面临医疗保健障碍的社区对多种癌症早期检测试验的看法。

Health affairs scholar Pub Date : 2024-08-16 eCollection Date: 2024-09-01 DOI:10.1093/haschl/qxae102
Kristi L Roybal, Robyn A Husa, Maria Connolly, Catherine Dinh, Kara M K Bensley, Staci J Wendt
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引用次数: 0

摘要

边缘化的种族和民族群体以及农村和低收入社区经历着严重的癌症不公平现象。基于血液的多种癌症早期检测试剂盒(MCED)提供了一种简单、侵入性较低的方法,可在单一就医点筛查多种癌症,可能是减少癌症不平等的重要策略。在这项定性研究中,我们探讨了阿拉斯加州、加利福尼亚州和俄勒冈州面临医疗服务获取障碍的社区采用 MCED 的障碍和促进因素。我们采用了反思性主题分析法来分析癌症筛查的一般障碍、MCED 的特定障碍、采用 MCED 的促进因素以及 MCED 的沟通策略。我们发现,采用 MCED 的障碍和促进因素横跨社会生态模型的 4 个层面:(1)个人;(2)人际;(3)医疗保健系统;(4)社会。这些障碍包括不良心理影响、对 MCED 的积极看法、有关癌症筛查的信息和知识、患者与医护人员关系的质量、医疗保健系统缺乏可信度、后勤便利性、患者支持以及经济便利性。最佳的 MCED 传播策略包括通过医疗环境和社区传播信息。这些发现强调了了解和解决可能影响社区采用 MCED 的多层次因素的重要性,这些因素可能会影响面临医疗服务获取障碍的社区采用 MCED,从而促进健康公平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perceptions of multi-cancer early detection tests among communities facing barriers to health care.

Marginalized racial and ethnic groups and rural and lower income communities experience significant cancer inequities. Blood-based multi-cancer early detection tests (MCEDs) provide a simple and less invasive method to screen for multiple cancers at a single access point and may be an important strategy to reduce cancer inequities. In this qualitative study, we explored barriers and facilitators to MCED adoption among communities facing health care access barriers in Alaska, California, and Oregon. We used reflexive thematic analysis to analyze general barriers to cancer screening, MCED-specific barriers, facilitators of MCED adoption, and MCED communication strategies. We found barriers and facilitators to MCED adoption across 4 levels of the social-ecological model: (1) individual, (2) interpersonal, (3) health care system, and (4) societal. These included adverse psychological impacts, positive perceptions of MCEDs, information and knowledge about cancer screening, the quality of the patient-provider relationship, a lack of health care system trustworthiness, logistical accessibility, patient supports, and financial accessibility. Optimal MCED communication strategies included information spread through the medical environment and the community. These findings underscore the importance of understanding and addressing the multilevel factors that may influence MCED adoption among communities facing health care access barriers to advance health equity.

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