Table 2.
Barriers to cervical cancer screening and solutions to increase screening rates.
| Barriers | ||
|---|---|---|
| Patient barriers | Provider barriers | System barriers |
| Demographic (n = 30) | Lack of HIT training (6) | Not using full capability of EMR (20) |
| Financial issues/uninsured (18) | Noncompliance with established protocols/guidelines (4) | Coordination with external labs or providers (13) |
| Transportation barriers (7) | Preventive care not embedded into practice (2) | Inadequate staff hours or employees: For patient education (3) For coordination (8) |
| Transient patient population (5) | General lack of education/training (2) | Limited clinical hours (3) |
| Lack of childcare (3) | No policy/procedure to document all practices (2) | |
| High patient turnover rate (1) | Lack of supplies/equipment for procedures (2) | |
| Other/general (13) | EMR not yet implemented (1) | |
| Cultural factors (n = 20) | Lack accurate patient contact information (1) | |
| Fear of procedure or results (9) | Health professional shortage area (1) | |
| Language barrier (5) | No patient surveys (1) | |
| Trust issues (4) | Primary care providers do not provide cervical cancer screening (1) | |
| Discomfort with male providers (3) | No OB/GYN specialist at HC (1) | |
| Immigration status (2) | ||
| Health beliefs/behaviors (n = 21) | ||
| Lack of awareness/knowledge of cervical cancer screening need (10) | ||
| Not seeking preventive care (8) | ||
| Do not keep appointments (7) | ||
| Lack knowledge of available cervices (2) | ||
| Late for appointments (1) | ||
|
| ||
| Solutions | ||
| Patient-targeted | Provider-targeted | System-targeted |
|
| ||
| Outreach, education, or health promotion for patient population, 59 (74%) | Education/training for providers, 44 (55%) | Utilize HIT/EMR, 63 (79%) |
| Improve/increase communication with patients, 53 (66%) | Feedback to providers Team performance, 7 (9%) Individual performance, 3 (4%) |
Staffing: hire new employee or increase hours, 46 (58%) |
| Facilitate access to care, 29 (36%) | Regular quality improvement process, 39 (49%) | |
| Implement protocol to better manage care, 32 (40%) | ||
| Improve recording keeping, 24 (30%) | ||
| Improve coordination with external providers, labs, 21 (25%) | ||