ASPO Abstracts
The Impact of Educational Attainment on Breast and Cervical Cancer Screening Outcomes Among Rural and Border Texas Women Participating in a Patient Navigation Intervention
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose: To evaluate if educational attainment affects screening outcomes for lower educated, women of color living in rural and border counties in Texas.Methods: This study analyzes program evaluation data collected from patient navigation participants from March 1, 2012 to November 5, 2016. Logistic regressions tested main and interaction effects of age, race/ethnicity, and education attainment on breast and cervical cancer screening outcomes for patient navigation participants (N=5,122). Separate models included women aged 40+ (N=3,721) for mammogram screening outcomes and aged 21-64 (N=4,879) for Pap screening outcomes as indicated by ACS guidelines at the time of the intervention. Interaction terms of race/ethnicity/language categories and education examined the impact of educational attainment within each group.Results: There was no significant difference in screening outcomes for African American, English Speaking Latina, and Spanish Speaking Latina women based on education, but both high school and college educated non-Hispanic White women experienced more than 1.5 greater odds of screening for breast cancer compared to lower educated non-Hispanic White women. The Pap screening outcomes demonstrated significantly higher odds of screening for high school educated Spanish Speaking Latina women compared to Spanish Speaking Latina women with less than a high school education (OR=1.55, CI=1.02-2.35); however, none of the other interaction terms were significant indicating no differences among the other race/ethnicity/language categories.Conclusions: The results demonstrate that the intervention effectively mitigated lower educational attainment as a barrier to screening for women of color and add to scientific understanding of cancer screening behavior among women of varying education levels by racial/ethnic/language groups in rural and border Texas. The Commission on Cancer’s standards include patient navigation as an essential component to patient-centered cancer care and should be embraced as a system that increases access to breast and cervical cancer screening services for un-/underserved populations.
Keywords: health disparities, patient navigation, education, socioeconomic status