experiences, and learning needs when working with WWD. Data were analyzed using qualitative content analysis. The focus group participants demonstrated a strong desire to provide a positive screening experience for all patients but had a tendency to respond to novel or unusual care situations involving WWD with social awkwardness or confused inaction. These findings underscore the need for greater disability awareness among HPs working in cancer screening.

Results: Merging the results of the 2 focus group studies with HPs and WWD, our team has developed creative, evidence-based educational tools and resources about how to create enabling screening environments. First, we developed an immersive learning program for HPs using standardized patients trained to role-play breast imaging scenarios. This highly effective method of education with breast imaging staff from the 3 teaching hospitals was successful in positively shifting intention to change behaviors with WWD, and participant satisfaction was very high. Subsequently, we developed e-learning modules, an educational film, tip sheets for WWD and HPs, and an accessible Web-based facilitation manual for use at other screening centers.

Conclusion: These educational tools and resources enable other screening centers to train their staff about respectful communication with WWD and improve future screening attendance. The research results from our 2 studies as well as these innovative tools and resources will be shared in this presentation.

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